Background/Objective: Determining the predictive variables associated with levels of alcohol craving can ease the identification of patients who can benefit from treatments. This study aimed to describe changes (improvement or no change/deterioration) in alcohol craving levels and explore the predictors of these changes from admission to discharge in outpatients with alcohol use disorder (AUD) undergoing treatment-as-usual (TAU), or treatment-as-usual supplemented with virtual reality cue-exposure therapy (TAU + VR-CET). Method: A prospective cohort study was conducted amongst 42 outpatients with AUD (n = 15 TAU + VR-CET and n = 27 TAU) from a clinical setting. Changes in the levels of alcohol craving between admission and discharge were assessed with the Multidimensional Alcohol Craving Scale. Sociodemographic characteristics (age, gender, education, and socioeconomic and civil status), cognitive-affective behavioral patterns (AUD severity, abstinence duration, psychiatric comorbidity, state anxiety, attentional bias, and substance use), and type of treatment (TAU + VR-CET and only TAU) were also evaluated. Results: The TAU + VR-CET group showed greater changes of improvement in the levels of alcohol craving than the TAU group (χ2 = 10.996; p = 0.001). Intragroup changes in alcohol craving from pre to post-treatment were significant in the TAU + VR-CET group (χ2 = 13.818; p = 0.003) but not within the TAU group (χ2 = 2.349; p = 0.503). The odds of an improvement in any of the craving levels between pre- and post-test was 18.18 (1/0.055) times higher in the TAU + VR-CET group with respect to the TAU group. The use of illicit drugs in the month prior to the test increased the odds of having a positive change by 18.18 (1/0.055) with respect to not having consumed. Conclusions: Including VR-CET in TAU programs may provide benefits in the treatment of AUDs mainly among patients with intense alcohol craving and individuals having used illicit substances prior to treatment.
Background: Metacognitive training (MCT) has demonstrated its efficacy in psychosis. However, the effect of each MCT session has not been studied. The aim of the study was to assess changes in cognitive insight after MCT: (a) between baseline, post-treatment, and follow-up; (b) after each session of the MCT controlled for intellectual quotient (IQ) and educational level. Method: A total of 65 patients with first-episode psychosis were included in the MCT group from nine centers of Spain. Patients were assessed at baseline, post-treatment, and 6 months follow-up, as well as after each session of MCT with the Beck Cognitive Insight Scale (BCIS). The BCIS contains two subscales: self-reflectiveness and self-certainty, and the Composite Index. Statistical analysis was performed using linear mixed models with repeated measures at different time points. Results: Self-certainty decreased significantly (p = 0.03) over time and the effect of IQ was negative and significant (p = 0.02). From session 4 to session 8, all sessions improved cognitive insight by significantly reducing self-certainty and the Composite Index. Conclusions: MCT intervention appears to have beneficial effects on cognitive insight by reducing self-certainty, especially after four sessions. Moreover, a minimum IQ is required to ensure benefits from MCT group intervention.
11 August 2021 in Journal of Gerontological Social Work
The use of Information and Communication Technologies (ICTs) for information-seeking, social contact and leisure activities is increasing in adults and older people. However, little is known about adults and older people who are already actively using ICTs to write a blog. The aim of this paper is to describe the benefits adults and older people gain from having a blog. Twenty-three older adult bloggers (aged 60–83 years; most of them with college degrees and retired) from Spain who, at the time of the study had an active blog were interviewed. A thematic analysis identified four different benefits related to blogging: (1) a general sense of satisfaction from producing the blog; (2) relational benefits; (3) cognitive benefits; and (4) identity benefits. Results showed that adults and older people experienced a variety of benefits that broadens the distinction between personal and social benefits found in previous research. Blogging in later life challenges the traditional passive/consumer and online user experience view of adults and older people and seems to be a good example of proactive participation through websites.
This study investigates, for the first time, clinical, cognitive, social cognitive and metacognitive differences in people diagnosed with first-episode of psychosis (FEP) with and without a family history of mental disorder split by maternal and paternal antecedents. A total of 186 individuals with FEP between 18 and 45 years old were recruited in community mental-health services. A transversal, descriptive, observational design was chosen for this study. Results suggest that there is a higher prevalence of maternal history of psychosis rather than paternal, and furthermore, these individuals exhibit a specific clinical, social and metacognitive profile. Individuals with a maternal history of mental disorder scored higher in delusional experiences, inhibition of the response to a stimulus and higher emotional irresponsibility while presenting a poorer overall functioning as compared to individuals without maternal history. Individuals with paternal history of mental disorder score higher in externalizing attributional bias, irrational beliefs of need for external validation and high expectations. This study elucidates different profiles of persons with FEP and the influence of the maternal and paternal family history on clinical, cognitive, social and metacognitive variables, which should be taken into account when offering individualized early treatment.
1 January 2026 in Clinical Psychology & Psychotherapy
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.
Background: University transition is often accompanied by psychological strain and lifestyle changes that may increase vulnerability to mental health and cognitive difficulties. Randomized evidence examining exercise-based, mindfulness-based, and movement-based mind–body interventions within one study remains limited. This study examined psychological and cognitive outcomes across three online interventions in university students. Methods: In this three-arm randomized controlled trial, 53 university students aged 18–25 years were randomly allocated to 12 weeks of high-intensity functional training (HIFT; n = 17), Mindfulness-Based Stress Reduction (MBSR; n = 18), or Qigong (QG; n = 18). Primary outcomes were the Depression Anxiety Stress Scales-21 (DASS-21) total score and cognitive composite scores for attention–processing speed, executive function, and memory. Secondary outcomes included mindfulness, self-esteem, physical activity, sleep quality, Mediterranean diet adherence, heart rate variability, and physical fitness. Linear mixed-effects models tested time-by-group interactions. Adherence, safety, and recruitment barriers were examined descriptively. Results: No clear between-group differences were detected in psychological distress or cognitive function. Overall intervention adherence was 83%. Memory and self-esteem improved within all three groups. The Observing mindfulness subscale showed a nominal time-by-group interaction, with a greater increase in MBSR than HIFT. Improvements in sleep quality were associated with reductions in psychological distress. Limited schedule availability was the most frequently recorded recruitment barrier. Conclusions: Psychological and cognitive outcomes showed broadly similar patterns across HIFT, MBSR, and QG. Shared within-group improvements and selected mindfulness-related signals warrant further investigation. Recruitment challenges highlight the value of flexible delivery in future university-based trials.