Does the Beck Cognitive Insight Scale Predict Response to Cognitive Remediation in Schizophrenia?

Abstract

Cognitive remediation therapy (CRT) has emerged as a viable treatment option for people diagnosed with schizophrenia presenting disabling cognitive deficits. However, it is important to determine which variables can influence response to CRT in order to provide cost-effective treatment. This study's aim was to explore cognitive insight as a potential predictor of cognitive improvement after CRT. Twenty patients with schizophrenia completed a 24-session CRT program involving 18 hours of computer exercises and 6 hours of group discussion to encourage generalization of cognitive training to everyday activities. Pre- and posttest assessments included the CogState Research Battery and the Beck Cognitive Insight Scale (BCIS). Lower self-certainty on the BCIS at baseline was associated with greater improvement in speed of processing (r s = −0.48; p < 0.05) and visual memory (r s = −0.46; p < 0.05). The results of this study point out potential associations between self-certainty and cognitive improvement after CRT, a variable that can easily be measured in clinical settings to help evaluate which patients may benefit most from the intervention. They also underline the need to keep investigating the predictors of good CRT outcomes, which can vary widely between patients.

Factors Associated With Response and Resistance to Cognitive Remediation in Schizophrenia: A Critical Review

“…A recent study by Davidson et al (2016) found that baseline learning potential (LP)—the ability to quickly learn and apply a new skill under testing conditions—significantly predicted skill acquisition in verbal and visuo-spatial memory domains after a 8-week CR intervention in patients with schizophrenia. Furthermore, Benoit et al (2016) demonstrated that higher initial cognitive insight was significantly correlated with greater improvement in speed of processing and visual memory after CR. Burton and Twamley (2015) found no evidence that unawareness of cognitive impairment is a barrier to participation in or ability to benefit from cognitive training, demonstrating no differences in patients with or without neurocognitive insight in terms of treatment utilization and good treatment outcomes in verbal memory and functional capacity (measured by the UCSD Performance-Based Skills Assessment—UPSA).…”

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

“…Better cognitive insight at baseline was reported to predict greater improvements in cognition following cognitive remediation 63 .…”

Does the Beck Cognitive Insight Scale predict change in delusional beliefs?

“…The latter presented with more overconfidence in their own objective errors and were slightly underconfident in correct appraisals (Balzan, 2016). However, the prediction of treatment outcomes by BCIS certainty scores as in our analysis has been found in several studies (Benoit, Harvey, Bherer, & Lepage, 2016; Ohmuro et al ., 2018). Others found that lower BCIS composite scores rather than the sub‐items predicted better treatment outcomes concerning positive symptoms (Perivoliotis et al ., 2010).…”