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Clinical insight in First Episode Psychosis: the role of metacognition

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posted on 2023-06-09, 23:13 authored by Abigail C Wright, Paul H Lysaker, David FowlerDavid Fowler, Kathryn GreenwoodKathryn Greenwood
Background Poor clinical insight has been commonly reported in those with First Episode Psychosis (FEP) and thought to be influenced by a range of factors, including neurocognition and symptoms. Clinical insight may be compromised as a result of alterations in higher-level reflective processes, such as metacognitive ability and cognitive insight. Aims To explore whether metacognitive ability and cognitive insight are associated with clinical insight while controlling for IQ, depression, and symptoms in FEP. Methods 60 individuals with FEP completed measures for clinical insight, metacognitive ability, cognitive insight, positive and negative symptoms, depression, and IQ. Results Higher levels of metacognitive ability were associated with better clinical insight, even when controlling for IQ, depression, positive and negative symptoms, and medication. Integration subscale of metacognitive ability was most strongly associated with clinical insight. Cognitive insight was associated with clinical insight when controlling for covariates. However, when including metacognitive ability and cognitive insight in the predictive model, only metacognitive ability was significantly related to clinical insight. Discussion Metacognitive ability, specifically the ability to describe one’s evolving mental state to provide a coherent narrative, was significantly related to clinical insight, independent of covariates, and may be a potentially important target for intervention in FEP.

History

Publication status

  • Published

File Version

  • Accepted version

Journal

Journal of Mental Health

ISSN

0963-8237

Publisher

Taylor & Francis

Department affiliated with

  • Psychology Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2021-03-04

First Open Access (FOA) Date

2022-05-18

First Compliant Deposit (FCD) Date

2021-03-03

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