{
  "abstract": "Background\n\nMetacognitive Training (MCT) for psychosis is designed to target metacognitive processes, yet evidence for its effects on cognitive insight remains inconclusive, owing primarily to the limited methodological quality of available trials. A potential explanation lies in baseline heterogeneity, with a substantial proportion of participants presenting high baseline cognitive insight, thereby limiting observable change.Methods\n\nThis study used harmonized individual participant data from the PERMEPSY database, including 614 participants with schizophrenia spectrum disorders from 13 international studies. Cognitive insight was assessed using the Beck Cognitive Insight Scale (BCIS), including Self-Reflectiveness (SR), Self-Certainty (SC), and a composite index (CI). Baseline moderation effects were examined using ANCOVA models with a continuous Group × Baseline interaction term, complemented by stratified ANOVAs to visualize the interaction pattern and estimate within-stratum effect sizes.Results\n\nANCOVA models revealed significant Group × Baseline interactions across all BCIS dimensions, indicating that baseline cognitive insight moderated treatment response. Stratified ANOVAs yielded convergent results for SR and SC. Effect sizes followed a consistent gradient, with larger improvements observed among participants with lower baseline insight. Notably, 26.5% of participants already scored in the high-insight category at baseline, suggesting that ceiling effects may have partially obscured treatment effects at the group level in previous trials.Conclusion\n\nMCT appears to improve cognitive insight, particularly among participants with greater baseline impairment. These findings suggest that baseline heterogeneity is a key determinant of MCT efficacy and may account for previously inconsistent results.",
  "abstract_shown": true,
  "affiliations": [
    "INSERM, UMR_S 1329: Strasbourg Translational Neuroscience & Psychiatry, Strasbourg, France.",
    "École doctorale des sciences de la vie et de la santé: ED 414, Université de Strasbourg, Strasbourg, France.",
    "Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain.",
    "Grup MERITT, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain.",
    "Consorcio de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.",
    "Klinik und Poliklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.",
    "Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland.",
    "Departamento de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile.",
    "Soft Computing Research Group at Intelligent Data Science and Artificial Intelligence Research Center, Universitat Politècnica de Catalunya, Barcelona, Spain.",
    "Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Bellaterra, Cerdanyola del Vallès, Barcelona, Spain.",
    "Faculté de Médecine, Université de Strasbourg, Strasbourg, France.",
    "Hôpitaux universitaires de Strasbourg, Strasbourg, France."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Adrien Goncalves",
      "orcid": "0009-0000-4834-3043"
    },
    {
      "affs": [
        2,
        3,
        4
      ],
      "name": "Susana Ochoa"
    },
    {
      "affs": [
        5
      ],
      "name": "Steffen Moritz"
    },
    {
      "affs": [
        6
      ],
      "name": "Łukasz Gawęda"
    },
    {
      "affs": [
        7
      ],
      "name": "Vanessa Acuña"
    },
    {
      "affs": [
        8
      ],
      "name": "Caroline König"
    },
    {
      "affs": [
        2,
        3,
        4,
        9
      ],
      "name": "Maria Lamarca"
    },
    {
      "affs": [
        0,
        10,
        11
      ],
      "name": "Fabrice Berna"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/60kg0d0yennn6.bib",
  "cited_by": 0,
  "doi": "10.3389/fpsyg.2026.1934181",
  "fulltext_url": "https://europepmc.org/articles/PMC13748317",
  "id": "60kg0d0yennn6",
  "issns": [
    "1664-1078"
  ],
  "landing_url": "https://europepmc.org/article/MED/43011308",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2738|Schizophrenia research and treatment"
    ]
  ],
  "openalex": "W7224011267",
  "pdf_url": "https://europepmc.org/articles/PMC13748317?pdf=render",
  "pmcid": "PMC13748317",
  "pmid": "43011308",
  "published": "2026-10-27",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/60kg0d0yennn6.ris",
  "sources": [
    {
      "first_seen": "2026-11-12T15:25:13Z",
      "native_id": "MED:43011308",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/43011308"
    },
    {
      "first_seen": "2026-11-13T12:26:11Z",
      "native_id": "PMC13748317",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fpsyg.2026.1934181"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2738|Schizophrenia research and treatment",
      "subfield": "psychiatry"
    }
  ],
  "title": "Baseline cognitive insight moderates the efficacy of metacognitive training for psychosis: an individual participant data analysis.",
  "title_text": "Baseline cognitive insight moderates the efficacy of metacognitive training for psychosis: an individual participant data analysis.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-14T12:21:19Z",
  "url": "https://research.draconitic.com/paper/60kg0d0yennn6",
  "venue": "Frontiers in psychology",
  "versions": []
}