02e516cd01ea537207ca1d46d432d203 joupermed_a2020v10n4p253.pdf 9e2978823820de77ee7eede83fd8c848cfa366a7 joupermed_a2020v10n4p253.pdf 737aaef1761cd24ae3a11f808f1606416aad0bdaba771be6b9e85f0cd805d906 joupermed_a2020v10n4p253.pdf Title: Cognitive Insight in First-Episode Psychosis: Changes during Metacognitive Training Subject: 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. Keywords: first-episode psychosis; metacognitive training; cognitive insight; sessions; experiment Author: Irene Birulés, Raquel López-Carrilero, Daniel Cuadras, Esther Pousa, Maria Luisa Barrigón, Ana Barajas, Ester Lorente-Rovira, Fermín González-Higueras, Eva Grasa, Isabel Ruiz-Delgado, Jordi Cid, Ana de Apraiz, Roger Montserrat, Trinidad Pélaez, Steffen Moritz, the Spanish Metacognition Study Group and Susana Ochoa Creator: LaTeX with hyperref package Producer: pdfTeX-1.40.18 CreationDate: Fri Nov 27 06:25:07 2020 CET ModDate: Fri Nov 27 06:25:07 2020 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 13 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 858741 bytes Optimized: no PDF version: 1.5 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- ULDBLH+URWPalladioL-Ital Type 1 Custom yes yes no 56 0 GQJIVQ+URWPalladioL-Bold Type 1 Custom yes yes no 57 0 JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 58 0 LZDGTK+Rpxb Type 1 Builtin yes yes no 59 0 QTLELQ+Pxbsy Type 1 Builtin yes yes no 60 0 XMNFFN+URWPalladioL-Roma Type 1 Custom yes yes no 61 0 OHKNFJ+VnURWPalladioL Type 1 Custom yes yes no 62 0 OFLXAT+Rpxr Type 1 Builtin yes yes no 63 0 SIBAAH+Pxsy Type 1 Builtin yes yes no 64 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 69 0 UIJACC+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 70 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 89 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 90 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 91 0 CZCIPP+URWPalladioL-BoldItal Type 1 Custom yes yes no 183 0 LKJJFI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 189 0 LKJJHJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 190 0 LKJJIK+PalatinoLinotype TrueType WinAnsi yes yes no 191 0 LKJOJM+TimesNewRoman CID TrueType Identity-H yes yes yes 192 0 LKJJFI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 225 0 LKJJHJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 226 0 LKJJIK+PalatinoLinotype TrueType WinAnsi yes yes no 227 0 LKJOJM+TimesNewRoman CID TrueType Identity-H yes yes yes 228 0 LKJJFI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 252 0 LKJJHJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 253 0 LKJJIK+PalatinoLinotype TrueType WinAnsi yes yes no 254 0 LKJOJM+TimesNewRoman CID TrueType Identity-H yes yes yes 255 0 LKJJFI+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 285 0 LKJJHJ+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 286 0 LKJJIK+PalatinoLinotype TrueType WinAnsi yes yes no 287 0 LKJOJM+TimesNewRoman CID TrueType Identity-H yes yes yes 288 0 NUUXUW+VnURWPalladioL-Italic Type 1 Custom yes yes no 404 0 VSHNAE+Rpcxr Type 1 Builtin yes yes no 415 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2021-01-16 05:44:39 CET RepresentationInformation: joupermed_a2020v10n4p253.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2021-01-12 11:22:10 CET Size: 858741 Format: PDF Version: 1.5 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 0 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: ぉのぴひはつふっぴどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸲ Item: Title: きちぴづひどちぬびぜ〴ぜ〰ちのつぜ〴ぜ〰きづぴとはつびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮ㄩ‾㸊⡜㌷㙜㌷㝜〰ぐちひぴどっどばちのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㈩‾㸊⡜㌷㙜㌷㝜〰ぉのびぴひふねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰ぐひはっづつふひづぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Children: Item: Title: ぐちひぴどっどばちのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㈩‾㸊⡜㌷㙜㌷㝜〰ぉのびぴひふねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰ぐひはっづつふひづぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: ぉのびぴひふねづのぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳畢獥捴楯渮㈮㌩‾㸊⡜㌷㙜㌷㝜〰ぐひはっづつふひづぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: ぐひはっづつふひづぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸳ Item: Title: げづびふぬぴびぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸴ Item: Title: いどびっふびびどはのぜ〴〩਼㰠⽓ 䝯呯 䐠⡳散瑩潮⸴ Item: Title: げづてづひづのっづび Filters: FilterPipeline: FlateDecode Fonts: Type1: Font: BaseFont: SIBAAH+Pxsy FontSubset: true FirstChar: 0 LastChar: 121 FontDescriptor: FontName: SIBAAH+Pxsy Flags: Symbolic FontBBox: -21, -994, 1292, 912 FontFile: true Font: BaseFont: NUUXUW+VnURWPalladioL-Italic FontSubset: true FirstChar: 178 LastChar: 178 FontDescriptor: FontName: NUUXUW+VnURWPalladioL-Italic Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: CZCIPP+URWPalladioL-BoldItal FontSubset: true FirstChar: 37 LastChar: 116 FontDescriptor: FontName: CZCIPP+URWPalladioL-BoldItal Flags: Symbolic FontBBox: -170, -300, 1073, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: ULDBLH+URWPalladioL-Ital FontSubset: true FirstChar: 40 LastChar: 122 FontDescriptor: FontName: ULDBLH+URWPalladioL-Ital Flags: Symbolic FontBBox: -170, -305, 1010, 941 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: GQJIVQ+URWPalladioL-Bold FontSubset: true FirstChar: 3 LastChar: 122 FontDescriptor: FontName: GQJIVQ+URWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: JYPLJJ+VnURWPalladioL-Bold FontSubset: true FirstChar: 161 LastChar: 226 FontDescriptor: FontName: JYPLJJ+VnURWPalladioL-Bold Flags: Symbolic FontBBox: -152, -301, 1000, 935 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: LZDGTK+Rpxb FontSubset: true FirstChar: 11 LastChar: 11 FontDescriptor: FontName: LZDGTK+Rpxb Flags: Symbolic FontBBox: -57, -266, 932, 729 FontFile: true Font: BaseFont: QTLELQ+Pxbsy FontSubset: true FirstChar: 121 LastChar: 121 FontDescriptor: FontName: QTLELQ+Pxbsy Flags: Symbolic FontBBox: 5, -978, 1382, 913 FontFile: true Font: BaseFont: XMNFFN+URWPalladioL-Roma FontSubset: true FirstChar: 2 LastChar: 252 FontDescriptor: FontName: XMNFFN+URWPalladioL-Roma Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: OHKNFJ+VnURWPalladioL FontSubset: true FirstChar: 129 LastChar: 226 FontDescriptor: FontName: OHKNFJ+VnURWPalladioL Flags: Symbolic FontBBox: -166, -283, 1021, 943 FontFile: true EncodingDictionary: Differences: true Font: BaseFont: OFLXAT+Rpxr FontSubset: true FirstChar: 11 LastChar: 62 FontDescriptor: FontName: OFLXAT+Rpxr Flags: Symbolic FontBBox: -40, -283, 904, 728 FontFile: true Font: BaseFont: VSHNAE+Rpcxr FontSubset: true FirstChar: 169 LastChar: 169 FontDescriptor: FontName: VSHNAE+Rpcxr Flags: Symbolic FontBBox: -212, -286, 1344, 973 FontFile: true Pages: Page: Sequence: 1 Annotations: Annotation: Subtype: Link Rect: 75, 757, 217, 793 Annotation: Subtype: Link Rect: 474, 757, 519, 793 Annotation: Subtype: Link Rect: 147, 660, 158, 674 Annotation: Subtype: Link Rect: 295, 660, 306, 674 Annotation: Subtype: Link Rect: 394, 660, 405, 674 Annotation: Subtype: Link Rect: 185, 647, 196, 660 Annotation: Subtype: Link Rect: 450, 633, 461, 647 Annotation: Subtype: Link Rect: 466, 165, 518, 184 Annotation: Subtype: Link Rect: 181, 38, 256, 50 Annotation: Subtype: Link Rect: 417, 38, 519, 50 Page: Sequence: 2 Annotations: Annotation: Subtype: Link Rect: 369, 512, 376, 521 ActionDest: 374 Annotation: Subtype: Link Rect: 376, 512, 383, 521 ActionDest: 374 Annotation: Subtype: Link Rect: 359, 471, 366, 480 ActionDest: 374 Annotation: Subtype: Link Rect: 366, 471, 373, 480 ActionDest: 374 Annotation: Subtype: Link Rect: 454, 471, 461, 480 ActionDest: 374 Annotation: Subtype: Link Rect: 197, 457, 204, 467 ActionDest: 374 Annotation: Subtype: Link Rect: 344, 457, 351, 467 ActionDest: 374 Annotation: Subtype: Link Rect: 352, 457, 359, 467 ActionDest: 374 Annotation: Subtype: Link Rect: 244, 430, 251, 440 ActionDest: 374 Annotation: Subtype: Link Rect: 377, 430, 389, 440 ActionDest: 374 Annotation: Subtype: Link Rect: 297, 403, 309, 413 ActionDest: 374 Annotation: Subtype: Link Rect: 207, 390, 219, 399 ActionDest: 374 Annotation: Subtype: Link Rect: 377, 336, 389, 345 ActionDest: 374 Annotation: Subtype: Link Rect: 364, 309, 376, 318 ActionDest: 374 Annotation: Subtype: Link Rect: 161, 282, 173, 291 ActionDest: 374 Annotation: Subtype: Link Rect: 174, 282, 186, 291 ActionDest: 374 Annotation: Subtype: Link Rect: 186, 282, 198, 291 ActionDest: 401 Annotation: Subtype: Link Rect: 199, 228, 211, 237 ActionDest: 374 Annotation: Subtype: Link Rect: 436, 174, 448, 183 ActionDest: 401 Annotation: Subtype: Link Rect: 158, 120, 170, 129 ActionDest: 401 Annotation: Subtype: Link Rect: 170, 120, 182, 129 ActionDest: 401 Page: Sequence: 3 Annotations: Annotation: Subtype: Link Rect: 122, 742, 134, 752 ActionDest: 401 Annotation: Subtype: Link Rect: 412, 729, 424, 738 ActionDest: 401 Annotation: Subtype: Link Rect: 158, 675, 170, 684 ActionDest: 401 Annotation: Subtype: Link Rect: 427, 661, 439, 671 ActionDest: 401 Annotation: Subtype: Link Rect: 134, 161, 146, 170 ActionDest: 374 Annotation: Subtype: Link Rect: 273, 147, 285, 157 ActionDest: 401 Annotation: Subtype: Link Rect: 285, 147, 297, 157 ActionDest: 401 Page: Sequence: 4 Annotations: Annotation: Subtype: Link Rect: 421, 715, 433, 725 ActionDest: 401 Annotation: Subtype: Link Rect: 131, 486, 143, 495 ActionDest: 401 Annotation: Subtype: Link Rect: 436, 472, 448, 481 ActionDest: 401 Annotation: Subtype: Link Rect: 353, 445, 365, 454 ActionDest: 401 Annotation: Subtype: Link Rect: 366, 445, 378, 454 ActionDest: 401 Annotation: Subtype: Link Rect: 300, 305, 307, 317 ActionDest: 179 Page: Sequence: 5 Annotations: Annotation: Subtype: Link Rect: 122, 397, 129, 409 ActionDest: 179 Page: Sequence: 6 Annotations: Annotation: Subtype: Link Rect: 132, 578, 139, 590 ActionDest: 214 Annotation: Subtype: Link Rect: 141, 578, 148, 590 ActionDest: 276 Page: Sequence: 7 Annotations: Annotation: Subtype: Link Rect: 124, 545, 131, 557 ActionDest: 306 Page: Sequence: 8 Page: Sequence: 9 Annotations: Annotation: Subtype: Link Rect: 390, 628, 402, 638 ActionDest: 401 Annotation: Subtype: Link Rect: 118, 426, 130, 435 ActionDest: 401 Annotation: Subtype: Link Rect: 394, 412, 406, 421 ActionDest: 401 Annotation: Subtype: Link Rect: 271, 385, 283, 394 ActionDest: 401 Annotation: Subtype: Link Rect: 283, 385, 295, 394 ActionDest: 401 Annotation: Subtype: Link Rect: 458, 331, 470, 340 ActionDest: 374 Annotation: Subtype: Link Rect: 147, 264, 159, 273 ActionDest: 374 Annotation: Subtype: Link Rect: 160, 264, 172, 273 ActionDest: 401 Annotation: Subtype: Link Rect: 323, 237, 335, 246 ActionDest: 401 Annotation: Subtype: Link Rect: 336, 237, 348, 246 ActionDest: 401 Annotation: Subtype: Link Rect: 182, 128, 194, 138 ActionDest: 401 Annotation: Subtype: Link Rect: 335, 128, 347, 138 ActionDest: 401 Annotation: Subtype: Link Rect: 174, 115, 186, 124 ActionDest: 401 Annotation: Subtype: Link Rect: 187, 115, 199, 124 ActionDest: 401 Annotation: Subtype: Link Rect: 268, 88, 280, 97 ActionDest: 401 Page: Sequence: 10 Annotations: Annotation: Subtype: Link Rect: 313, 715, 325, 725 ActionDest: 374 Annotation: Subtype: Link Rect: 484, 702, 496, 711 ActionDest: 412 Annotation: Subtype: Link Rect: 277, 688, 289, 698 ActionDest: 412 Annotation: Subtype: Link Rect: 454, 648, 466, 657 ActionDest: 401 Annotation: Subtype: Link Rect: 463, 607, 475, 617 ActionDest: 401 Annotation: Subtype: Link Rect: 219, 594, 231, 603 ActionDest: 412 Page: Sequence: 11 Annotations: Annotation: Subtype: Link Rect: 295, 552, 333, 562 Annotation: Subtype: Link Rect: 339, 552, 375, 562 Annotation: Subtype: Link Rect: 213, 513, 251, 524 Annotation: Subtype: Link Rect: 257, 513, 293, 524 Annotation: Subtype: Link Rect: 478, 487, 516, 498 Annotation: Subtype: Link Rect: 100, 475, 136, 485 Annotation: Subtype: Link Rect: 324, 448, 362, 459 Annotation: Subtype: Link Rect: 273, 423, 310, 433 Annotation: Subtype: Link Rect: 236, 397, 273, 408 Annotation: Subtype: Link Rect: 456, 371, 494, 382 Annotation: Subtype: Link Rect: 297, 332, 334, 343 Annotation: Subtype: Link Rect: 100, 307, 137, 317 Annotation: Subtype: Link Rect: 312, 280, 350, 291 Annotation: Subtype: Link Rect: 478, 229, 516, 240 Annotation: Subtype: Link Rect: 100, 217, 136, 227 Annotation: Subtype: Link Rect: 150, 178, 187, 188 Annotation: Subtype: Link Rect: 193, 178, 230, 188 Annotation: Subtype: Link Rect: 181, 126, 219, 136 Annotation: Subtype: Link Rect: 225, 126, 261, 136 Annotation: Subtype: Link Rect: 478, 87, 516, 98 Annotation: Subtype: Link Rect: 100, 75, 136, 85 Page: Sequence: 12 Annotations: Annotation: Subtype: Link Rect: 268, 714, 305, 725 Annotation: Subtype: Link Rect: 311, 714, 348, 725 Annotation: Subtype: Link Rect: 277, 675, 314, 686 Annotation: Subtype: Link Rect: 366, 650, 403, 661 Annotation: Subtype: Link Rect: 251, 573, 289, 583 Annotation: Subtype: Link Rect: 100, 521, 137, 531 Annotation: Subtype: Link Rect: 143, 521, 179, 531 Annotation: Subtype: Link Rect: 233, 482, 271, 493 Annotation: Subtype: Link Rect: 277, 482, 313, 493 Annotation: Subtype: Link Rect: 316, 443, 353, 454 Annotation: Subtype: Link Rect: 100, 405, 137, 415 Annotation: Subtype: Link Rect: 143, 405, 179, 415 Annotation: Subtype: Link Rect: 353, 314, 391, 325 Annotation: Subtype: Link Rect: 414, 288, 451, 299 Annotation: Subtype: Link Rect: 457, 288, 494, 299 Annotation: Subtype: Link Rect: 250, 249, 288, 260 Annotation: Subtype: Link Rect: 438, 211, 476, 222 Annotation: Subtype: Link Rect: 275, 185, 312, 196 Annotation: Subtype: Link Rect: 163, 160, 201, 170 Annotation: Subtype: Link Rect: 235, 133, 273, 144 Annotation: Subtype: Link Rect: 279, 133, 315, 144 Annotation: Subtype: Link Rect: 132, 82, 169, 92 Annotation: Subtype: Link Rect: 176, 82, 212, 92 Page: Sequence: 13 Annotations: Annotation: Subtype: Link Rect: 358, 714, 396, 725 Annotation: Subtype: Link Rect: 402, 714, 438, 725 Annotation: Subtype: Link Rect: 364, 688, 401, 699 Annotation: Subtype: Link Rect: 407, 688, 443, 699 Annotation: Subtype: Link Rect: 444, 663, 482, 673 Annotation: Subtype: Link Rect: 76, 591, 166, 622 Annotation: Subtype: Link Rect: 234, 585, 407, 596 Checksum: b2509841 Type: CRC32 Checksum: 02e516cd01ea537207ca1d46d432d203 Type: MD5 Checksum: 9e2978823820de77ee7eede83fd8c848cfa366a7 Type: SHA-1