Exploring the Temporal Relationship Between Cognitive Insight and Neurocognition in Schizophrenia: A Prospective Analysis

Abstract

The present research is an investigation of prospective links between neurocognition (assessed with a well-validated, computerized battery of performance tasks) and cognitive insight (assessed with the Beck Cognitive Insight Scale), using data from two longitudinal studies of adult outpatients diagnosed with schizophrenia or schizoaffective disorder: a 6-month naturalistic follow-up (N = 168) and a 24-month clinical trial of recovery-oriented cognitive therapy (N = 60). In both studies, cognitive insight prospectively predicted changes in neurocognitive performance, suggesting that reductions in cognitive insight temporally preceded neurocognitive changes. It is important that in neither study was the reverse relationship supported, nor do the findings appear to be accounted for by differential stability of the measures or changes in symptomatology. If corroborated by further research, a significant implication is that increasing cognitive insight may bolster neurocognition (as a possible alternative or supplement to “cognitive remediation”). Potential mechanisms involved in this link are discussed.