Theory of mind deficits in schizophrenia have been parsed into mental state
reasoning and mental state decoding components. We report that mental state
decoding as measured by the ‘Eyes task’ better predicted social
function than mental state reasoning as measured by the ‘Hinting
task’ in 73 out-patients with chronic schizophrenia. Mental state
decoding task performance also partly mediated the influence of basic
neuropsychological performance on social function. We discuss these findings
in terms of the accumulating evidence that mental state decoding has
particular relevance for understanding deficits in social function in
schizophrenia.
Poor insight is associated with impaired cognitive function in psychosis. Whether poor clinical insight overlaps with other aspects of self-awareness in schizophrenia, such as cognitive self-awareness, is unclear. We investigated whether awareness of clinical state ("clinical insight") and awareness of cognitive deficits ("cognitive insight") overlap in schizophrenia in a sample of 51 stabilized patients with chronic schizophrenia. Cognitive insight was assessed in terms of the agreement between subjective self-report and neuropsychological assessment. Patients who show good cognitive insight did not necessarily show good clinical insight. By contrast, self-report and objective neuropsychological assessment only correlated for patients in the intact clinical insight group and not for those in the impairment clinical insight group. We conclude that while good cognitive insight may not be necessary for good clinical insight, good cognitive awareness is at least partly reliant on the processes involved in clinical insight.
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