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Insight and cognitive deficits in schizophrenia: evidence for a curvilinear relationship

Published online by Cambridge University Press:  09 July 2009

Mike Startup*
Affiliation:
Department of Psychology, University College of North Wales, Bangor
*
1Address for correspondence: Dr Mike Startup, Department of Psychology, University College of North Wales, Bangor, Gwynedd LL57 2DG.

Synopsis

Both motivational and defect theories have been offered to explain variations in insight among schizophrenic individuals but the results of tests of these theories have been inconclusive and inconsistent. The present study was designed to test the hypothesis that both motivation and cognitive deficits affect insight, with a trade-off between the two processes, giving rise to quadratic relationships between insight and cognitive deficits. Twenty-six schizophrenic patients completed battery of neuropsychological tests and participated in an interview designed to assess insight. In a multiple regression analysis predicting test results from insight scores, the linear component was non-significant while the quadratic component accounted for a highly significant 56% of the variance. Theoretical and clinical implications of this result are discussed briefly.

Type
Brief Communication
Copyright
Copyright © Cambridge University Press 1996

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References

Amador, X. F., Strauss, D. H., Yale, S. A. & Gorman, J. M. (1991). Awareness of illness in schizophrenia. Schizophrenia Bulletin 17, 113132.CrossRefGoogle ScholarPubMed
Amador, X. F., Flaum, M., Andreason, N. C., Strauss, D. H., Yale, S. A., Clark, S. C. & Gorman, J. M. (1994). Awareness of illness in schizophrenia and schizoaffective and mood disorders. Archives of General Psychiatry 51, 826836.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn. revised). American Psychiatric Association: Washington, DC.Google Scholar
Baddeley, A., Emslie, H. & Nimmo-Smith, I. (1993). The Spot-the-Word test: a robust estimate of verbal intelligence based on lexical decision. British Journal of Clinical Psychology 32, 5566.CrossRefGoogle Scholar
Bentall, R. P., Kinderman, P. & Kaney, S. (1994). The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions. Behaviour Research and Therapy 32, 331341.CrossRefGoogle Scholar
Cohen, J. & Cohen, P. (1983). Applied Multiple Regression/Correlation Analysis for the Behavioral Sciences (2nd edn). Lawrence Erlbaum: London.Google Scholar
Crawford, J. R., Obonsawin, M. C., & Bremner, M. (1993). Frontal lobe impairment in schizophrenia: relationship to intellectual functioning. Psychological Medicine 23, 787790.CrossRefGoogle ScholarPubMed
Cuesta, M. J. & Peralta, V. (1994). Lack of insight in schizophrenia. Schizophrenia Bulletin 20, 359366.CrossRefGoogle ScholarPubMed
Lezak, M. D. (1983). Neuropsychological Assessment (2nd edn). Oxford University Press: Oxford.Google Scholar
Liddle, P. F. & Morris, D. L. (1991). Schizophrenic syndromes and frontal lobe performance. British Journal of Psychiatry 158, 340345.CrossRefGoogle ScholarPubMed
Lysaker, P. & Bell, M. (1995). Work rehabilitation and improvements in insight in schizophrenia. Journal of Nervous and Mental Disease 183, 103106.CrossRefGoogle ScholarPubMed
Lysaker, P., Bell, M., Milstein, R., Bryson, G. & Beam-Goulet, J. (1994). Insight and psychosocial treatment compliance in schizophrenia. Psychiatry 57, 289297.CrossRefGoogle ScholarPubMed
McEvoy, J. P., Apperson, L. J., Appelbaum, P. S., Ortlip, P., Brecosky, J., Hammill, K., Geller, J. L. & Roth, L. (1989 a). Insight in schizophrenia: its relationship to acute psychopathology. Journal of Nervous and Mental Disease 177, 4347.CrossRefGoogle ScholarPubMed
McEvoy, J. P., Freter, S., Everatt, G., Geller, J. L., Appelbaum, P., Apperson, L. J. & Roth, L. (1989 b). Insight and the clinical outcome of schizophrenic patients. Journal of Nervous and Mental Disease 177, 4851.CrossRefGoogle ScholarPubMed
McGlynn, S. M. & Schacter, D. L. (1989). Unawareness deficits in neuropsychological syndromes. Journal of Clinical and Experimental Neuropsychology 11, 143205.CrossRefGoogle ScholarPubMed
Miller, E. (1984). Verbal fluency as a function of a measure of verbal intelligence and in relation to different types of cerebral pathology. British Journal of Clinical Psychology 23, 5357.CrossRefGoogle ScholarPubMed
Milner, B. (1965). Visually-guided maze-learning in man: effects of bilateral hippocampal, bilateral frontal, and unilateral cerebral lesions. Neuropsychologia 3, 317338.CrossRefGoogle Scholar
Raven, J. C., Court, J. H. & Raven, J. (1988). Manual for Raven's Progressive Matrices and Vocabulary Scales. H. K. Lewis: London.Google Scholar
Reitan, R. M. (1958). Validity of the Trail Making test as an indicator of organic brain damage. Perceptual and Motor Skills 8, 271276.CrossRefGoogle Scholar
Shallice, T. & Evans, M. E. (1978). The involvement of the frontal lobes in cognitive estimation. Cortex 14, 294303.CrossRefGoogle ScholarPubMed
Shallice, T., Burgess, P. W. & Frith, C. D. (1991). Can the neuropsychological case-study approach be applied to schizophrenia? Psychological Medicine 21, 661673.CrossRefGoogle ScholarPubMed
Shoqeirat, M. A., Mayes, A., MacDonald, C., Meudell, P. & Pickering, A. (1990). Performance on tests sensitive to frontal lobe lesions by patients with organic amnesia: Leng & Parkin revisited. British Journal of Clinical Psychology 29, 401408.CrossRefGoogle ScholarPubMed
Startup, M. (1995). A microcomputer-based version of the Stylus Maze Test. Unpublished manuscript. University of Wales, Bangor, UK.Google Scholar
Taylor, K. E. & Perkins, R. E. (1991). Identity and coping with mental illness in long-stay psychiatric rehabilitation. British Journal of Clinical Psychology 30, 7385.CrossRefGoogle ScholarPubMed
Taylor, S. E. & Brown, J. D. (1988). Illusion and well-being: a social psychological perspective on mental health. Psychological Bulletin 103, 193210.CrossRefGoogle ScholarPubMed
Thompson, E. H. (1988). Variation in the self-concept of young adult chronic patients: chronicity reconsidered. Hospital and Community Psychiatry 39, 771775.Google ScholarPubMed
Trenerry, M. R., Crosson, B., DeBoe, J. & Leber, W. R. (1989). Manual to the Stroop Neuropsychological Screening Test. Psychological Assessment Resources: Odessa, FL.Google Scholar
Warner, R., Taylor, D., Powers, M. & Hyman, J. (1989). Acceptance of the mental illness label by psychotic patients: effects on functioning. American Journal of Orthopsychiatry 59, 398409.CrossRefGoogle ScholarPubMed
Young, D. A., Davila, R. & Scher, H. (1993). Unawareness of illness and neuropsychological performance in chronic schizophrenia. Schizophrenia Research 10, 117124.CrossRefGoogle ScholarPubMed