Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

Schrank, Beate; Amering, Michaela; Hay, Astrid Grant; Weber, Michael; Sibitz, Ingrid

doi:10.1017/s2045796013000322

Cited by 81 publications

(71 citation statements)

References 45 publications

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“…Concerning the influence of parental/caregiver insight on patient insight, patients with parents/caregivers who had less rejecting attitudes tended to have better insight [119]. Finally, structural equation modeling with 284 people with schizophrenia spectrum disorders supported the hypothesis that insight diminishes hope and increases depression and self-stigma [120]. In this study, negative symptoms reduced hope and increased depression and self-stigma, while positive symptoms diminished self-stigma through a pathway via insight.…”

Section: Paradoxical Distress and The Contribution Of Stigmasupporting

confidence: 59%

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

Vohs

George

Leonhardt

et al. 2016

Expert Review of Neurotherapeutics

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Introduction: 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. Areas covered: 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.

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Section: Paradoxical Distress and The Contribution Of Stigmasupporting

confidence: 59%

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

Vohs

George

Leonhardt

et al. 2016

Expert Review of Neurotherapeutics

View full text Add to dashboard Cite

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“…Schrank et al 81 found mutual and causal relationships in path analyses, with clinical insight promoting depression and self-stigma, and negative but not positive symptoms affecting that relationship.…”

Section: Good Clinical Insight Is Associated With Depression and Poormentioning

confidence: 99%

“…As reviewed above, stigma may result in insight leading to despair, and individuals may consider a meaningful life no longer a viable possibility 39,81 . Other studies have also found a direct link between insight and stigma 148 , though others have failed to replicate that 149 .…”

Section: Social and Political Factors As A Root Of Poor Insightmentioning

confidence: 99%

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

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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“…Since patients included in this research were post-acute, this can explain this correlation 17,18 . There was no correlation between stigma resistance subscale and insight, which implies that this subscale is related to some other variables yet to be determined 19,20 . There were several limitations to the study important to consider.…”

Section: Vidović Et Almentioning

confidence: 86%

Insight and Self-Stigma in Patients With Schizophrenia

Vidović¹

2016

ACC

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SUMMARY -Poor insight and high level of self-stigma are often present among patients with schizophrenia and are related to poorer treatment adherence, poorer social function and rehabilitation, aggressive behavior, higher level of depression, social anxiety, lower quality of life and selfesteem. Reports on a relationship between insight and stigma are controversial. We examined the relationship of the level of insight and self-stigma in a sample of 149 patients with schizophrenia. Insight was measured with the Scale to assess Unawareness of Mental Disorder and self-stigma with the Internalized Stigma of Mental Illness. Results showed 88.6% of the patients to have high or moderate insight, with a mean value of 2.73. General insight showed the highest level (2.58) and insight in positive symptoms the lowest level (2.9). The self-stigma score in general was 2.13, with stereotype endorsement being lowest (1.98). According to study results, 77.1% of patients felt minimal or low self-stigma across all subscales, except for stigma resistance subscale. Statistically significant correlation was found between insight and four subscales of self-stigma, while no correlation was found for the stigma resistance subscale only. These results imply the need of individually tailored antistigma and insight promoting programs for patients with schizophrenia.

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Insight, positive and negative symptoms, hope, depression and self-stigma: a comprehensive model of mutual influences in schizophrenia spectrum disorders

Cited by 81 publications

References 45 publications

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

An integrative model of the impairments in insight in schizophrenia: emerging research on causal factors and treatments

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

Insight and Self-Stigma in Patients With Schizophrenia

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