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Schizophrenia Bulletin Advance Access originally published online on January 5, 2006
Schizophrenia Bulletin 2006 32(2):310-326; doi:10.1093/schbul/sbj035
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© The Author 2006. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Real-World Cognitive—and Metacognitive—Dysfunction in Schizophrenia: A New Approach for Measuring (and Remediating) More "Right Stuff"

Danny Koren1,2,3,, Larry J Seidman2, Morris Goldsmith3 and Phillip D Harvey4
2 Department of Psychiatry, Harvard Medical School, Boston, MA
3 Department of Psychology, University of Haifa, Haifa, Israel
4 Department of Psychiatry, Mt. Sinai School of Medicine, New York, NY

1To whom correspondence should be addressed; e-mail: dkoren{at}psy.haifa.ac.il.

While the role of impaired cognition in accounting for functional outcome in schizophrenia is generally established by now, the overlap is far from complete. Moreover, little is known about the potential mechanisms that bridge between cognition and functional outcome. The aim of this article is to aid in closing this gap by presenting a novel, more ecologically valid approach for neuropsychological assessment. The new approach is motivated by the view that metacognitive processes of self-monitoring and self-regulation are fundamental determinants of competent functioning in the real world. The new approach incorporates experimental psychological concepts and paradigms used to study metacognition into current standard neuropsychological assessment procedures. Preliminary empirical data that support and demonstrate the utility of the new approach for assessment, as well as remediation efforts, in schizophrenia are presented and discussed.

Keywords: Cognition / metacognition / real-world functioning / schizophrenia / ecological validity


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