Can cognitive insight predict symptom remission in a first episode psychosis cohort?
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BACKGROUND: The outcome of first episode psychosis (FEP) is highly variable and difficult to predict. Cognitive insight measured at illness onset has previously been found to predict psychopathology 12-months later. The aims of this study were to examine whether the prospective relationship between cognitive insight and symptom severity is evident at four-years following FEP and to examine some psychological correlates of cognitive insight. METHODS: FEP participants (n = 90) completed the Beck Cognitive Insight Scale (BCIS) at illness onset, and associations between BCIS scores with symptom severity outcomes (4-years after FEP) were assessed. The BCIS scales (self-reflectiveness and self-certainty) were examined as a composite score, and individually compared to other cognitive measures (IQ and jumping to conclusions (JTC) bias). RESULTS: Regression analyses revealed that the cognitive insight composite did not predict 4-year symptom remission in this study while the self-reflection subscale of the BCIS predicted severity of symptoms at 4-years. Self-certainty items of the BCIS were not associated with symptom severity. Significant correlations between the JTC bias, self-certainty and IQ were found, but self-reflection did not correlate with these other cognitive measures. CONCLUSIONS: Self-reflective capacity is a more relevant and independent cognitive construct than self-certainty for predicting prospective symptom severity in psychosis. Improving self-reflection may be a useful target for early intervention research.
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Better cognitive insight in self-reflection predicts less severe overall psychopathology in first-episode psychosis over four years.
“In a four-year longitudinal study, better cognitive insight in the domain of self-reflection was found to predict less severe levels of overall psychopathology in first-episode psychosis 62 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [62]
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Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018) · World Psychiatry · doi:10.1002/wps.20508 · Cited by 247 · see citing works
- Authors
- O’Connor, J. A., Ellett, L., Ajnakina, O., Schoeler, T., Kollliakou, A., Trotta, A., Wiffen, B. D., Falcone, A. M., Di Forti, M., Murray, R. M., Bhattacharyya, S., & David, A. S.
- Affiliations
- Royal Holloway University of London (GB)
- Corresponding author
- O’Connor, Jennifer A.
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2017-02-06
- Volume
- 17
- Issue
- 1
- Pages
- 54-54
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC5294763
- OpenAlex
- W2587045731
- Cited by
- 37
- References
- 60
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 5 · 2020: 7 · 2019: 4 · 2018: 2 · 2017: 3
- FWCI
- 3.59
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- UCL Discovery (University College London) (submittedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by)
- Funders
- Biomedical Research Centre for Mental Health
- National Institute for Health Research
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- cognitive insight, first-episode psychosis, symptom remission, self-reflection, self-certainty, jumping to conclusions bias, Beck Cognitive Insight Scale, symptom severity, early intervention
- MeSH terms
- Adult, Awareness, Cognition, Female, Humans, Male, Predictive Value of Tests, Psychiatric Status Rating Scales, Psychopathology, Psychotic Disorders, Regression Analysis, Self Concept, Cohort Studies
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