Clinical insight in first episode psychosis: the role of metacognition

被引:7
作者
Wright, Abigail C. [1 ,2 ]
Lysaker, Paul H. [3 ,4 ]
Fowler, David [5 ,6 ]
Greenwood, Kathryn [5 ,6 ]
机构
[1] Massachusetts Gen Hosp, Dept Psychiat, Ctr Excellence Psychosocial & Syst Res, Boston, MA 02114 USA
[2] Harvard Med Sch, Dept Psychiat, Boston, MA 02115 USA
[3] Richard L Roudebush VA Med Ctr, Dept Psychiat, Indianapolis, IN USA
[4] Indiana Univ, Sch Med, Indianapolis, IN USA
[5] Univ Sussex, Sch Psychol, Brighton, E Sussex, England
[6] Sussex Partnership NHS Fdn Trust, Res & Dev Dept, Hove, England
关键词
First episode psychosis; clinical insight; cognitive insight; metacognition; positive symptoms; IQ; depression; negative symptoms; medication; COGNITIVE INSIGHT; INTERNALIZED STIGMA; SOCIAL COGNITION; ASSESSMENT SCALE; SELF-REFLECTION; SCHIZOPHRENIA; SYMPTOMS; 1ST-EPISODE; ASSOCIATIONS; ILLNESS;
D O I
10.1080/09638237.2021.1922629
中图分类号
B849 [应用心理学];
学科分类号
040203 ;
摘要
Background Poor clinical insight has been commonly reported in those with First Episode Psychosis (FEP) and thought to be influenced by a range of factors, including neurocognition and symptoms. Clinical insight may be compromised as a result of alterations in higher-level reflective processes, such as metacognitive ability and cognitive insight. Aims To explore whether metacognitive ability and cognitive insight are associated with clinical insight while controlling for IQ, depression, and symptoms in FEP. Methods 60 individuals with FEP completed measures for clinical insight, metacognitive ability, cognitive insight, positive and negative symptoms, depression, and IQ. Results Higher levels of metacognitive ability were associated with better clinical insight, even when controlling for IQ, depression, positive and negative symptoms, and medication. Integration subscale of metacognitive ability was most strongly associated with clinical insight. Cognitive insight was associated with clinical insight when controlling for covariates. However, when including metacognitive ability and cognitive insight in the predictive model, only metacognitive ability was significantly related to clinical insight. Discussion Metacognitive ability, specifically the ability to describe one's evolving mental state to provide a coherent narrative, was significantly related to clinical insight, independent of covariates, and may be a potentially important target for intervention in FEP.
引用
收藏
页码:78 / 86
页数:9
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