Associations of Awareness of Illness in Schizophrenia Spectrum Disorder With Social Cognition and Cognitive Perceptual Organization

Abstract

Although impairment in flexibility of abstract thought has been linked to poor insight in schizophrenia, little is known about the association of other cognitive processes to insight. To explore the possibility that social cognition and perceptual organizational capacity are linked to insight, we assessed awareness of illness and administered the Thematic Apperception Test and Rorschach Inkblot Test to 31 adult participants with schizophrenia. Partial correlations controlling for perseverative errors on the Wisconsin Card Sorting Test revealed that lesser capacities to organize and make sense of ambiguous stimuli, to distinguish between one's own and other's perspectives, and to formulate logical accounts of behavior and social exchange predicted poorer awareness of psychiatric symptoms. With replication, results may suggest that to attain awareness of illness, some with schizophrenia may need assistance making sense of the social world and organizing the complexities of their experience of illness.

Insight in bipolar disorder: associations with cognitive and emotional processing and illness characteristics

“…This relationship was confirmed by Lysaker et al. (24), suggesting that patients with poor illness insight may have problems in the exchange of social information and using social cues in the interpretation of behaviour. Finally, the association between symptom severity and illness insight has been studied in schizophrenia (2, 25).…”

“…Bora et al (23) found a significant relationship between Theory of Mind and illness insight, which was most prominent for second-order false belief conditions or the ability to look at yourself through the eyes of another person. This relationship was confirmed by Lysaker et al (24), suggesting that patients with poor illness insight may have problems in the exchange of social information and using social cues in the interpretation of behaviour. Finally, the association between symptom severity and illness insight has been studied in schizophrenia (2,25).…”

“To see or not to see: that is the question.” The “Protection-Against-Schizophrenia” (PaSZ) model: evidence from congenital blindness and visuo-cognitive aberrations

“…Some of the cognitive domains deficient in patients with schizophrenia include but are not limited to VS memory (Goldman-Rakic, 1994; Green et al, 2000; Piskulic et al, 2007; Landgraf et al, 2011c), VS attention (Posner et al, 1988; Danckert et al, 2004; Granholm and Verney, 2004; Gouzoulis-Mayfrank et al, 2007), and VS executive functions (Laws, 1999; Eisenberg and Berman, 2010; Landgraf et al, 2011a,b,c). An impressive number of studies have actually shown that the development of schizophrenia may be associated with these cognitive deficits and that these cognitive deficits could be stage-specific (Heaton et al, 1994; Niendam et al, 2006; Fusar-Poli et al, 2007; Lysaker et al, 2007; Langdon and Ward, 2008; Picard et al, 2009; Barlati et al, 2012). …”

High Prevalence of Insecure Attachment in Patients with Primary Hypertension

“…It could be argued that the Thematic Apperception Test (TAT, Murray, 1943 ) would have been an interesting alternative since it is also a projective measure. The TAT is a widely used projective measure of personality and was assessed in several clinical samples to analyze the underlying dynamics of personality features from a psychodynamic perspective (e.g., Lysaker et al, 2007 ; Conway et al, 2013 ; Haggerty et al, 2015 ). In psychosomatic research, the TAT was e.g., used for a better understanding of the psychodynamics in patients with the chronic idiopathic pain syndrome (Sivik and Hösterey, 1992 ).…”