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Introduction: The study aimed to assess gender differences in the efficacy of metacognitive training (MCT) in people with first-episode psychosis in terms of symptoms and cognitive insight as a primary outcome and other metacognitive and social cognition measures as a secondary outcome. Method: A multicenter, controlled, randomized clinical trial was performed including 122 patients with first-episode psychosis. A total of 8 weekly group sessions of MCT or a psychoeducational intervention were performed. Patients were assessed at baseline, posttreatment, and follow-up. Symptoms were assessed with the Positive and Negative Syndrome Scale and cognitive insight with the Beck Cognitive Insight Scale. A battery of questionnaires on metacognition and social cognition variables was included to assess secondary outcomes. A regression model for repeated measures was performed by gender. Results: Women of the MCT group improved more in general symptoms (p =.046), self-certainty (p =.010), and a composite index of the cognitive insight (p =.031). Moreover, women in the MCT group showed a reduction in personalizing bias (p =.021) and irrational beliefs related to dependence (p =.024), while men in the MCT group showed an improvement in intolerance to frustration (p =.017). In the Jumping to Conclusions task, men in the MCT group improved in the affective task (p =.021) while no differences were found in women. Conclusions: Our results suggest that MCT is more effective in reducing symptoms and improving cognitive insight for women than men. Moreover, different irrational beliefs and cognitive biases were reduced differently considering gender. MCT could be a gender-sensitive intervention. What is the public health significance of this article?: The gender-sensitive approach should be considered in psychological interventions such as metacognitive training. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyze the relationship between selfesteem, symptomatology, cognitive functioning and self-reported cognitive deficits in patients with schizophrenia, and evaluate the effectiveness of a Mind Training Program specifically designed to work self-esteem through cognitive exercises in these patients. The 83 patients with schizophrenia who participated were assessed with the Scale of Positive and Negative Syndrome, the Rosenberg Self-Esteem Scale and the "MATRICS Battery". Subsequently, 40 of these patients were randomized to one of two experimental groups: one that was trained for 10 weeks with a "Mind Training Program" and another that received no training. The results indicate the existence of a negative correlation between self-esteem and self-reported cognitive deficits, so that patients with higher self-esteem have a lower perception of their cognitive deficits. On the other hand, the Mind Training program was not effective in improving symptoms, cognition and selfesteem of these patients. [ABSTRACT FROM AUTHOR]

Background: Social cognition and metacognition have emerged as cornerstones of research and treatment of schizophrenia. Both constructs are known to influence the onset of psychosis, to predict functional outcome and to be associated with symptoms. However, whether the deficits in first-episode psychosis are homogeneous or group in patterns remains to be studied. This study aimed to analyze patterns of social cognitive and metacognitive variables in a sample of subjects with first-episode psychosis. Methods: We recruited 192 subjects with first-episode psychosis from ten public mental-health services in Spain. We collected: demographic information, measures of functioning, performance in social cognition (the Faces Test, IPSAQ and the Hinting Task), a battery of metacognitive tasks (BCIS, and the Beads Task) and a neuropsychological assessment. We performed a Latent Profile Analysis (LPA) with the metacognitive and social-cognitive variables. The variable importance was assessed via a classification tree (CART) and the mean differences among the resulting groups for clinical, neuropsychological and functioning variables were calculated with ANOVA and Kruskal-Wallis tests. Results: Our sample was comprised of 192 (62 women) with first-episode psychosis. The mean age of the sample was 27.93(1.39). The mean PANSS total score of the sample was 58.48 (17.79). The average GAF score was 58.93 (12.25). We included 174 cases with complete social-cognitive and metacognitive data in the cluster analysis. We identified three type-VEE clusters (i.e. ellipsoidal clusters with equal shape and orientation) according to BIC (BIC=3600.651). The 85-15 condition of the Beads Task and the Hinting Task emerged as the most important variables in determining the clustering structure. The first cluster (60.9%) was characterized by average scores in most of the metacognitive and social cognitive variables, but the presence of the jumping to conclusions bias. The second cluster (5.7%) was characterized by low selfreflectiveness, presence of personalizing bias and an excessive number of trials in the beads task. The third cluster (33.5%) was characterized by average scores in all metacognitive tasks but low scores in the social cognitive tasks. Discussion: We found three clusters in a large sample of subjects with firstepisode psychosis. Our results indicate that the three groups differ in the proneness to present deficits in specific domains. Furthermore, in our sample, patients may not exhibit a homogeneous deficit in all social-cognitive and metacognitive variables. Instead, the impairment may be particularly prominent in either social-cognitive or metacognitive variables. Subjects in different clusters may present differences in their clinical characteristics, what could be relevant in the treatment. Therefore, with further research, a thorough assessment of social cognition and metacognition may help personalize the treatment according to the person’s subtype of the deficit. [ABSTRACT FROM AUTHOR]

Background: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. Method: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. Results: Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. Conclusions: MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention. [ABSTRACT FROM AUTHOR]

Introduction. Facial emotion recognition is considered the foundation of effective social functioning, but it has been found impaired in several clinical populations. However, there are few validated tests to measure the ability. To the best of our knowledge, there is no validated measure in a Spanish population. We translated and validated Baron Cohen's Face Test in a general Spanish population. Methods. The test was administered to 211 (63.3% female) healthy volunteers between 19 and 70 years of age. We used tetrachoric matrices to obtain item per item test-retest reliability and internal consistency. We used confirmatory factor analysis to test for unidimensionality. We used Pearson correlations to examine associations between variables. Results. The mean score was 18 (SD=1.38). Cronbach's alfa was 0.75. Guttman Lambda 3 indexes yielded 17 out of 20 items to have excellent test-retest reliability. Gender or age differences in performance were not found. The test seems to comply with a one-dimensional structure: CFI=0.889; TLI=0.873 and RMSEA=0.047. Conclusions. Baron Cohen's Face Test could be a valid measure of FER, although it is not sensitive to age or gender. Because it presents a certain ceiling effect, it could not be appropriate to detect excelling performance. [ABSTRACT FROM AUTHOR]

Facial emotion recognition is considered the foundation of effective social functioning, but it has been found impaired in several clinical populations. How- ever, there are few validated tests to measure the ability. To the best of our knowledge, there is no validated measure in a Spanish population. We translated and validated Baron Cohen’s Face Test in a general Spanish population.