Sex differences in neurocognitive response to metacognitive training in first-episode psychosis: Implications for personalized interventions

PurposeNeurocognitive impairments are a core feature of psychosis and impact long-term outcomes. While sex differences in neurocognition have been observed in first-episode psychosis (FEP), findings remain mixed, and little is known about differential responses to metacognitive interventions. This s...

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Autores: Verdaguer-Rodríguez, M, Comas, JO, López-Carrilero, R, Díaz-Cutraro, L, Espinosa, V, Ruiz-Delgado, I, Barrigón, ML, Grasa, E, Pousa, E, González-Higueras, F, Cid, J, Lorente-Rovira, E, Barajas, A, Acevedo, A, Alonso-Solís, A, Anglès, J, Ansó, L, Argany, MA, Aznar, A, Beltrán, M, Birulés, I, Bogas, JL, Camprubí, N, Carbonero, M, Carrasco, E, Casañas, R, Conesa, E, Corripio, I, Cortes, P, De Apraiz, A, Delgado, M, Domínguez, L, Escartí, MJ, Escudero, A, Pinos, IE, Franco, C, García, C, Gonzalez-Casares, R, González-Montoro, MAL, González, E, Grasa-Bello, E, Guasp, A, Huerta-Ramos, ME, Huertas, P, Jiménez-Díaz, A, Lalucat, LL, Llacer, B, López-Frutos, A, Lorente, E, Luengo, A, Mantecón, N, Mas-Expósito, L, Montes, M, Moritz, S, Murgui, E, Nuñez, M, Palomer, E, Peláez, T, Planell, K, Planellas, C, Pleguezuelo-Garrote, P, Renovell, M, Rodríguez, N, Rubio, R, San Emeterio, M, Sánchez, E, Sánchez-Alonso, S, Sanjuán, J, Sans, B, Sió, H, Teixidó, M, Torres, P, Vidiella, M, Vila, MA, Vila-Badia, R, Villegas, F, Ochoa, S
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2026
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:dnet:incliva_____::b3d1b02bc80169dcd38924d2f5f9568f
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/20879
Access Level:acceso abierto
Palabra clave:Psychosis
Cognition
Psychological Interventions
Gender
Intersectionality
Descripción
Sumario:PurposeNeurocognitive impairments are a core feature of psychosis and impact long-term outcomes. While sex differences in neurocognition have been observed in first-episode psychosis (FEP), findings remain mixed, and little is known about differential responses to metacognitive interventions. This study examined sex differences in the effectiveness of Metacognitive Training (MCT) on neurocognitive outcomes in FEP.MethodsA total of 122 individuals with FEP were randomized to receive either MCT or psychoeducational intervention. Neurocognitive performance was assessed at baseline and at 6-month follow-up using a comprehensive battery (CPT-II, TMT, WCST, Stroop test, TAVEC, WAIS-III Digit Span). General Linear Models tested the effects of intervention, sex, and their interaction, both unadjusted and adjusted for covariates.ResultsMCT led to greater improvements than psychoeducation in immediate recall, processing speed, cognitive flexibility, inhibitory control, and attention. Improvements in immediate recall and Stroop Interference remained significant after adjustment, with Stroop performance also influenced by diagnosis. Across groups, men performed better in verbal memory, while women showed increased serial clustering in short-term recall, an effect that remained significant after adjustment. Notably, a group-by-sex interaction indicated that women receiving MCT experienced greater gains in short-term recall after controlling for covariates.ConclusionsMCT enhances specific neurocognitive functions in FEP and shows promising effects for women in verbal memory processes. These findings underscore the importance of incorporating sex and diagnostic factors when tailoring early interventions for psychosis and highlight the potential of MCT as a personalized cognitive strategy.

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