Unawareness of illness and neuropsychological performance in chronic schizophrenia

Young, Donald A.; Davila, Rafaela; Scher, Hal

doi:10.1016/0920-9964(93)90046-l

Cited by 179 publications

(104 citation statements)

References 32 publications

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“…This metacognitive ability is impaired in populations with frontal lobe dysfunction. For example, most schizophrenic patients deny having a problem, and more importantly, this denial of deficit is correlated with perseverative errors, which are a measure of executive dysfunction (Young, Davila, & Sher, 1993).…”

Section: Future Researchmentioning

confidence: 99%

Executive Attention and Metacognitive Regulation

Fernandez-Duque

Baird

Posner

2000

Consciousness and Cognition

542

316

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Metacognition refers to any knowledge or cognitive process that monitors or controls cognition. We highlight similarities between metacognitive and executive control functions, and ask how these processes might be implemented in the human brain. A review of brain imaging studies reveals a circuitry of attentional networks involved in these control processes, with its source located in midfrontal areas. These areas are active during conflict resolution, error correction, and emotional regulation. A developmental approach to the organization of the anatomy involved in executive control provides an added perspective on how these mechanisms are influenced by maturation and learning, and how they relate to metacognitive activity. © 2000 Academic PressMetacognitively sophisticated children or adults are like busy executives, analyzing new problems, judging how far they are from the goal, allocating attention, selecting a strategy, attempting a solution, monitoring the success or failure of current performance, and deciding whether to change to a different strategy.-J. H. Flavell, P. H. Miller, and S. A. Miller, Cognitive Development

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Section: Future Researchmentioning

confidence: 99%

Executive Attention and Metacognitive Regulation

Fernandez-Duque

Baird

Posner

2000

Consciousness and Cognition

542

316

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“…Es posible que, por ejemplo, los procesos patológicos sean más susceptibles de revertirse con intervenciones farmacológicas o psicológicas al comienzo de la enfermedad (35) . Desde un punto de vista clínico, se ha sugerido que las anormalidades de las funciones ejecutivas se asociarían con una pobre o reducida conciencia de enfermedad (36) . Sin embargo, varios estudios no han apoyado dicha asociación (37)(38)(39) y en otro estudio la asociación se presentaba en el caso de síntomas negativos pero no en los sínto-mas positivos (40) .…”

Section: Las Funciones Ejecutivas En Pacientes Con Esquizofreniaunclassified

Los trastornos cognitivos de la esquizofrenia

Barrera¹

2006

Rev. chil. neuro-psiquiatr.

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Introducción utores como Masselon o Bleuler(1,2) ya habían indicado que los pacientes con esquizofrenia presentaban trastornos cognitivos. Solo recientemente, sin embargo, dichas alteraciones han sido definidas con claridad y cuantificado (3) . Se ha establecido que los déficits cognitivos de la esquizofrenia son un factor que determina el nivel de discapacidad de los pacientes (3)(4)(5) en mayor medida, quizás, que los síntomas positivos y negativos propios de la enfermedad (6,7) . De hecho, la respuesta a los programas de rehabilitación, así como la habilidad para resolver problemas y el nivel de funcionamiento en la comunidad son aspectos determinados por las siguientes funciones cognitivas: 1. La memoria declarativa (8) verbal, es decir la capacidad de aprender y recordar conscientemente material verbal por más de unos pocos segundos (evaluada, por ejemplo, mediante la prueba de aprendizaje auditivo de palabras (9) ; 2. Las funciones ejecutivas o capacidad de iniciar, planificar, controlar y monitorizar la propia conducta, y manipular información abstracta (10)(11)(12) (evaluadas, por ejemplo, mediante la prueba de cartas de Wisconsin) (13) ; 3. La memoria de trabajo o capacidad de mantener transitoriamente (durante algunos segundos) material mental en un estado activo o accesible mientras otras funciones cognitivas (razonamiento, planificación a largo plazo, etc) están ocurriendo (14) ; y 4. La vigilancia o capacidad de mantener un nivel de alerta durante varios minutos (evaluada mediante pruebas de rendimiento continuo) (15) . Este artí-culo se centrara en los trastornos de la memoria, de las funciones ejecutivas, y de la atención.A

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“…For example, in patients with psychoses, some studies have found a significant relationship between patients' insight and the severity of their psychopathology [11][12][13], whilst others have found no such association [2,14,15]. Likewise, some researchers suggest that in patients with schizophrenia, there is a direct relationship between impaired insight and neuropsychological impairment [16], whereas other research finds no such relationship [17], and still others claim a converse relationship, i.e., patients with poor insight perform better on neuropsychological tests [15]. In a similar vein, studies exploring insight in patients with dementia have yielded variable results, with some finding no association between levels of insight and severity of dementia [3,18,19] and others suggesting significant relationships [20,21].…”

Section: Introductionmentioning

confidence: 99%

“…It is apparent, for example, that researchers are attempting (both explicitly and implicitly) to link unawareness/anosognosia (in neurological states) with loss of insight in functional psychiatric disorders. Thus, studies exploring correlations between frontal lobe and right hemispheric dysfunction and impaired insight in patients with schizophrenia [15][16][17] or with bipolar affective disorders [28] appear to be based on the finding that anosognosia has been linked with frontal lobe dysfunction and right-hemisphere damage [29,30]. In other words, it is assumed that 'anosognosia' as assessed in neurological conditions (where the 'object' of insight may be 'neurological deficit', e.g., hemiplegia) and 'impaired insight' as assessed in schizophrenia (where the 'object' of insight may be 'mental illness') both refer to the same phenomenon.…”

Section: Introductionmentioning

confidence: 99%

The ‘Object’ of Insight Assessment: Relationship to Insight ‘Structure’

Marková

Berríos

2001

Psychopathology

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Insight is a relational or ‘intentional’ concept, i.e., it is only understood in terms of its relation to something; and that ‘something’ is the ‘object’ of insight. In clinical practice, the ‘object’ of insight thus generally refers to a particular mental or physical state (e.g., mental illness, neuropsychological deficit) in relation to which insight is being assessed. It is argued in this paper that the ‘object’ of insight plays a crucial role in shaping or determining the sort of insight that is elicited in clinical practice (i.e., the phenomenon of insight). Three ways in which the ‘object’ of insight can shape the clinical phenomenon of insight are discussed. One concerns the conceptual background in which the ‘object’ is embedded and which is likely to impose a similar structure onto the phenomenon of insight. Another is the semantic category to which the ‘object’ of insight belongs and which will imprint its particular structure on the phenomenon of insight. Yet another concerns the specific nature of the ‘object’ which itself will shape the insight phenomenon elicited. This carries implications for research on insight, since insight tends to be explored in relation to a variety of ‘objects’. Phenomena of insight in relation to different ‘objects’ are likely to vary in structure, and this, in turn, has consequences for mechanisms underlying insight in each case. Understanding more about the nature and contribution of the ‘object’ of insight in the insight-‘object’ relationship will help to delineate separate insight phenomena and achieve consistency in empirical studies on insight.

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Unawareness of illness and neuropsychological performance in chronic schizophrenia

Cited by 179 publications

References 32 publications

Executive Attention and Metacognitive Regulation

Executive Attention and Metacognitive Regulation

Los trastornos cognitivos de la esquizofrenia

The ‘Object’ of Insight Assessment: Relationship to Insight ‘Structure’

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