The neuropsychology of insight and distress among outpatients with schizophrenia and schizoaffective disorder.
Item
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Title
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The neuropsychology of insight and distress among outpatients with schizophrenia and schizoaffective disorder.
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Identifier
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AAI9959174
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identifier
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9959174
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Creator
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Creech, Bonnie Kathleen.
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Contributor
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Adviser: Judith Jaeger
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Date
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2000
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical | Psychology, Cognitive | Psychology, Physiological | Psychology, Psychobiology
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Abstract
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Patients with schizophrenia often show lack of insight into their disease and display a striking lack of distress that seems inappropriate considering the serious, disabling, and incurable illness they have. This project investigated whether impaired insight and inappropriate distress regarding mental illness and its consequences were related to specific neuropsychological (NP) deficits in outpatients with schizophrenia or schizoaffective disorder.;The literature revealed a lack of consensus on the definition, conceptualization, and assessment of insight. An alternative conceptualization was proposed incorporating three distinct mental operations; intellect, volition, and affect. An existing instrument for rating judgment was adapted to encompass these components of insight and provide additional ratings of apparent and reported distress.;It was hypothesized that NP deficits, especially those involving frontal and executive systems, would be associated with impaired insight and inappropriate distress. Associations with psychiatric symptoms, medications and demographic characteristics were also explored.;The hypothesis was essentially supported, however insight and distress related to NP differently in males than females and among patients with schizophrenia and schizoaffective disorder. The relationship between insight, distress and NP among the schizophrenia subgroup was non-significant, although the ability to detect a relationship was affected by restricted range and confounds with gender differences. In males, insight and apparent distress related to auditory working memory, apparent distress also related to dexterity. In females, insight and apparent distress related to ideational fluency and set-shifting. In schizoaffectives, apparent distress related to ideational fluency, set-shifting, and working memory, while reported distress related to verbal short-term memory. Inappropriate distress related to reduced psychiatric symptoms especially depression, anxiety, guilt, and tension.;NP deficits, especially those relating to executive functions, may play an important role in the poor insight observed in these patients. The findings uncover differences in the relationship between NP and insight as a function of diagnostic subgroup and gender. It is proposed that poor insight may be a result of impairments in intellectual, affective and volitional processes, as well as abnormal integration of these processes, and that the complex interaction of these processes requires intact frontal and executive functioning.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
