Cognitive insight and psychotic disorder: The impact of active delusions

• Published in: Schizophrenia research 2007-02, Vol.90 (1), p.325-333
• Main Authors: Warman, Debbie M, Lysaker, Paul H, Martin, Joel M
• Format: Article
• Language: English
• Subjects: Adult; Adult and adolescent clinical studies; Awareness; Biological and medical sciences; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Cognitive insight; Comorbidity; Decision Making; Delusions; Delusions - diagnosis; Delusions - psychology; Depression - diagnosis; Depression - psychology; Female; Humans; Male; Medical sciences; Middle Aged; Psychiatric Status Rating Scales - statistics & numerical data; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychometrics; Psychopathology. Psychiatry; Psychoses; Psychosis; Psychotic Disorders - diagnosis; Psychotic Disorders - psychology; Reference Values; Schizophrenia; Self Concept
• ISSN: 0920-9964; 1573-2509
• DOI: 10.1016/j.schres.2006.09.011

Abstract While several studies have determined the Beck Cognitive Insight Scale (BCIS; [Beck, A.T., Baruch, E., Balter, J.M., Steer, R.A., Warman, D.M., 2004. A new instrument for measuring insight: The Beck Cognitive Insight Scale. Schizophr. Res. 68, 319–329] is a useful measure of cognitive insight, a number of questions have remained unanswered. While individuals with psychotic disorders have been shown to have impaired cognitive insight compared to a psychiatric comparison group, it has remained unclear how the cognitive insight of individuals with psychotic disorders compares to healthy individuals. Further, as previous studies have classified participants based on diagnostic classification, it has remained unknown if individuals with delusions and individuals with psychotic disorders without active delusions score differently on this measure. To examine these questions, we assessed the cognitive insight of healthy individuals and individuals with psychotic disorders, both with and without active delusions. Results indicated that individuals with psychotic disorders had impaired cognitive insight relative to healthy controls ( p = .005), though individuals with active delusions and individuals with psychotic disorders without delusions had impairments in different domains. Individuals with delusions were overly confident in their own judgment relative to healthy controls and those without delusions ( p = .011), though their self-reflectiveness was the same as normal controls. Individuals without delusions reported low self-reflectiveness relative to healthy controls and individuals with delusions ( p = .004), though they were not overconfident in their judgment. These results are discussed in terms of existing research on cognitive insight, decision making, and psychosis.