title: Longitudinal relations between symptoms, neurocognition, and self-concept in schizophrenia.
abstract: OBJECTIVE
  Cognitive models suggest that the self-concept of persons with psychosis can be fundamentally affected. Self-concepts were found to be related to different symptom domains when measured concurrently. Longitudinal investigations to disentangle the possible causal associations are rare.
  
  
  METHODS
  We examined a sample of 160 people with a diagnosis of schizophrenia who took part in a psychotherapy study. All participants had the DSM-IV diagnosis of a schizophrenia and pronounced negative symptoms. Neurocognition, symptoms, and self-concepts were assessed at two time points 12 months apart. Structural equation modeling was used to test whether symptoms influence self-concepts (scar-model) or self-concepts affect symptoms (vulnerability model).
  
  
  RESULTS
  Negative symptoms correlated concurrently with self-concepts. Neurocognitive deficits are associated with more negative self-concepts 12 months later. Interpersonal self-concepts were found to be relevant for paranoia.
  
  
  CONCLUSIONS
  The findings implicate that if deficits in neurocognition are present, fostering a positive self-concept should be an issue in therapy. Negative interpersonal self-concept indicates an increased risk for paranoid delusions in the course of 1 year. New aspects for cognitive models in schizophrenia and clinical implications are discussed.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Tübingen Tübingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Hesse
authors.affiliation: Department of Medical Psychology, University Medical Center Hamburg-Eppendorf Hamburg, Germany.
authors.forename: Levente
authors.initials: L
authors.lastname: Kriston
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Tübingen Tübingen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wittorf
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Frankfurt Frankfurt, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Herrlich
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duesseldorf Duesseldorf, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wölwer
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Tübingen Tübingen, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Klingberg
keywords: cognitive models; psychological model; self-esteem; self-schema; structural equation modeling