Clinical insight in First Episode Psychosis: the role of metacognition

Wright, Abigail C, Lysaker, Paul H, Fowler, David and Greenwood, Kathryn (2021) Clinical insight in First Episode Psychosis: the role of metacognition. Journal of Mental Health. ISSN 0963-8237 (Accepted)

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Abstract

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, the 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 is, therefore, a potentially important target for intervention in FEP.

Item Type: Article
Schools and Departments: School of Psychology > Psychology
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 04 Mar 2021 08:19
Last Modified: 04 Mar 2021 09:00
URI: http://sro.sussex.ac.uk/id/eprint/97559

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