Experiencing hallucinations in daily life: The role of metacognition

Abigail C Wright; Emma Palmer-Cooper; Matteo Cella; Nicola McGuire; Marcella Montagnese; Viktor Dlugunovych; Chih-Wei Joshua Liu; Til Wykes; Corinne Cather

doi:10.1016/j.schres.2022.12.023

Experiencing hallucinations in daily life: The role of metacognition

Abigail C Wright, Emma Palmer-Cooper, Matteo Cella, Nicola McGuire, Marcella Montagnese, Viktor Dlugunovych, Chih-Wei Joshua Liu, Til Wykes, Corinne Cather

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

122 Downloads (Pure)

Abstract

Background: Hallucinations have been linked to failures in metacognitive reflection suggesting an association between hallucinations and overestimation of performance, although the cross-sectional findings are inconsistent. This inconsistency may relate to the fluctuating hallucinatory experiences that are not captured in cross-sectional studies. Ecological Momentary Assessment (EMA) captures in-the-moment experiences over time so can identify causal relationships between variables such as the associations between metacognition and hallucinatory experience in daily life and overcome problems in cross-sectional designs. Methods: Participants (N = 41) experiencing daily hallucinations completed baseline questionnaires and smartphone surveys 7 times per day for 14 days. They were prompted to identify a task they would complete in the next 4 h and to make metacognitive predictions around the likelihood of completing the task, the difficulty of the task, and how well they would complete it (standard of completion). Results: 76 % finished the 14-days of assessment with an average of 42.2 % survey completion. Less accurate metacognition was associated with more hallucinations, but less accurate likelihood and standard of completion was associated with fewer hallucinations. Using a cross-lagged analysis, metacognitive predictions around the likelihood of completion (p < .001) and standard of completion (p = .01) predicted hallucination intensity at the following timepoint, and metacognitive predictions regarding likelihood of completion (p = .02) predicted hallucination control at the following timepoint. Discussion: Interventions that aim to improve metacognitive ability in-the-moment may serve to reduce the intensity and increase the control of hallucinations.

Original language	English
Journal	Schizophrenia Research
Early online date	7 Jan 2023
DOIs	https://doi.org/10.1016/j.schres.2022.12.023
Publication status	E-pub ahead of print - 7 Jan 2023

Access to Document

10.1016/j.schres.2022.12.023

Experiencing hallucinations in daily life_WRIGHT_Publishedonline7January2023_GREEN AAMAccepted author manuscript, 371 KBLicence: CC BY-NC-ND

Cite this

@article{567ee08f999d47e8af310661b6c08ca3,

title = "Experiencing hallucinations in daily life: The role of metacognition",

abstract = "Background: Hallucinations have been linked to failures in metacognitive reflection suggesting an association between hallucinations and overestimation of performance, although the cross-sectional findings are inconsistent. This inconsistency may relate to the fluctuating hallucinatory experiences that are not captured in cross-sectional studies. Ecological Momentary Assessment (EMA) captures in-the-moment experiences over time so can identify causal relationships between variables such as the associations between metacognition and hallucinatory experience in daily life and overcome problems in cross-sectional designs. Methods: Participants (N = 41) experiencing daily hallucinations completed baseline questionnaires and smartphone surveys 7 times per day for 14 days. They were prompted to identify a task they would complete in the next 4 h and to make metacognitive predictions around the likelihood of completing the task, the difficulty of the task, and how well they would complete it (standard of completion). Results: 76 % finished the 14-days of assessment with an average of 42.2 % survey completion. Less accurate metacognition was associated with more hallucinations, but less accurate likelihood and standard of completion was associated with fewer hallucinations. Using a cross-lagged analysis, metacognitive predictions around the likelihood of completion (p < .001) and standard of completion (p = .01) predicted hallucination intensity at the following timepoint, and metacognitive predictions regarding likelihood of completion (p = .02) predicted hallucination control at the following timepoint. Discussion: Interventions that aim to improve metacognitive ability in-the-moment may serve to reduce the intensity and increase the control of hallucinations.",

author = "Wright, {Abigail C} and Emma Palmer-Cooper and Matteo Cella and Nicola McGuire and Marcella Montagnese and Viktor Dlugunovych and Liu, {Chih-Wei Joshua} and Til Wykes and Corinne Cather",

note = "Funding Information: This research project was supported by an internal fund from Massachusetts Department of Mental Health to the Center of Excellence for Psychosocial and Systemic Research at Massachusetts General Hospital . Publisher Copyright: {\textcopyright} 2023 Elsevier B.V.",

year = "2023",

month = jan,

day = "7",

doi = "10.1016/j.schres.2022.12.023",

language = "English",

journal = "Schizophrenia Research",

issn = "0920-9964",

publisher = "Elsevier",

}

TY - JOUR

T1 - Experiencing hallucinations in daily life

T2 - The role of metacognition

AU - Wright, Abigail C

AU - Palmer-Cooper, Emma

AU - Cella, Matteo

AU - McGuire, Nicola

AU - Montagnese, Marcella

AU - Dlugunovych, Viktor

AU - Liu, Chih-Wei Joshua

AU - Wykes, Til

AU - Cather, Corinne

N1 - Funding Information: This research project was supported by an internal fund from Massachusetts Department of Mental Health to the Center of Excellence for Psychosocial and Systemic Research at Massachusetts General Hospital . Publisher Copyright: © 2023 Elsevier B.V.

PY - 2023/1/7

Y1 - 2023/1/7

N2 - Background: Hallucinations have been linked to failures in metacognitive reflection suggesting an association between hallucinations and overestimation of performance, although the cross-sectional findings are inconsistent. This inconsistency may relate to the fluctuating hallucinatory experiences that are not captured in cross-sectional studies. Ecological Momentary Assessment (EMA) captures in-the-moment experiences over time so can identify causal relationships between variables such as the associations between metacognition and hallucinatory experience in daily life and overcome problems in cross-sectional designs. Methods: Participants (N = 41) experiencing daily hallucinations completed baseline questionnaires and smartphone surveys 7 times per day for 14 days. They were prompted to identify a task they would complete in the next 4 h and to make metacognitive predictions around the likelihood of completing the task, the difficulty of the task, and how well they would complete it (standard of completion). Results: 76 % finished the 14-days of assessment with an average of 42.2 % survey completion. Less accurate metacognition was associated with more hallucinations, but less accurate likelihood and standard of completion was associated with fewer hallucinations. Using a cross-lagged analysis, metacognitive predictions around the likelihood of completion (p < .001) and standard of completion (p = .01) predicted hallucination intensity at the following timepoint, and metacognitive predictions regarding likelihood of completion (p = .02) predicted hallucination control at the following timepoint. Discussion: Interventions that aim to improve metacognitive ability in-the-moment may serve to reduce the intensity and increase the control of hallucinations.

AB - Background: Hallucinations have been linked to failures in metacognitive reflection suggesting an association between hallucinations and overestimation of performance, although the cross-sectional findings are inconsistent. This inconsistency may relate to the fluctuating hallucinatory experiences that are not captured in cross-sectional studies. Ecological Momentary Assessment (EMA) captures in-the-moment experiences over time so can identify causal relationships between variables such as the associations between metacognition and hallucinatory experience in daily life and overcome problems in cross-sectional designs. Methods: Participants (N = 41) experiencing daily hallucinations completed baseline questionnaires and smartphone surveys 7 times per day for 14 days. They were prompted to identify a task they would complete in the next 4 h and to make metacognitive predictions around the likelihood of completing the task, the difficulty of the task, and how well they would complete it (standard of completion). Results: 76 % finished the 14-days of assessment with an average of 42.2 % survey completion. Less accurate metacognition was associated with more hallucinations, but less accurate likelihood and standard of completion was associated with fewer hallucinations. Using a cross-lagged analysis, metacognitive predictions around the likelihood of completion (p < .001) and standard of completion (p = .01) predicted hallucination intensity at the following timepoint, and metacognitive predictions regarding likelihood of completion (p = .02) predicted hallucination control at the following timepoint. Discussion: Interventions that aim to improve metacognitive ability in-the-moment may serve to reduce the intensity and increase the control of hallucinations.

UR - http://www.scopus.com/inward/record.url?scp=85146072371&partnerID=8YFLogxK

U2 - 10.1016/j.schres.2022.12.023

DO - 10.1016/j.schres.2022.12.023

M3 - Article

C2 - 36623979

SN - 0920-9964

JO - Schizophrenia Research

JF - Schizophrenia Research

ER -

Experiencing hallucinations in daily life: The role of metacognition

Abstract

Access to Document

Other files and links

Fingerprint

Cite this