Jaargang 30 (2010)
Nummer: 4
Artikel: 263


DT-30-4-263.pdf 490.89 KB 11 downloads

MCT voor patiënten met een psychotische kwetsbaarheid ...


Recente onderzoeksbevindingen tonen aan dat een aantal denk- en redeneerprocessen een belangrijke rol speelt bij het ontstaan en voortduren van wanen bij schizofreniepatiënten. In een poging om deze bevindingen om te zetten in een voor de praktijk relevante klinische interventie is de zogenaamde metacognitieve training (MCT) ontwikkeld. We onderzochten of MCT cognitieve tendensen en wanen kan verminderen. Het effect van acht sessies groepsgewijze MCT werd geëvalueerd in een ongecontroleerde studie met 29 klinisch paranoïde patiënten.

Paranoïde gedachten en wanen verminderden. De onderdelen ‘overhaast concluderen’ en ‘cognitieve flexibiliteit’ verbeterden en bij ‘sociale cognitie’ (inlevingsvermogen) werd een tendens tot verbetering gesignaleerd als resultaat van voorlichting en doelgericht oefenen. Op ‘zelfwaardering’ en ‘geheugencorruptie’ had de training geen effect. We concluderen dat MCT mogelijkheden kan bieden bij de psychologische behandeling van wanen. Een gecontroleerde studie is gestart om de effecten van de MCT op cognitieve tendensen en psychopathologie verder te onderzoeken.


Cognitive biases are associated to the formation and maintenance of delusions. We tried to demonstrate that metacognitive training can make patients aware of these biases and correct them. The effects of eight sessions of metacognitive training have been evaluated in an uncontrolled study with 29 clinically paranoid schizophrenia patients.

Paranoid thoughts and delusions diminished. Data gathering and cognitive flexibility improved and theory of mind showed a tendency to improve as a result of targeted training. Depression, self-esteem and knowledge corruption were unaffected in this study. We concluded that metacognitive training is a promising intervention in the psychological treatment of delusions.


Aghotor, J., Pfueller, U., Moritz, S., Weisbrod, M., & Roesch-Ely, D. (2010). Metacognitive training for patients with schizophrenia (MCT): Feasibility and preliminary evidence for its efficacy. Journal of Behavior Therapy and Experimental Psychiatry, 41, 207-211.

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Beck, A.T., Baruch, E., Balter, J.M., Steer, R.A., & Warman, D.M. (2004). A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophrenia Research, 68), 319-329.

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Bora, E., Yucel, M., & Pantelis, C. (2009). Theory of mind impairment in schizophrenia: Meta-Analysis. Schizophrenia Research, 109, 1-9.

Brüne, M. (2005). ‘Theory of mind’ in schizophrenia: a review of the literature. Schizophrenia Bulletin, 31, 21-42.

Combs, D.R., Penn, D.L., Chadwick, P., Trower, P., Michael, C.O., & Basso, M.R.( 2007). Subtypes of paranoia in a nonclinical sample. Cognitive Neuropsychiatry, 12(6), 537-553.

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Freeman, D. (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychology Review, 27, 425-457.

Freeman, D., Pugh, K., & Garety, P. (2008). Jumping to conclusions and paranoid ideation in the general population. Schizophrenia Research, 102, 254-260.

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Lecomte, T., Corbière, M., & Laisné, F. (2004). Investigating self-esteem in individuals with schizophrenia: relevance of the Self-Esteem Rating Scale-Short Form Psychiatric research, 143(1), 99-108.

Lincoln, T.M., Lullmann, E., & Rief, W. (2007). Correlates and long-term consequences of poor insight in patients with schizophrenia. A systematic review. Schizophrenia Bulletin, 33, 1324-1342.

Moritz, S. & Woodward, T.S. (2005). Jumping to conclusions in delusional and non-delusional schizophrenic patients. British Journal of Clinical Psychology 44, 193-207.

Moritz, S. & Woodward, T.S. (2006a). A generalized bias against disconfirmatory evidence in schizophrenia. Psychiatric Research, 142, 157-165.

Moritz, S. & Woodward, T.S. (2006b) The Contribution of Metamemory Deficits to Schizophrenia. Journal of Abnormal Psychology, 15(1), 15-25.

Moritz, S. & Woodward, T.S. (2007a). Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Current Opinions in Psychiatry, 20, 619-625.

Moritz, S. & Woodward, T.S. (2007b). Metacognitive training for schizophrenia patients (MCT): A pilot study on feasibility, treatment adherence, and subjective efficacy. German Journal of Psychiatry, 10, 69-78.

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Ross, K., Freeman, D., Dunn, G., & Garety, P. (in press). A randomized experimental investigation of reasoning training for people with delusions. Schizophrenia Bulletin (advance access juni 11, 2009).

Uekermann, J., Channon, S., Lehmkamper, C., Abdel-Hamid, M., Vollmoeller, W., & Daum, I. (2008). Executive function, mentalizing and humor in major depression. Journal of the International Neuropsychological Society, 14, 55-62.

Dael, F. van, Versmissen, D., Janssen, I., Myin-Germeys, I., Os, J. van, & Krabbendam, L. (2006). Data gathering: biased in psychosis? Schizophrenia Bulletin, 32, 341-351.

White, L.O. & Mansell, W. (2009). Failing to ponder? Delusion-prone individuals rush to conclusions. Clinical Psychology and Psychotherapy, 16(2), 111-124.

Woodward, T.S., Buchy, L., Moritz, S., & Liotti, M. (2007). A bias against disconfirmatory evidence is associated with delusion proneness in a nonclinical sample. Schizophrenia Bulletin, 33, 1023-1028.

Woodward, T.S., Moritz, S., Cuttler, C., & Whitman, J.C. (2006). The contribution of a cognitive bias against disconfirmatory evidence (BADE) to delusions in schizophrenia. Journal of Clinical and Experimental Neuropsychology, 28, 605-617.

Woodward, T.S., Moritz, S., Menon, M., & Klinge, R. (2008). Belief inflexibility in schizophrenia. Cognitive Neuropsychiatry, 13, 267-277.


DT-30-4-263.pdf 490.89 KB 11 downloads

MCT voor patiënten met een psychotische kwetsbaarheid ...