Relationship Between Cognitive and Clinical Insight at Different Durations of Untreated Attenuated Psychotic Symptoms in High-Risk Individuals

Xu, Li-Hua; Zhang, Mei; Wang, Shuqing; Wei, Yanyan; Cui, Huiru; Qian, Zhenying; Wang, Yingchan; Tang, Xiaochen; Hu, YeGang; Tang, Yingying; Zhang, Tianhong; Wang, Jijun

doi:10.3389/fpsyt.2021.753130

Cited by 4 publications

(7 citation statements)

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“…Our previous study also found that self-reflectiveness positively correlated with negative symptoms. 28 However, this study further selected self-reflectiveness as the independent variable and blunted affect as the dependent variable to conduct regression analysis and found that it did not reach significance. Blunted affect refers to diminished emotional responsiveness, characterised by a reduction in facial expression, modulation of feelings, and communicative gestures.…”

Section: Discussionmentioning

confidence: 90%

“…A high level of self-reflectiveness was not only associated with good clinical insight,1 2 including awareness of illness, relabelling of specific symptoms, and treatment compliance, but also with increased depressive symptomatology 3 4. In addition, we found that self-reflectiveness had potential positive correlations with negative symptoms in individuals with attenuated psychotic symptoms (APS)--one type of clinical high risk for psychosis (CHR)--when the duration of untreated APS was longer than 12 months 5. Previous studies consistently demonstrated the paradox of self-reflectiveness, emerging not only in patients with schizophrenia spectrum disorders6 7 but also in individuals with subclinical psychosis 8.…”

Section: Introductionmentioning

confidence: 79%

“…However, Clark19 found that self-reflectiveness was significantly higher in CHR individuals than in HC subjects. Our previous study found that CHR individuals demonstrated poorer cognitive insight, with lower scores on self-reflectiveness than HC subjects 5…”

Section: Introductionmentioning

confidence: 90%

“… 3 4 In addition, we found that self-reflectiveness had potential positive correlations with negative symptoms in individuals with attenuated psychotic symptoms (APS)--one type of clinical high risk for psychosis (CHR)--when the duration of untreated APS was longer than 12 months. 5 Previous studies consistently demonstrated the paradox of self-reflectiveness, emerging not only in patients with schizophrenia spectrum disorders 6 7 but also in individuals with subclinical psychosis. 8 However, García-Mieres et al 3 showed that the association between higher self-reflectiveness and increased depression was meaningful because self-reflectiveness can moderate the relationship between depressive symptoms and general psychological distress.…”

Section: Introductionmentioning

confidence: 94%

“…Our previous study found that CHR individuals demonstrated poorer cognitive insight, with lower scores on self-reflectiveness than HC subjects. 5 …”

Section: Introductionmentioning

confidence: 99%

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Relationships between self-reflectiveness and clinical symptoms in individuals during pre-morbid and early clinical stages of psychosis

Cui

Wei

et al. 2022

Gen Psych

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BackgroundSelf-reflectiveness, one dimension of cognitive insight, plays a protective role in an individual’s mental state. Both high and low levels of self-reflectiveness have been reported in patients with schizophrenia and individuals at clinical high risk for the illness.AimsThis study aimed to explore the relationship patterns between self-reflectiveness and clinical symptoms in individuals during the pre-morbid and early clinical stages of psychosis.MethodsA total of 181 subjects, including individuals with attenuated positive symptoms (APS, n=122) and patients with first-episode psychosis (FEP, n=59), completed the Beck Cognitive Insight Scale and were evaluated using the Schedule of Assessment of Insight and Positive and Negative Syndrome Scale. All subjects were classified into three groups according to their level of self-reflectiveness: low level (LSR, n=59), medium level (MSR, n=67) and high level (HSR, n=55). Both linear and non-linear relationships between self-reflectiveness and clinical symptoms were explored.ResultsMore individuals with APS were classified into the MSR group, while more patients with FEP were classified into the LSR group. The LSR group demonstrated less awareness of illness than the MSR and HSR groups, more stereotyped thinking and poorer impulse control but less anxiety than the MSR group, and lower levels of blunted affect and guilt feelings than the HSR group. The MSR group demonstrated lower stereotyped thinking than the HSR group. Compared to the LSR group, the MSR group had increased self-reflectiveness, improved awareness of illness, decreased stereotyped thinking, and better impulse control, but increased feelings of guilt. The HSR group showed increased stereotyped thinking when compared to the MSR group, but the other variables did not change significantly between these two groups. Overall, self-reflectiveness demonstrated an approximately inverse S-shaped relationship with the awareness of illness, a U-shaped relationship with stereotyped thinking and poor impulse control, and an almost linear relationship with anxiety and guilt feelings.ConclusionsSelf-reflectiveness demonstrates complex relationships with clinical symptoms and fails to exert significant positive effects when reaching a certain high level.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 94%

“…Our previous study found that CHR individuals demonstrated poorer cognitive insight, with lower scores on self-reflectiveness than HC subjects. 5 …”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations