Assessing metacognition in schizophrenia with the Metacognition Assessment Scale: associations with the Social Cognition and Object Relations Scale

Objectives. Impairments in metacognition are believed to be closely linked with functional impairments among persons with schizophrenia. Recently, we proposed a method for assessing multiple domains of metacognition by rating a narrative generated by a semi-structured interview with an abbreviated form of the Metacognition Assessment Scale (MAS). Less is known about how this measure is linked to social cognition. Design. The current study sought to compare, in a cross-sectional design, assessments of metacognition using the MAS and social cognition measured using the Social Cognition and Object Relations Scale (SCORS). Methods. Participants were 37 adults with schizophrenia spectrum disorders who completed an assessment battery that included the Hopkins Verbal Learning Test, Wisconsin Card Sorting Test, the Positive and Negative Syndrome Scale, and the procedures needed to derive the MAS and SCORS indices. Results. Univariate correlations and multiple regressions revealed that mastery, a domain of metacognition measuring thinking about oneself and coping with psychological challenges, was linked to SCORS indices which assess awareness of interpersonal relationships as the result of complex psychological forces and the recognition that relationships involve people with independent needs. This relationship persisted when the effects of symptoms and neurocognitive deficits were statistically controlled. Conclusions. Mastery, one domain of metacognition, is linked to social cognition independent of neurocognitive function and symptoms.