Metacognitive Beliefs, Cognitive Functioning, Psychiatric Symptoms and Empathy in People with Schizophrenia

People with schizophrenia often exhibit deficits in empathy, which plays a major role in social cognition and interpersonal relationship. However, little work has investigated potential factors that influence empathy in schizophrenia. The study aimed to investigate the relationship among metacognition, psychiatric symptoms, cognitive functioning and empathy in patients diagnosed with schizophrenia.

Forty-eight people with schizophrenia were enrolled in the study group. All subjects participated in the metacognitions questionnaire-30 (MCQ-30), brief psychiatric rating scale (BPRS), neurocognitive functioning, interpersonal reactivity index (IRI), and the pictorial empathy test (PET).

Stepwise regression analysis revealed that cognitive self-consciousness (domain of metacognitions questionnaire-30) accounted for 37% of the variance in perspective taking scores (domain of interpersonal reactivity index). Resistance (subscale of brief psychiatric rating scale) and positive beliefs about worry (domain of metacognitions questionnaire-30) accounted for 34% of the variance in fantasy (domain of interpersonal reactivity index). Activation (subscale of brief psychiatric rating scale) was a significant predictor for empathic concern (domain of interpersonal reactivity index). Resistance, cognitive confidence (domain of metacognitions questionnaire-30), intellectual processes and inhibitory control (go-no-go task) accounted for 38% of the variance in personal distress. Negative symptoms (subscale of brief psychiatric rating scale) and cognitive self-consciousness were significant predictors for the pictorial empathy test.

The study was aimed to examine self-perception of metacognitive beliefs and empathy. More research is needed to explore the association between metacognitive beliefs, cognitive functioning and psychiatric symptoms on empathy in people with schizophrenia.