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.

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 respon...

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Detalles Bibliográficos
Autores: Goncalves A, Lamarca M, Moritz S, Gaweda L, Acuña V, König C, Berna F, Ochoa S
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:Fundació Sant Joan de Déu
Repositorio:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:dnet:r-fsjd______::1ef704f9e49134df1c044980b9170691
Acceso en línea:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=30382
Access Level:acceso abierto
Palabra clave:Insight
Jumping to conclusions
MCT
Metacognitive training
Psychosis
Sex differences
Descripción
Sumario: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.