Abstract
The synthetic metacognition as a psychological process is a capability to synthesize intentions, thoughts, feelings, and connections between events, and to integrate them into larger complex representations of self and others including also a reflection about that larger representation that involves reflexive functions (thinking about thinking). Disturbed synthetic metacognition was found in early as well as in late forms of schizophrenia and has its typical formula.
Deficit of synthetic metacognition is related to symptoms of schizophrenia, social and vocational functions, intrinsic motivation, subjective experience of recovery, stigma resistance and therapeutic alliance. Synthetic metacognition is measurable by analyzing discourse using standardized procedures.
A sample of the patients spontaneous narrative is initially obtained by semistructured interview. The level of metacognition is then assessed from the sample of narrative by trained evaluators on the basis of the Metacognitive Assessment Scale-Abbreviated (MAS-A).
A deficit of synthetic metacognition occurs probably in a close relationship to psychological mechanism of splitting or mental disorganization in schizophrenia and synthetic metacognition could be considered as a reciprocal function in relation to splitting. In this respect the assessment of synthetic metacognition could be a perspective method for further research into the links between mental and neuronal disorganization in schizophrenia.
Psychotherapies focused on strengthening of metacognitive functions concentrate on integration of fragmented mental content or on promoting of formation of stable mental representations in schizophrenia. With the help of the measurement of synthetic metacognition in the course of psychotherapy it is possible to predict a development of therapeutic alliance or to follow an increase in metacognition or to direct the content and focus of interventions.