Metacognition and meta-emotion in schizophrenia, bipolar I disorder, and obsessive-compulsive disorder: A...

Severe psychiatric disorders such as schizophrenia (SCZ), bipolar I disorder (BID), and obsessive-compulsive disorder (OCD) involve cognitive and emotional dysfunction, often associated with deficits in metacognition (thinking about one's thinking) and meta-emotion (thoughts and feelings about one's own emotions).

This cross-sectional study compared metacognitive and meta-emotional profiles among 120 participants-30 each with SCZ, BID, OCD, and healthy controls. Diagnoses were confirmed using DSM-5-TR criteria through structured clinical interviews. Participants completed the Metacognitions Questionnaire-30 (MCQ-30) and the Meta-Emotion Scale (MES) to assess metacognitive beliefs and meta-emotional processing. Group differences across the five MCQ-30 subscales, six MES subscales, and two composite scores (Positive and Negative Meta-Emotions) were analyzed using one-way multivariate analyses of variance (MANOVAs), followed by Bonferroni-adjusted univariate ANOVAs (p < .01).

Participants with SCZ exhibited the lowest scores on Cognitive Self-Consciousness, Cognitive Confidence, and the Positive Meta-Emotion subscale Interest. Individuals with OCD showed the highest Cognitive Self-Consciousness and elevated Negative Meta-Emotion scores, consistent with heightened self-focused monitoring and emotional suppression. Participants with BID demonstrated relatively intact metacognitive functioning and higher Positive Meta-Emotion scores compared to the other clinical groups, although all patient groups scored below healthy controls.

SCZ is characterized by selective impairments in metacognitive and meta-emotional processes-most notably reduced Interest and Cognitive Self-Consciousness, with a trend toward lower Cognitive Confidence. OCD, in contrast, is marked by excessive self-focus and negative emotional evaluation. Examining metacognition and meta-emotion together offers a nuanced understanding of both shared and disorder-specific vulnerabilities across severe mental disorders, potentially guiding more targeted cognitive-emotional interventions.