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This study investigates the effectiveness of Individualised Metacognitive Training (MCT+) in reducing personal stigma among individuals with recent\u2010onset psychosis, with a focus on sex\u2010specific outcomes and the predictive roles of self\u2010certainty, self\u2010esteem and quality of life (QoL). A randomised controlled trial was conducted across multiple Spanish clinical sites, comparing MCT+ with treatment as usual. Participants were assessed at baseline, post\u2010treatment and 6\u2010month follow\u2010up using validated measures of stigma, cognitive insight, QoL and self\u2010esteem. Robust linear mixed models revealed that MCT+ significantly reduced perceived stigma over time, with QoL emerging as a strong predictor of perceived stigma levels. However, no significant effects were observed for internalised stigma, although self\u2010certainty was positively associated with its severity. Exploratory analyses suggested potential sex differences in stigma trajectories, with males showing greater improvements in internalised stigma. These findings highlight the nuanced impact of metacognitive interventions on stigma and underscore the importance of tailoring treatments to individual psychosocial and cognitive profiles. Future research should explore gender\u2010sensitive adaptations of MCT+ and the inclusion of targeted self\u2010stigma modules to enhance intervention efficacy.<\/jats:p>","DOI":"10.1002\/cpp.70171","type":"journal-article","created":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T07:00:33Z","timestamp":1762844433000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Role of Sex, Quality of Life, Self\u2010Esteem and Cognitive Insight in Reducing Personal Stigma in Psychosis"],"prefix":"10.1002","volume":"32","author":[{"given":"Maria","family":"Lamarca","sequence":"first","affiliation":[{"name":"Parc Sanitari Sant Joan de D\u00e9u  Sant Boi de Llobregat Barcelona Spain"},{"name":"MERITT Group, Fundaci\u00f3 Sant Joan de D\u00e9u Institut Sant Joan de D\u00e9u  Esplugues de Llobregat Barcelona Spain"},{"name":"Consorcio de Investigaci\u00f3n Biom\u00e9dica en Red de Salud Mental Instituto de Salud Carlos 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