Tiril Østefjells will defend her PhD-thesis on December 07, 2017

The title of the thesis is "Metacognition in severe mental disorders".

Tiril Østefjells

Official announcement: Disputas: Tiril Østefjells

Title of trial lecture

"Neurocognitive antecedents for schizophrenia".

Thesis summary

Affective dysregulation and psychosis often co-occur in bipolar and psychotic disorders, and more frequently with early trauma. Studies of shared mechanisms are rare. Metacognition – thinking about thinking – has been proposed as a common factor. This thesis investigated self-reported metacognitive beliefs and thought control strategies in patients with bipolar or psychotic disorders compared to controls, and used regression analyses to examine relationships between metacognition and illness-related factors in bipolar and psychotic disorders obtained from clinical interviews. Further, it explored whether metacognitive beliefs could mediate symptomatic responses to early trauma.  

All patients reported more unhelpful metacognitive beliefs than controls. Metacognitive beliefs were linked to higher levels of depressive symptoms in both disorders. Metacognitive beliefs were independently linked to factors predating or related to the onset of illness, which are often linked to a poorer long-term outcome, with somewhat clearer findings for individuals with psychosis. Individuals with bipolar disorder reported using more unhelpful thought control strategies than controls, in particularly worry, social control, and punishment. Use of such strategies was related to more unhelpful metacognitive beliefs.

Early emotional abuse increased levels of depressive symptoms, but this effect was mediated through metacognitive beliefs. Early emotional abuse increased levels of psychotic symptoms, but this effect was serially mediated through metacognitive beliefs and depressive symptoms.

Overall, metacognitive factors differentiated patients with bipolar and psychotic disorders from controls and were linked to depressive and psychotic symptoms. Targeting metacognitive beliefs and thought control strategies could help tailor treatment for bipolar and psychotic disorders, especially for individuals where comorbid depression and early emotional trauma is clinically relevant.

Published Nov. 24, 2017 2:42 PM - Last modified Nov. 24, 2017 2:42 PM