Neurocognitive insight and executive functioning in schizophrenia

Prouteau, A.; Atzeni, Thierry; Tastet, Hélène; Bergua, Valérie; Destaillats, Jean-Marc; Verdoux, Hélène

doi:10.1080/13546805.2014.973486

Cited by 5 publications

(5 citation statements)

References 20 publications

(25 reference statements)

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“…However, investigations of the accuracy of self-reported cognitive functioning in individuals with schizophrenia have predominantly found little correspondence between subjective self-assessments of cognition and objective neuropsychological measures. This is true of both global cognitive abilities (Chang et al, 2015; Ehmann, Goldman, Yager, Xu, & MacEwan, 2007; Johnson, Tabbane, Dellagi, & Kebir, 2011; Keefe, Poe, Walker, Kang, & Harvey, 2006; Poletti et al, 2012; Prouteau et al, 2015; Saperstein, Thysen, & Medalia, 2012) and specific cognitive domains including attention, memory, and executive function (Gilleen, Greenwood, & David, 2011; Medalia & Lim, 2004; Prouteau et al, 2004). Low correspondence of self-report information with neuropsychological performance does not appear to be strongly correlated with positive symptomology (Chang et al, 2015; Medalia & Lim, 2004; Medalia, Thysen, & Freilich, 2008), nor is it restricted to those with lower cognitive performance.…”

Section: Self-reported Cognition In Schizophreniamentioning

confidence: 99%

Profiles of self-evaluation as a metacognitive skill: An indicator of rehabilitation potential among people with schizophrenia.

Harris¹,

Rempfer²

2020

Psychiatric Rehabilitation Journal

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Objective: The purpose of this study is to identify subgroups of people with schizophrenia on the basis of self-assessment accuracy (metacognition) and examine group differences in rehabilitation potential. Method: Participants were 51 individuals with schizophrenia-spectrum disorders recruited from community mental health centers. Data from a self-report measure of cognition and a neuropsychological battery were compared and utilized to place participants in 3 accuracy groups: overestimators, accurate estimators, and underestimators. A multivariate analysis of variance was used to compare performance between accuracy groups on an index of rehabilitation potential. Results: Three distinct profiles of metacognitive ability were identified. The analysis found that participants who underestimated their cognitive functioning had the highest scores on an index of rehabilitation potential (learning potential), and those who overestimated their functioning had the lowest. No significant differences in diagnostic or sociodemographic variables were found among accuracy groups. Conclusions and Implications for Practice: Results suggest that there are differences in the way people with schizophrenia evaluate their cognition and, further, these metacognitive profiles are associated with differences in the ability to learn new tasks quickly. Thus, identifying subgroups of individuals based on metacognitive processing may help identify those most likely to benefit from cognitive remediation and other rehabilitative therapies. Future research should explore the link between metacognitive ability and rehabilitation potential in greater detail. Future investigations should also clarify the implications that underestimation of ability has for overall recovery and quality of life in people with schizophrenia.

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Section: Self-reported Cognition In Schizophreniamentioning

confidence: 99%

Profiles of self-evaluation as a metacognitive skill: An indicator of rehabilitation potential among people with schizophrenia.

Harris¹,

Rempfer²

2020

Psychiatric Rehabilitation Journal

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“…Of all 12 papers in this review that examined the relationship between self-assessment and depression, only 3 [22,24,35] failed to find any significant relationship.…”

Section: Predictors Of Self-report Concordancementioning

confidence: 82%

“…Prouteau et al [22] split participants with schizophrenia into two subgroups based on their performance on the Trail Making Test (TMT): a subgroup identified as "executively normal" and a "dysexecutive" subgroup. Researchers then calculated discrepancy scores using the SSTICS and performance on the Modified Card Sorting Test (MCST) to represent neurocognitive insight and compared the two subgroups to each other and a control group.…”

Section: Self-reported Cognitionmentioning

confidence: 99%

“…Self-reported cognition appears to often be discordant with neuropsychological tests [15,17,19,20], though greater cognitive insight may increase correspondence [16,19]. Importantly, one study found that SSD groups with better executive functioning estimated their cognitive ability similarly to a healthy control group [22], and another found good concordance between subjective estimates and performance [25].…”

Section: Self-reported Cognitionmentioning

confidence: 99%

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The Discrepancy between Subjective and Objective Evaluations of Cognitive and Functional Ability among People with Schizophrenia: A Systematic Review

Harris,

Blanco,

Howie

et al. 2023

Behavioral Sciences

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Background: An important aspect of recovery in schizophrenia relates to one’s subjective, lived experience. Self-report is a subjective measurement method with yet-uncertain utility in the assessment of functioning among individuals diagnosed with schizophrenia-spectrum disorder. No review to date has comprehensively synthesized existing research to evaluate the degree of correspondence, or lack thereof, between subjective and objective assessments of cognitive and everyday functioning, nor how extant data can inform the use of self-reported information in treatment and research. Methods: A systematic review was completed to provide a broad perspective of the literature on this topic. Relevant manuscripts were identified via a search strategy using key terms in PubMed and PsycINFO and a review of manuscript bibliographies. Twenty-six studies met the inclusion criteria. Results: These studies show minimal to modest associations between subjective assessments of cognition and everyday functioning and objective assessments of these domains, including informant reports and neuropsychological and behavioral measures. Individuals with schizophrenia appear to overestimate their functioning when compared to objective measures. Depression and greater cognitive ability tend to predict greater correspondence between subjective and objective assessments of cognition and everyday functioning. Discussion: This review discusses how we might understand the low correspondence between subjective and objective measures of functioning and provides recommendations for using and eliciting self-reported information in the pursuit of recovery-centered practices.

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“…These results suggest that levels of depressive symptoms and cognitive performance are crucial signals determining the accuracy and direction (underestimation or overestimation) of patients’ subjective self-reported evaluations of their own cognitive impairments. Furthermore, it has been suggested that weakened executive function [ 11 , 12 ] and autistic traits [ 13 ] are also determinants of IA impairment. To date, the problem of self-assessment in patients with schizophrenia has been investigated by comparing the patient's self-rating with informant-rating (high-contact clinician or case manager, or patient’s family member) or using correlations between self-rating and performance of objective neuropsychological tests [ 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

Premorbid intellectual ability in schizophrenia influence family appraisal related to cognitive impairments: a cross-sectional study on cognitive impairment and family assessments

et al. 2022

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Background Patients with schizophrenia are unaware of their cognitive impairments. Misperception of cognitive impairment is an important factor associated with real-world functional outcomes in patients with schizophrenia. The patient’s family member plays a crucial role in detecting patients’ cognitive impairments when the patients are unaware of their own cognitive impairments. Previous studies have reported that not only the patient’s subjective rating, but also the patient’s family members’ rating of their cognitive impairment may not be precise. However, it is unclear why family ratings are inaccurate, and which factors impact family ratings. This study investigated whether family ratings differed significantly from the patients’ subjective ratings of the patients’ cognitive impairments and sought to determine the reason for the differences between the family ratings and the patients’ neurocognitive performances. We investigated the relationship between patients’ subjective ratings, family ratings for patients’ cognitive impairments, neuropsychological performance, and other aspects, including premorbid IQ and clinical symptoms. Method We evaluated 44 patients with schizophrenia for cognitive function using neuropsychological tests; in addition, both the patients and their families rated the patients’ cognitive impairments through questionnaires. We used the Mann–Whitney U test to examine whether the family ratings differed significantly from the patients’ self-reported ratings of their cognitive impairment. We conducted multiple regression analysis and structural equation modeling to determine why the patients’ subjective ratings and the family ratings were not definitively associated with the patients’ neurocognitive performances. We performed multiple regression analysis with a stepwise method with neurocognitive performance, premorbid IQ, positive symptoms, and negative symptoms as independent variables and family ratings of patients’ cognitive impairments as dependent variables. Results We found that the family ratings differed significantly from the patients’ subjective self-reported ratings of their cognitive impairments. Our results showed that the premorbid IQ of patients is the strongest predictor of family ratings. Furthermore, among the neurocognitive domains, only the processing speed of patients was associated with family ratings. Conclusions We found that the family ratings were not consistent with the patients’ subjective self-reported ratings and the family ratings were most affected by the patients’ premorbid intellectual abilities. These results suggest that the families’ current assessments of the patients’ current cognitive impairments were affected by the patients’ premorbid intellectual ability rather than the patients’ current neurocognitive performance. Patients’ processing speed predicted family ratings; however, family members' ratings were not related to verbal learning/memory, executive function, and language of patients. Therefore, our findings highlight that patients’ family ratings may differ from patients’ subjective ratings, results of performance-based neuropsychological tests, and clinician ratings.

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Neurocognitive insight and executive functioning in schizophrenia

Abstract: These results provide support for the hypothesis that executive dysfunctioning is a limiting factor for NI, independently from depressive and anxiety symptoms.

Cited by 5 publications

References 20 publications

Profiles of self-evaluation as a metacognitive skill: An indicator of rehabilitation potential among people with schizophrenia.

Profiles of self-evaluation as a metacognitive skill: An indicator of rehabilitation potential among people with schizophrenia.

The Discrepancy between Subjective and Objective Evaluations of Cognitive and Functional Ability among People with Schizophrenia: A Systematic Review

Premorbid intellectual ability in schizophrenia influence family appraisal related to cognitive impairments: a cross-sectional study on cognitive impairment and family assessments

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