The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research

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Main Authors: Luciana Díaz‐Cutraro, Marina Verdaguer‐Rodriguez, Marta Ferrer‐Quintero, Roger Montserrat, Steffen Moritz, Paul Lysaker, Giancarlo Dimaggio, Carolina Palma‐Sevillano, María Lamarca, Victoria Espinosa, Rabea Fischer, Marina Peniza‐Soriano, Raquel López‐Carrilero, Helena García‐Mieres, Susana Ochoa
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Published: Wiley 2026
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author Luciana Díaz‐Cutraro
Marina Verdaguer‐Rodriguez
Marta Ferrer‐Quintero
Roger Montserrat
Steffen Moritz
Paul Lysaker
Giancarlo Dimaggio
Carolina Palma‐Sevillano
María Lamarca
Victoria Espinosa
Rabea Fischer
Marina Peniza‐Soriano
Raquel López‐Carrilero
Helena García‐Mieres
Susana Ochoa
author_facet Luciana Díaz‐Cutraro
Marina Verdaguer‐Rodriguez
Marta Ferrer‐Quintero
Roger Montserrat
Steffen Moritz
Paul Lysaker
Giancarlo Dimaggio
Carolina Palma‐Sevillano
María Lamarca
Victoria Espinosa
Rabea Fischer
Marina Peniza‐Soriano
Raquel López‐Carrilero
Helena García‐Mieres
Susana Ochoa
Luciana Díaz‐Cutraro
Marina Verdaguer‐Rodriguez
Marta Ferrer‐Quintero
Roger Montserrat
Steffen Moritz
Paul Lysaker
Giancarlo Dimaggio
Carolina Palma‐Sevillano
María Lamarca
Victoria Espinosa
Rabea Fischer
Marina Peniza‐Soriano
Raquel López‐Carrilero
Helena García‐Mieres
Susana Ochoa
collection Wiley Open Access
contents The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research Luciana Díaz‐Cutraro Marina Verdaguer‐Rodriguez Marta Ferrer‐Quintero Roger Montserrat Steffen Moritz Paul Lysaker Giancarlo Dimaggio Carolina Palma‐Sevillano María Lamarca Victoria Espinosa Rabea Fischer Marina Peniza‐Soriano Raquel López‐Carrilero Helena García‐Mieres Susana Ochoa Clinical Psychology & Psychotherapy ABSTRACT Impaired metacognition, the capacity to understand one's own and others' mental states, has gained increasing attention in psychosis research. Different conceptualizations, psychological treatments and assessment methods have emerged; however, there is a lack of consensus regarding the appropriate tools for clinical and research use. This systematic review had two aims: (1) to compile and organize available assessment tools and (2) to propose an index of metacognitive domains and processes. Instruments were categorized according to authorship, year of use in psychosis, outcomes assessed, language/version, administration time and type of Clinical Outcome Assessment (ClinRO, PRO or PerfO). We identified 42 studies that used 31 instruments. The tools were classified into four domains: Metacognitive Awareness, Metacognitive Capacity, Neurometacognition and Social Metacognition. Our findings highlight the diversity of the available measures and propose a framework for aligning instruments with specific reflective processes. This work represents a practical and theoretical first step toward building consensus and facilitating both the use of available tools according to practical needs and the development of an agreed‐upon definition and components of metacognition. 10.1002/cpp.70223 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/cpp.70223
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license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
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spellingShingle The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research
Luciana Díaz‐Cutraro
Marina Verdaguer‐Rodriguez
Marta Ferrer‐Quintero
Roger Montserrat
Steffen Moritz
Paul Lysaker
Giancarlo Dimaggio
Carolina Palma‐Sevillano
María Lamarca
Victoria Espinosa
Rabea Fischer
Marina Peniza‐Soriano
Raquel López‐Carrilero
Helena García‐Mieres
Susana Ochoa
Clinical Psychology & Psychotherapy
The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research Luciana Díaz‐Cutraro Marina Verdaguer‐Rodriguez Marta Ferrer‐Quintero Roger Montserrat Steffen Moritz Paul Lysaker Giancarlo Dimaggio Carolina Palma‐Sevillano María Lamarca Victoria Espinosa Rabea Fischer Marina Peniza‐Soriano Raquel López‐Carrilero Helena García‐Mieres Susana Ochoa Clinical Psychology & Psychotherapy ABSTRACT Impaired metacognition, the capacity to understand one's own and others' mental states, has gained increasing attention in psychosis research. Different conceptualizations, psychological treatments and assessment methods have emerged; however, there is a lack of consensus regarding the appropriate tools for clinical and research use. This systematic review had two aims: (1) to compile and organize available assessment tools and (2) to propose an index of metacognitive domains and processes. Instruments were categorized according to authorship, year of use in psychosis, outcomes assessed, language/version, administration time and type of Clinical Outcome Assessment (ClinRO, PRO or PerfO). We identified 42 studies that used 31 instruments. The tools were classified into four domains: Metacognitive Awareness, Metacognitive Capacity, Neurometacognition and Social Metacognition. Our findings highlight the diversity of the available measures and propose a framework for aligning instruments with specific reflective processes. This work represents a practical and theoretical first step toward building consensus and facilitating both the use of available tools according to practical needs and the development of an agreed‐upon definition and components of metacognition. 10.1002/cpp.70223 http://creativecommons.org/licenses/by/4.0/
title The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research
topic Clinical Psychology & Psychotherapy
url https://onlinelibrary.wiley.com/doi/10.1002/cpp.70223