Insight and executive functioning in schizophrenia: a multidimensional approach.
Past research suggests that unawareness of illness in schizophrenia is associated with deficits in executive functions; however, the relationships between executive processes and the various dimensions of insight are still unclear. Recent models of executive functioning have proposed that four executive processes - inhibition, updating, shifting and dual task coordination - are moderately related yet separable. In this study, we proposed to investigate and clarify the relationships between insight dimensions and the aforementioned four executive components. A total of 60 patients were administered the Test for Attentional Performance and the Scale to Assess Unawareness of Mental Disorder. The effect of potential confounding variables such as medication, symptomatology, demography, psycho-affective state, and general processing speed were also examined in a preliminary statistical analysis. We found that both awareness of disorder and awareness of response to medication were significantly related to Updating. Awareness of the social consequences of the disease was significantly related to Updating, Divided Attention and Inhibition Processes. The analysis indicates that poor insight in schizophrenia may be partially related to executive dysfunction. Finally, our study emphasizes the possible role of neuropsychological intervention in improving patients' insight into illness.
Raffard
Stéphane
S
University Department of Adult Psychiatry, CHU, Université Montpellier 1, France. s-raffard@chu-montpellier.fr
Bayard
Sophie
S
Gely-Nargeot
Marie-Christine
MC
Capdevielle
Delphine
D
Maggi
Maximilien
M
Barbotte
Emeline
E
Morris
Davina
D
Boulenger
Jean-Philippe
JP
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D001364:Awareness; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012559:Schizophrenia / Q000175:diagnosis / Q000503:physiopathology*; D012565:Schizophrenic Psychology