Psychotic Patients' Awareness of Mental Illness: Implications for Legal Defense Proceedings

Neumann, Craig S.; Walker, Elaine F.; Weinstein, Jay A.; Cutshaw, Chris

doi:10.1177/009318539602400305

Cited by 6 publications

(2 citation statements)

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“…Yet, awareness of illness has been shown to fractionate by domain with some independence between each. For example, David 38 delineated 3 dimensions of awareness: awareness of illness, ability to relabel symptoms as pathological (a form of attribution), and treatment compliance, to which there is some statistical 39 and neuroimaging support. 40,41 Another commonly used scale, the Scale to assess Unawareness of Mental Disorder (SUMD) 42 has a similar multidimensional structure.…”

Section: Domains Of Awarenessmentioning

confidence: 99%

Domains of Awareness in Schizophrenia

Gilleen

Greenwood

David

2010

Schizophrenia Bulletin

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Patients with schizophrenia are often characterized as lacking insight or awareness into their illness and symptoms, yet despite considerable research, we still lack a full understanding of the factors involved in causing poor awareness. Within schizophrenia, there has been shown to be a fractionation across dimensions of awareness into mental illness: of being ill, of symptoms, and of treatment compliance. Recently, attention has turned to evidence of a fractionation between awareness of illness and of cognitive impairments and functioning. The current study investigated the degree of fractionation across a broad range of domains of function in schizophrenia and how each domain may be associated with neuropsychological functioning, clinical, mood, and demographic variables. Thirty-one mostly chronic stable patients with schizophrenia completed a battery of neuropsychological tests and measures of psychopathology, including mood. Cognitive insight and awareness of illness, symptoms, memory, and behavioral functioning were also measured. Insight and awareness were assessed using a combination of semistructured interview, observer-rated, self-rated, and objective measures, and included measures of the discrepancy between carer and self-ratings of impairment. Results revealed that awareness of functioning in each domain was largely independent and that awareness in each domain was predicted by different factors. Insight into symptoms was relatively poor while insight into cognitive deficits was preserved. Relative to neuropsychological variables, cognitive insight, comprising self-certainty and self-reflexivity, was a greater predictor of awareness. In conclusion, awareness is multiply fractionated and multiply determined. Therapeutic interventions could, therefore, produce beneficial changes within specific domains of awareness.

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Section: Domains Of Awarenessmentioning

confidence: 99%

Domains of Awareness in Schizophrenia

Gilleen

Greenwood

David

2010

Schizophrenia Bulletin

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“…Patients with schizophrenia who engage in violent behavior often lack insight into their legal situation 16 have impairments in decisional competence 13 leading to problems providing consent for research participation. In some cases, like evaluating violence on an inpatient forensic unit, informed consent is not needed for data collection.…”

Section: Study Methodologies and Inconsistencies Complicate Interpretation Of Risk Of Violence And Required Interventionsmentioning

confidence: 99%

Psychopharmacology of Aggression in Schizophrenia

Buckley¹,

Citrome

Nichita

et al. 2011

Schizophrenia Bulletin

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The management of aggression in patients with schizophrenia is a complex and challenging clinical dilemma. It also is greatly influenced by prevailing societal and medicolegal considerations regarding the perceived associations between violence and mental illness. This article provides a succinct account of a complex area and offers evidence for available treatments to reduce the occurrence of violent behavior among patients with schizophrenia.

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