Examining sex as a potential moderator of metacognitive training for psychosis efficacy on cognitive insight and jumping to conclusions bias: Evidence from a large-scale harmonized database.
Por:
Goncalves A, Lamarca M, Moritz S, Gaweda L, Acuña V, König C, Berna F and Ochoa S
Publicada:
1 jun 2026
Ahead of Print:
27 abr 2026
Resumen:
BACKGROUND: Whereas biological sex differences in psychosis are well-documented in terms of clinical presentation and illness course, their moderating role in the effectiveness of cognitive interventions remains unclear. Previous studies in first-episode psychosis (FEP) suggested sex-specific responses to Metacognitive Training for psychosis (MCT) on cognitive insight and jumping to conclusions (JTC) bias, but generalizability to broader clinical populations is unknown. METHODS: This retrospective study analyzed harmonized individual participant data from 633 persons with schizophrenia spectrum disorders (SSD) who received MCT across 22 international studies. Treatment effects and potential sex moderation were analyzed using repeated-measures ANOVAs and mixed-effects logistic regression on cognitive insight (Beck Cognitive Insight Scale) and JTC bias (Cognitive Biases Questionnaire for Psychosis, JTC subscale; Beads tasks). RESULTS: MCT produced significant improvements in cognitive insight and JTC bias, including reduced self-certainty (F = 22.899, p < .001), improved composite cognitive insight score (F = 11.787, p < .001), and decreased JTC bias on both continuous (F = 4.109, p = .044) and dichotomous measures (OR = 0.592, 95% CI: 0.356-0.984). However, no significant time × sex interactions were observed for any outcome, indicating equivalent treatment benefits across sexes. CONCLUSIONS: Contrary to previous FEP-specific findings, sex does not moderate MCT efficacy in heterogeneous clinical samples including established schizophrenia. These results may support MCT implementation without sex-specific adaptations in routine clinical practice.
Filiaciones:
Goncalves A:
INSERM, UMR_S 1329: Strasbourg Translational Neuroscience & Psychiatry, Strasbourg, France
University of Strasbourg, École doctorale des sciences de la vie et de la santé: ED 414, Strasbourg, France
:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830, Barcelona, Spain
Grup MERITT, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950, Barcelona, Spain
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, 08193, Barcelona, Spain
Moritz S:
Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
Gaweda L:
Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
Acuña V:
Departamento de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
König C:
Soft Computing Research Group at Intelligent Data Science and Artificial Intelligence Research Center, Universitat Politècnica de Catalunya, Barcelona, Spain
Berna F:
INSERM, UMR_S 1329: Strasbourg Translational Neuroscience & Psychiatry, Strasbourg, France
University of Strasbourg, Faculty of medicine, Strasbourg, France
Hôpitaux Universitaires de Strasbourg, Strasbourg, France
Ochoa S:
Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, 08830, Barcelona, Spain
Grup MERITT, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, 08950, Barcelona, Spain
Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
Open Access
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