Differential Relationships between Set-Shifting Abilities and Dimensions of Insight in Schizophrenia

Abstract

Background: To assess insight in a large sample of patients with schizophrenia and to study its relationship with set shifting as an executive function. Methods: The insight of a sample of 161 clinically stable, community-dwelling patients with schizophrenia was evaluated by means of the Scale to Assess Unawareness of Mental Disorder (SUMD). Set shifting was measured using the Trail-Making Test time required to complete part B minus the time required to complete part A (TMT B-A). Linear regression analyses were performed to investigate the relationships of TMT B-A with different dimensions of general insight. Results: Regression analyses revealed a significant association between TMT B-A and two of the SUMD general components: ‘awareness of mental disorder' and ‘awareness of the efficacy of treatment'. The ‘awareness of social consequences' component was not significantly associated with set shifting. Conclusions: Our results show a significant relation between set shifting and insight, but not in the same manner for the different components of the SUMD general score.

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

“…Poor insight has been correlated with difficulties in set shifting in acute and non-acute phases of schizophrenia 121,122 , the ability to change behavior following feedback on an executive function task 123 , complex motor sequencing 124 , and the ability to recall autobiographical details about negative events 125 .…”

Clinical insight in first episode psychosis: the role of metacognition

“…Neurocognitive deficits may make it challenging for the individual to access relevant memories about their mental illness and their current or previous experiences. Empirical research has supported the association between clinical insight and neurocognition (Bhagyavathi et al, 2015;Cooke et al, 2007), including premorbid IQ (Černis et al, 2015), self-reflection, and set-shifting (Diez-Martin et al, 2014;Gilleen, David, & Greenwood, 2016), and, more broadly, social cognitive deficits, such as Theory of Mind, which has shown a significant relationship with clinical insight (Bora, 2017).…”