Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention.
Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention.
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DOI：
10.1080/15487768.2011.622159
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发表时间：
2011-10-01
期刊：
影响因子：
--
通讯作者：
Twamley EW
中科院分区：
文献类型：
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作者：
Burton CZ;Vella L;Twamley EW
有限洞察力的影响是治疗精神疾病患者的一个重要考虑因素。在精神病的背景下，临床和认知洞察力都已被描述。本研究旨在评估参与补偿性认知训练（CT）干预的原发性精神障碍患者的临床和认知洞察力与神经心理功能、精神症状严重程度和日常功能之间的关系。 69 名被诊断患有原发性精神障碍的个体被随机接受为期 3 个月的 CT 干预或标准药物治疗，他们在基线、3 个月和 6 个月时完成了全面的神经心理学、临床和功能测试。 CT干预重点关注四个领域的习惯形成和补偿策略学习：前瞻记忆、注意力和警惕性、学习和记忆以及解决问题/认知灵活性。在基线时，更好的临床洞察力与更好的执行功能和不太严重的阴性症状显着相关。认知洞察力与认知功能、症状严重程度或日常功能之间没有显着关联。 CT 干预对临床或认知洞察力没有影响，但参与 CT 之前较好的认知洞察力可显着预测治疗后阳性和抑郁症状严重程度的降低，而更好的临床洞察力可预测自我报告的生活质量的改善。尽管临床洞察力与执行功能相关，但认知洞察力的相关性仍然难以捉摸。完整的洞察力似乎有利于改善临床症状，如阳性症状和抑郁症，而不是增强认知。在其他社会心理康复之前，制定旨在改善临床和认知洞察力的简短干预措施可能很有价值，以便最大限度地提高治疗效果。
The impact of limited insight is a crucial consideration in the treatment of individuals with psychiatric illness. In the context of psychosis, both clinical and cognitive insight have been described. This study aimed to evaluate the relationships between clinical and cognitive insight and neuropsychological functioning, psychiatric symptom severity, and everyday functioning in patients with a primary psychotic disorder participating in a compensatory cognitive training (CT) intervention. Sixty-nine individuals diagnosed with a primary psychotic disorder were randomized to a 3-month CT intervention or to standard pharmacotherapy, and they completed a comprehensive neuropsychological, clinical, and functional battery at baseline, 3 months, and 6 months. The CT intervention focused on habit formation and compensatory strategy learning in four domains: prospective memory, attention and vigilance, learning and memory, and problem-solving/cognitive flexibility. At baseline, better clinical insight was significantly related to better executive functioning and less severe negative symptoms. There was no significant association between cognitive insight and cognitive functioning, symptom severity, or everyday functioning ability. The CT intervention did not have an effect on clinical or cognitive insight, but better cognitive insight prior to participation in CT significantly predicted decreased positive and depressive symptom severity posttreatment, and better clinical insight predicted improved self-reported quality of life. Although clinical insight is related to executive functioning, the correlates of cognitive insight remain elusive. Intact insight appears to be beneficial in ameliorating clinical symptomatology like positive symptoms and depression, rather than augmenting cognition. It may be valuable to develop brief interventions aimed at improving clinical and cognitive insight prior to other psychosocial rehabilitation in order to maximize the benefit of treatment.