Evidence accumulation in the pre-supplementary motor area and insula drives confidence and changes of mind.

Evidence accumulation is a powerful mechanism to explain the temporal dynamics of decisions, as well as their metacognitive components such as confidence judgments and changes of mind. However, it is still unclear how and where in the brain evidence accumulation leads to these two metacognitive components. We report intracranial high-gamma activity in patients with epilepsy recorded while they perform a visual discrimination task and estimate their confidence level.

Confidence in visual detection, familiarity and recollection judgments is preserved in schizophrenia spectrum disorder.

An effective way to quantify metacognitive performance is to ask participants to estimate their confidence in the accuracy of their response during a cognitive task. A recent meta-analysis raised the issue that most assessments of metacognitive performance in schizophrenia spectrum disorders may be confounded with cognitive deficits, which are known to be present in this population. Therefore, it remains unclear whether the reported metacognitive deficits are metacognitive in nature or rather inherited from cognitive deficits.

Preserved electrophysiological markers of confidence in schizophrenia spectrum disorder.

A large number of behavioral studies suggest that confidence judgments are impaired in schizophrenia, motivating the search for neural correlates of an underlying metacognitive impairment. Electrophysiological studies suggest that a specific evoked response potential reflecting performance monitoring, namely the error-related negativity (ERN), is blunted in schizophrenia compared to healthy controls. However, attention has recently been drawn to a potential confound in the study of metacognition, namely that lower task-performance in schizophrenia compared to healthy controls involves a decreased index of metacognitive performance (where metacognitive performance is construed as the ability to calibrate one's confidence relative to response correctness), independently of metacognitive abilities among patients.

Metacognitive improvement: Disentangling adaptive training from experimental confounds.

Metacognition is defined as the capacity to monitor and control one's own cognitive processes. Recently, Carpenter and colleagues (2019) reported that metacognitive performance can be improved through adaptive training: healthy participants performed a perceptual discrimination task, and subsequently indicated confidence in their response. Metacognitive performance, defined as how much information these confidence judgments contain about the accuracy of perceptual decisions, was found to increase in a group of participants receiving monetary reward based on their confidence judgments over hundreds of trials and multiple sessions.

Systematic review and meta-analysis of metacognitive abilities in individuals with schizophrenia spectrum disorders.

Metacognitive deficits are well documented in schizophrenia spectrum disorders as a decreased capacity to adjust confidence to performance in a cognitive task. Because metacognitive ability directly depends on task performance, metacognitive deficits might be driven by lower task performance among patients. To test this hypothesis, we conducted a Bayesian meta-analysis of 42 studies comparing metacognitive abilities in 1425 individuals with schizophrenia compared to 1256 matched controls.