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We evaluated the effectiveness and acceptability of metacognitive interventions for mental disorders. We searched electronic databases and included randomized and nonrandomized controlled trials comparing metacognitive interventions with other treatments in adults with mental disorders. Primary effectiveness and acceptability outcomes were symptom severity and dropout, respectively. We performed random-effects meta-analyses. We identified Metacognitive Training (MCTrain), Metacognitive Therapy (MCTherap), and Metacognition Reflection and Insight Therapy (MERIT). We included 49 trials with 2,609 patients. In patients with schizophrenia, MCTrain was more effective than a psychological treatment (cognitive remediation, SMD = -0.39). It bordered significance when compared with standard or other psychological treatments. In a post hoc analysis, across all studies, the pooled effect was significant (SMD = -0.31). MCTrain was more effective than standard treatment in patients with obsessive-compulsive disorder (SMD = -0.40). MCTherap was more effective than a waitlist in patients with depression (SMD = -2.80), posttraumatic stress disorder (SMD = -2.36), and psychological treatments (cognitive-behavioural) in patients with anxiety (SMD = -0.46). In patients with depression, MCTherap was not superior to psychological treatment (cognitive-behavioural). For MERIT, the database was too small to allow solid conclusions. Acceptability of metacognitive interventions among patients was high on average. Methodological quality was mostly unclear or moderate. Metacognitive interventions are likely to be effective in alleviating symptom severity in mental disorders. Although their add-on value against existing psychological interventions awaits to be established, potential advantages are their low threshold and economy.
Cognitive representations and beliefs are what comprise an individual’s self-concept. A positive self-concept is related to and influences academic achievement, and the relationship between a domain-specific self-concept and achievement in the same domain is positive and strong. However, insufficient attention has been paid to these issues among multilingual children. More importantly, since instruction strongly contributes to the development of metacognition and executive functions (EFs), and since the bilingual advantage hypothesis holds that the constant management of multiple languages entails benefits for EF, we bring together these important issues in the present study. We examine the relationship between domain-specific self-concepts and standardized assessment of reading and spelling competences against the background of potential differences in self-concept between monolingual and multilingual German children. While between-group comparisons revealed no significant differences for self-concept nor reading competency, monolinguals outperformed multilinguals in spelling. Correlations between domain-specific self-concepts and academic achievement in reading comprehension, reading fluency, and spelling were positive and significant for both groups. Regardless of language background, children’s evaluations of their academic achievement (reading and spelling) were realistic. We argue, on a theoretical basis, that metacognition and EFs could facilitate a bilingual advantage and improve educational outcomes.