I-AM-ME onderzoek

Interactions of Aggression, Mentalizing, Metacognition and Empathy in a forensic population of persons with a psychotic disorder. 

This study compares persons with a psychotic disorder currently in treatment at a forensic clinic (F-P), with patients with a psychotic disorder currently not in treatment at a forensic clinic (P) and with healthy controls (HC). Confounders such as current mood state, threat/control-override (TCO), temperament and character, trauma and the existence of a diagnosis of psychopathy will be statistically controlled for. 

The study will test four hypotheses:

  1. (F-P) show a pattern of more affective metacognitive impairments than (HC) and (P). Cognitively oriented aspects of metacognition are expected to be equally impaired in (P) and (F-P) (Abu-Akel & Abushua’leh, 2004; Bogaerts, Polak, Spreen, & Zwets, 2012).
  2. We expect that in (F-P) deficits in metacognitive “mastery” as measured by the MASA are more severe than those found in (P), and correlate significantly with assessments of risk for future violence (Brüne, Schaub, Juckel, & Langdon, 2011; Lysaker, Erickson, Buck, et al., 2011; Lysaker, Erickson, Ringer, et al., 2011).
  3. We expect that in F-P metacognitive deficits in understanding others and empathy, are significantly correlated with “Clinical” items of the HKT-30 regarding Empathy, Hostility and Social and Relational skills.
  4. Persons with aggression where the primary explanation is positive psychotic will score elevated on measures of Threat/Control-override (TCO). This group will be more prone to impulsive violence as measured by the IPAS, while those with personality-related difficulties (psychopathic traits) will show a tendency toward premeditated violence as measured by the IPAS (Nederlof et al., 2011a; Nederlof, Muris, & Hovens, 2011b).

It is our hope that this study will provide a significant contribution not only to our understanding of the interactions between aggression and metacognition, but will also have direct clinical implications. We foresee that findings in this study will provide adequate choices in treatment paths for persons with a psychotic disorder in a forensic setting, and that the model constructed will assist in risk assessment for future violence in people with a psychotic disorder. Should the model constructed as a result of this data hold, factor analysis may provide the means to construct a singular, integrative test (or test battery) consisting of items and components that load best onto the various factors. After validation, such an instrument may make it possible to quantify the risk deficits in metacognitive capacity and empathy pose, in a more empirical manner than is currently available.

Rijksuniversiteit Groningen

drs. S. de Jong; dr. M. Pijnenborg; drs. H. Bokern; prof. dr. M. van der Gaag; dr. L. Wunderink;prof. dr. A. Aleman; dr. P. Lysaker; drs. R. van Donkersgoed