An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments.
Poor insight, or unawareness of some major aspect of mental illness, is a major barrier to wellness when it interferes with persons seeking out treatment or forming their own understanding of the challenges they face. One barrier to addressing impaired insight is the absence of a comprehensive model of how poor insight develops.



To explore this issue we review how poor insight is the result of multiple phenomena which interfere with the construction of narrative accounts of psychiatric challenges, rather than a single social or biological cause. Expert commentary: We propose an integrative model of poor insight in schizophrenia which involves the interaction of symptoms, deficits in neurocognition, social cognition, metacognition, and stigma. Emerging treatments for poor insight including therapies which focus on the development of metacognition are discussed.
a Department of Psychiatry , Indiana University School of Medicine , Indianapolis , IN , USA.
Jenifer L
JL
Vohs
b School of Psychological Sciences , University of Indianapolis , Indianapolis , IN , USA.
Sunita
S
George
a Department of Psychiatry , Indiana University School of Medicine , Indianapolis , IN , USA.
Bethany L
BL
Leonhardt
a Department of Psychiatry , Indiana University School of Medicine , Indianapolis , IN , USA.|c Roudebush VA Medical Hospital , Indianapolis , IN , USA.
Paul H
PH
Lysaker
D006801:Humans; D000067489:Metacognition; D008959:Models, Neurological; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D012565:Schizophrenic Psychology; D012919:Social Behavior
Schizophrenia; insight; metacognition; neurocognition; social cognition; stigma; symptoms