title: Personal narratives of illness in schizophrenia: associations with neurocognition and symptoms.
abstract: Controversy exists regarding whether unawareness/denial of illness in schizophrenia results from neurocognitive deficits or a rejection of stigmatized social roles. One possibility is that some elements of a narrative of mental illness are primarily a matter of personal/social construction while others may be uniquely curtailed by neurocognitive deficits. Accordingly, we gathered narratives of illness among 52 persons with schizophrenia spectrum disorders using a semi-structured interview. Ratings of the plausibility, adequacy of detail, and temporal conceptual organization of each narrative were correlated with assessments of neurocognition, symptoms, and traditional insight measures. Degree of plausibility was significantly related to performance on the Wisconsin Card Sorting Test (WCST), a measure of executive function and levels of Positive symptoms on the Positive and Negative Syndrome Scale (PANSS). When entered into a regression to predict plausibility, positive symptoms and WCST performance made unique contributions (R2 = .51, p < .0001). Higher levels of Positive symptoms were associated with poorer temporal conceptual organization within narratives. Adequacy of detail within narratives of illness was related to traditional insight measures but not neurocognition or symptoms.
authors.affiliation: Roudebush VA Medical Center, Day Hospital 116H, 1481 West 10th Steet, Indianapolis, IN 46202, USA. paul.lysaker@med.va.gov
authors.forename: Paul H
authors.initials: PH
authors.lastname: Lysaker
authors.forename: Christopher M
authors.initials: CM
authors.lastname: France
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Hunter
authors.forename: Louanne W
authors.initials: LW
authors.lastname: Davis
mesh_terms: D001294:Attitude to Health; D001364:Awareness; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D033262:Narration; D012559:Schizophrenia / Q000150:complications*