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The Effect of Alexithymia, Metacognitive Beliefs and Self‐Efficacy on Disability in Patients With Schizophrenia: A Cross‐Sectional Study

Year: 2026

Type: article

Abstract: INTRODUCTION: Schizophrenia is a chronic mental disorder and one of the leading causes of disability worldwide, with greater levels of disability being associated with lower general self-efficacy. Reducing disability and enhancing self-sufficiency in individuals diagnosed with schizophrenia are among the primary goals of treatment and care. AIM: This study aimed to examine the effects of alexithymia and metacognitive beliefs on self-efficacy levels and disability in individuals diagnosed with schizophrenia. METHODS: The study was conducted with 145 individuals under the age of 30 (67 individuals diagnosed with schizophrenia and 78 healthy controls) using a descriptive and correlational design. Data were collected using a sociodemographic data form, the Toronto Alexithymia Scale (TAS-20), the Metacognition Questionnaire (MCQ-30), the General Self-Efficacy Scale (GSES) and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). RESULTS: Compared to the control group, the patient group demonstrated significantly higher TAS-20, MCQ-30 and WHODAS 2.0 scores, and significantly lower GSES scores (p < 0.05). The patients' total MCQ-30 scores were significantly associated with both WHODAS 2.0 and GSES scores (p < 0.05); however, TAS-20 did not mediate the relationship between MCQ-30 and WHODAS 2.0 (p > 0.05), whereas it showed a significant mediating effect in the relationship between MCQ-30 and GSES (p < 0.05). DISCUSSION: Patients exhibited higher disability and lower general self-efficacy than the control group. Cognitive-behavioural and metacognitive therapeutic approaches targeting alexithymia may contribute to improved functioning and reduced disability in individuals with schizophrenia. IMPLICATIONS FOR PRACTICE: The findings improve understanding of factors related to disability and diminished general self-efficacy in individuals with schizophrenia and may inform the development of targeted psychosocial interventions. RELEVANCE STATEMENT: Self-efficacy and disability are key determinants of recovery in schizophrenia. By demonstrating the roles of alexithymia and metacognitive beliefs, this study provides a conceptual framework to guide clinical practice and supportive care strategies.

Source: Journal of Psychiatric and Mental Health Nursing

DOI: 10.1111/jpm.70126

Authors: Hatice Polat, Kerim Uğur, Tunahan Sun

Institutions: Malatya Turgut Özal Üniversitesi, Turgut Özal University

Language: English

Topic: Schizophrenia research and treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $4,850