Are self-reports valid for schizophrenia patients with poor insight? Relationship of unawareness of illness to psychological self-report instruments

Bell, Morris D.; Fiszdon, Joanna M.; Richardson, Randall; Lysaker, Paul H.; Bryson, Gary

doi:10.1016/j.psychres.2006.04.012

Cited by 89 publications

(65 citation statements)

References 41 publications

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“…However, research has shown that personality domains can be reliably measured with self-report instruments and results are easy to obtain [57,68] , which renders such assessments relevant for clinical use.…”

Section: Discussionmentioning

confidence: 99%

Sensation/novelty seeking in psychotic disorders: A review of the literature

Peritogiannis¹

2015

WJP

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The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients' personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking (SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person's tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independently associated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients' aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients' quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders' course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients' accounts could inform clinicians when planning management and delivering individualized treatment. Core tip: This review summarizes current research on the personality trait sensation/novelty seeking (SNS) in psychotic disorders. There is an emerging literature on SNS in psychotic patients, suggesting that this trait is associated with patients' alcohol and substance misuse. Some evidence suggests that SNS may be related to medication non-adherence and aggressive behavior, whereas data on other illness dimensions, such as quality of life and psychopathology are scarce and controversial. In general, patients with psychotic disorders appear to have lower SNS levels than healthy controls, but abusing patients, who probably have high SNS levels are often excluded from research. REVIEWSubmit a

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Section: Discussionmentioning

confidence: 99%

Sensation/novelty seeking in psychotic disorders: A review of the literature

Peritogiannis¹

2015

WJP

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“…The use of self-report measures in schizophrenia to tap into psychological constructs has its disadvantages compared with objective or clinician-rated measures [47][48][49] ; however, there is also evidence that self-reports are equally valid instruments to measure abstract constructs in schizophrenia. 50 Additionally, given the nature of the psychological constructs studied, interview-based instruments may not accurately gauge a person's perspective of task value or enjoyment.…”

Section: Discussionmentioning

confidence: 99%

Expectancy-Value Theory in Persistence of Learning Effects in Schizophrenia: Role of Task Value and Perceived Competency

Choi

Fiszdon

Medalia

2010

Schizophrenia Bulletin

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Expectancy-value theory, a widely accepted model of motivation, posits that expectations of success on a learning task and the individual value placed on the task are central determinants of motivation to learn. This is supported by research in healthy controls suggesting that beliefs of selfand-content mastery can be so influential they can predict the degree of improvement on challenging cognitive tasks even more so than general cognitive ability. We examined components of expectancy-value theory (perceived competency and task value), along with baseline arithmetic performance and neuropsychological performance, as possible predictors of learning outcome in a sample of 70 outpatients with schizophrenia randomized to 1 of 2 different arithmetic learning conditions and followed up after 3 months. Results indicated that as with nonpsychiatric samples, perceived self-competency for the learning task was significantly related to perceptions of task value attributed to the learning task. Baseline expectations of success predicted persistence of learning on the task at 3-month follow-up, even after accounting for variance attributable to different arithmetic instruction, baseline arithmetic ability, attention, and self-reports of task interest and task value. We also found that expectation of success is a malleable construct, with posttraining improvements persisting at follow-up. These findings support the notion that expectancy-value theory is operative in schizophrenia. Thus, similar to the nonpsychiatric population, treatment benefits may be enhanced and better maintained if remediation programs also focus on perceptions of self-competency for the training tasks. Treatment issues related to instilling self-efficacy in cognitive recovery programs are discussed.

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“…Although self-report measures may have some disadvantages in assessing psychotic symptoms or assessing other symptoms in populations with psychosis (e.g., due to possible cognitive deficits, lack of awareness and/or insight, shame-related difficulties, social desirability -for a review see Bell, Fiszdon, Richardson, Lysaker, & Bryson, 2007) some studies have been emerging defending the use of self-report in this context. Regarding insight, it has been found that patients with schizophrenia are able to accurately report symptoms and personality characteristics and a distinction has been made between awareness of symptoms and awareness of illness (Bell et al, 2007), thus emphasizing the potential validity of self-report measures for this population.…”

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confidence: 99%

“…Regarding insight, it has been found that patients with schizophrenia are able to accurately report symptoms and personality characteristics and a distinction has been made between awareness of symptoms and awareness of illness (Bell et al, 2007), thus emphasizing the potential validity of self-report measures for this population. Rabinowitz et al (2008) also found results supporting the reliability and validity of patient reports, specifically for symptom severity, with a significant linear trend emerging between the clinician and patient-rated measures (differences between the clinician' s and patient' s ratings attributed to poor insight).…”

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confidence: 99%

“…The authors argued the validity of using self-report assessment of psychotic symptoms, highlighting its advantages of practicality (easier to administer, interpret and score) and reliability. Considering the delusions assessment, Bell et al (2007) also state that although self-report do not allow to perform diagnosis, such instruments may have utility in assessing specific information on delusions (e.g., distress, preoccupation) and comparing clinical and non-clinical populations.…”

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