Psychotic symptoms and dissociative symptoms in the general population: their prospective association and the predictive effects of metacognitive dysfunctions

Despite converging evidence suggesting that subclinical psychotic and dissociative symptoms frequently co-occur in non-patients, it has been increasingly recognised that symptoms may affect individuals not just independently, but also in interaction (Černis et al., 2022; Varese et al., 2011). The understanding of how symptoms interact prospectively are crucial to informing and conceptualising the dynamics of development of multiple symptoms or a syndrome. In addition to the temporal dynamics between symptoms, the onset of both set of symptoms may also be entailed by other psychological mechanisms. A dysfunction in metacognition, broadly defined as an individual’s capacity to ‘think about one’s thinking’ and/or to think about the thinking of others, is an established transdiagnostic risk factor for psychopathology. The two relevant approaches are: maladaptive metacognitive beliefs (Wells & Matthews, 1996) measured by Metacognitive Questionnaire (MCQ-30), and deficits in synthetic metacognitive functioning (Lysaker et al., 2020, 2021) measured by Metacognition Self Assessment Scale (MSAS). Both approaches maintain that metacognition is a multidimensional construct consisting of distinct but interrelated aspects and/or abilities, and that deficits in the specific aspects/abilities could be differentially linked to specific symptoms. The objective of the current study is to explore the dynamics between psychotic and dissociative symptoms prospectively in a non-clinical sample. Secondly, this study will model the role of distinct sub-domains of metacognition on the development of psychosis and dissociation. Correspondingly, the first aim is to elucidate the nature of bidirectionality between psychotic and dissociative symptoms using a prospective approach in a non-clinical sample. Secondly, this study examines the independent predictive effect of individual dimensions of dysfunctional metacognitions on psychotic and dissociative symptoms respectively.