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Title: Can Cognitive Insight predict recovery from psychosis in a first-episode cohort
Author: O'Connor, Jennifer
ISNI:       0000 0004 8498 486X
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2015
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Recovery from first episode psychosis (FEP) is heterogeneous and level of cognitive impairment at illness onset may explain later recovery (symptom severity and functional disability). Poor ability to self-reflect (a meta-cognitive impairment) and over-confidence in judgement (a reasoning bias) are associated with greater symptom severity in FEP. However, the relationship between these higher-order cognitive constructs and recovery over time is unclear. It was hypothesised that good Cognitive Insight (high self-reflectiveness and low self-certainty) would predict better mediumterm recovery (five years) after the onset of psychotic illness. An additional interest was whether Cognitive Insight would predict recovery status after accounting for other cognitive variables (Jumping to Conclusions: JTC bias and IQ). FEP participants (n= 111) completed the Beck Cognitive Insight Scale (BCIS) at illness onset, and associations between BCIS scores and symptom and functional recovery 12 months and five years later, were assessed. Cognitive Insight did not predict recovery in this study. Rather, only aspects of the BCIS scale that indexed meta-cognition (self-reflection items) predicted symptom recovery at five years, whereas reasoning processes (self-certainty items) were not associated with symptom recovery. No aspect of cognition in this study predicted functional disability. Significant correlations between the JTC bias, self-certainty and IQ were found, which suggests a neuropsychological basis to reasoning processes, separate to meta-cognitive ability. Psychological interventions should focus on increasing self-reflective capacity rather than correcting reasoning bias to reduce symptom severity in psychosis.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available