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Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem

BACKGROUND: People with a diagnosis of schizophrenia have limited metacognitive awareness of their symptoms. This is also evident for cognitive difficulties when neuropsychological assessments and self-reports are compared. Unlike for delusions and hallucinations, little attention has been given to...

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Autores principales: Cella, M., Swan, S., Medin, E., Reeder, C., Wykes, T.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880064/
https://www.ncbi.nlm.nih.gov/pubmed/23734941
http://dx.doi.org/10.1017/S0033291713001189
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author Cella, M.
Swan, S.
Medin, E.
Reeder, C.
Wykes, T.
author_facet Cella, M.
Swan, S.
Medin, E.
Reeder, C.
Wykes, T.
author_sort Cella, M.
collection PubMed
description BACKGROUND: People with a diagnosis of schizophrenia have limited metacognitive awareness of their symptoms. This is also evident for cognitive difficulties when neuropsychological assessments and self-reports are compared. Unlike for delusions and hallucinations, little attention has been given to factors that may influence the mismatch between objective and subjectively reported cognitive problems. Symptom severity, and also self-esteem and social functioning, can have an impact on cognitive problem perception and help to explain the gap between objective and subjective cognitive assessments in psychosis. METHOD: One-hundred participants with a diagnosis of schizophrenia were recruited and assessed with a comprehensive neuropsychological battery, a measure of awareness of cognitive problems and measures of psychotic symptoms, social and behavioural functioning and self-esteem. Regression was used to investigate the influence of symptoms, social functioning and self-esteem, and patients with different levels of cognitive problem awareness were contrasted. RESULTS: Simple correlation analysis replicated the lack of association between objective cognitive measures and metacognitive awareness of cognitive problems. However, the results of the regression analyses highlight that self-esteem and negative symptoms predict metacognitive awareness. When significant predictors were controlled, individuals with better awareness had more impaired working memory but higher IQ. CONCLUSIONS: Poor self-esteem and high negative symptoms are negatively associated with metacognitive awareness in people with schizophrenia. Interventions that aim to improve cognition should consider that cognitive problem reporting in people with schizophrenia correlates poorly with objective measures and is biased not only by symptoms but also by self-esteem. Future studies should explore the causal pathways using longitudinal designs.
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spelling pubmed-38800642014-01-03 Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem Cella, M. Swan, S. Medin, E. Reeder, C. Wykes, T. Psychol Med Original Articles BACKGROUND: People with a diagnosis of schizophrenia have limited metacognitive awareness of their symptoms. This is also evident for cognitive difficulties when neuropsychological assessments and self-reports are compared. Unlike for delusions and hallucinations, little attention has been given to factors that may influence the mismatch between objective and subjectively reported cognitive problems. Symptom severity, and also self-esteem and social functioning, can have an impact on cognitive problem perception and help to explain the gap between objective and subjective cognitive assessments in psychosis. METHOD: One-hundred participants with a diagnosis of schizophrenia were recruited and assessed with a comprehensive neuropsychological battery, a measure of awareness of cognitive problems and measures of psychotic symptoms, social and behavioural functioning and self-esteem. Regression was used to investigate the influence of symptoms, social functioning and self-esteem, and patients with different levels of cognitive problem awareness were contrasted. RESULTS: Simple correlation analysis replicated the lack of association between objective cognitive measures and metacognitive awareness of cognitive problems. However, the results of the regression analyses highlight that self-esteem and negative symptoms predict metacognitive awareness. When significant predictors were controlled, individuals with better awareness had more impaired working memory but higher IQ. CONCLUSIONS: Poor self-esteem and high negative symptoms are negatively associated with metacognitive awareness in people with schizophrenia. Interventions that aim to improve cognition should consider that cognitive problem reporting in people with schizophrenia correlates poorly with objective measures and is biased not only by symptoms but also by self-esteem. Future studies should explore the causal pathways using longitudinal designs. Cambridge University Press 2014-02 2013-06-05 /pmc/articles/PMC3880064/ /pubmed/23734941 http://dx.doi.org/10.1017/S0033291713001189 Text en © Cambridge University Press 2013 The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution licence <http://creativecommons.org/licenses/by/3.0/
spellingShingle Original Articles
Cella, M.
Swan, S.
Medin, E.
Reeder, C.
Wykes, T.
Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
title Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
title_full Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
title_fullStr Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
title_full_unstemmed Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
title_short Metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
title_sort metacognitive awareness of cognitive problems in schizophrenia: exploring the role of symptoms and self-esteem
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3880064/
https://www.ncbi.nlm.nih.gov/pubmed/23734941
http://dx.doi.org/10.1017/S0033291713001189
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