Metacognitive Aspects of Basic Self-Disturbance in Adolescents with Schizotypal Disorder

Background: the study of metacognitive abilities in adolescents is crucial for understanding early mechanisms in the developmental of psychotic disorders. Evidence suggests that impairments in metacognitive monitoring and control may strengthen the association between neurocognitive deficits and attenuated psychotic symptoms in adolescence. However, existing studies are few, and their findings need to be systematized to clarify the characteristics of metacognition in schizotypal disorder (SD) specifically during adolescence.

The aim of study was to examine mental-state integration and monitoring in adolescents with SD.

Patients and Methods: a pilot cross-sectional study using psychometric instruments was performed on adolescents with SD (F21 in ICD-10; n = 11), nonpsychotic internalizing disorders (F41, F42, F43.2 in ICD-10; n = 6), and externalizing disorders (F90, F91 in ICD-10; n = 5). Statistical analysis included descriptive statistics, correlation analysis, between-group comparisons, and post hoc pairwise comparisons.

Results: compared with peers with nonpsychotic internalizing and externalizing disorders, adolescents with SD showed more pronounced identity disturbance and alexithymia.

Conclusion: the complex impairments in mental-state integration and monitoring in adolescents with SD resemble basic self-disturbance (BSD), which is characteristic of schizophrenia. Further research is needed to investigate metacognitive abilities in adolescents with SD and their relationship with BSD, as this complex may represent a potential predictor of psychosis risk.

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