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

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.

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Posted in: Journal Article Abstracts on 03/28/2026 | Link to this post on IFP |
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