How social problem-solving, meta-cognition and autobiographical memory differ in negative subtypes of psychosis

Background: Negative symptoms in schizophrenia are an important area of research due to their relationship with reduced quality of life. Interventions targeting defeatist beliefs have been found to improve negative symptoms, which are also associated with poor meta-cognition and autobiographical memory. Understanding metacognition may help us to understand the processes that affect social problem-solving (SPS) and negative symptoms, and together this information may help focus newer, more effective interventions. Aims: The aims of this study were to examine how negative symptoms experienced by people with schizophrenia interact with meta-cognitive, autobiographical memory and social problem-solving deficits. Method: This was a cross-sectional study of 14 inpatients from the community mental health inpatient and forensic directorate wards across GGandC who had a diagnosis of schizophrenia and were experiencing difficulties with negative symptoms. Participants were asked to complete measures of social problem-solving, mood and negative symptoms. They were then asked to complete four social problem-solving scenarios, then asked questions about their life using the Indiana Psychiatric Illness Inventory (IPII) and finally they were presented with the AM task which consisted of 15 words and each required the participant to attribute the word to a specific memory. Finally, participants were categorized into predominant or prominent symptom profiles for comparison between groups. Results: Participants were found to have lower levels of avolition and alogia if they have a positive orientation to solving problems and are able to consider various options when trying to solve a problem. In addition the meta-cognition subscale of mastery was positively related to actual problem-solving performance and effectiveness. Conclusion: Post hoc analysis found that the negative symptoms of avolition and alogia are positively associated with the functional problem-solving constructs of rational problem-solving and positive problem orientation. Whilst this study experienced major methodological limitations the findings could guide future studies to focus on attitudes and actual problem-solving ability, which could be important factors in relation to interventions for negative symptoms