Clinical and Cognitive Insight Sample Clauses

Clinical and Cognitive Insight. A pivotal study by Amador and Gorman (1998) found that 50-80% of people with schizophrenia did not believe that they had a mental illness. Insight is a term that may refer to different dimensions such as; awareness of having a mental disorder, awareness of the effects of medication, and understanding the consequences of disorder (Amador Strauss & Yale, 1993; David, 1990). Impaired insight has been found to lead to poorer psychosocial functioning, poor adherence to psychiatric treatment and increased severity of positive and negative symptoms in people with schizophrenia (Amador et al., 1994; Pini, Cassano, & Dell’Osso, 2001). It is thought to be one of the main factors contributing to treatment non-adherence and relapse in schizophrenia (Henriksen & Parnas, 2014). Beck et al., (2004) make the important distinction between clinical insight and cognitive insight. Clinical insight is described above; awareness of having a mental disorder, the effects of medication and psychosocial consequences and is measured by scales such as the Scale for the Unawareness of Mental Disorder (SUMD) (Amador et al., 1993). Beck et al., (2004) argued that these scales miss out on the cognitive processes that may contribute to impaired insight, such cognitive insight or the ability to evaluate, detect and correct misinterpretations about their experience. The higher order evaluative process of cognitive insight may be an important mediator of improved clinical insight and therefore functional outcomes and relapse prevention. Donohoe et al., (2009) investigated whether illness awareness (clinical insight) was related to other aspects of self-awareness such as cognitive self-monitoring or awareness of errors. They found that those with better clinical insight, as measured by the Schedule for Assessment of Insight (SAI) (David, 1990), also had more cognitive insight into their performance on neuropsychological tasks. Support for a distinction between clinical and cognitive insight comes from a study which found that each affected different symptoms (Greenberger & Serper, 2010). Those with higher cognitive insight were found to have less severe preoccupation with symptoms and whereas those with higher clinical insight had increased depression symptoms. Underpinning the development of cognitive and clinical insight is thought to be a core cognitive skill; metacognition (David, Bedford, Wiffen, & Gilleen, 2012; Lysaker et al., 2005)
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