Metacognitive abilities in adults with substance abuse treated in therapeutic community

The term metacognition reflects a spectrum of psychological activities that allows people to form and integrate representations about their own mental states and those of others. The main goal of this study was to examine whether people with substance abuse disorders (SUDs), and treated in therapeutic community regime, displayed specific patterns of metacognitive deficits on Self-reflectivity, Understanding others’ mind, Decentration, and Mastery, comparing their scores with two clinical groups of patients with schizophrenia spectrum disorders (SSDs) and anxiety disorders.

A mixed-methods (qualitative-quantitative) study was designed. Two hundred and sixteen adults aged 18-65 with principal diagnoses of SUDs (n = 52), SSDs (n = 49), and anxiety disorders (n = 115) were recruited. Qualitative data were obtained with the Metacognition Assessment Interview, which was then rated using a quantitative scale, the Metacognition Assessment Scale-Abbreviated (MAS-A).

The anxiety disorders group had significantly higher MAS-A total scores than the SUDs group, and the SUDs group obtained significantly higher MAS-A total scores than the SSDs group. Concerning the MAS-A subscale scores, the SUDs group displayed significantly lower scores only on the Mastery subscale compared to the anxiety disorders group, with the SUDs and SSDs groups obtaining equivalent Mastery scores.

According to these findings, current interventions for addiction should focus more specifically on improving metacognitive Mastery.