ArticleCognitive neuropsychiatry2019
Impaired introspective accuracy in schizophrenia: an independent predictor of functional outcomes.
Article in Cognitive neuropsychiatry, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 40 papers, 2 of them syntheses that pooled it.
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Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- European Psychiatric Association guidance on assessment of cognitive impairment in schizophrenia.European psychiatry : the journal of the Association of European Psychiatrists · 2022Pooled it
- The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research.Clinical psychology & psychotherapyPooled it
- Subjective perceptions of negative symptoms among outpatients with schizophrenia and their relatives or caregivers: Definitions, importance, measurement, and desired improvement.Schizophrenia research · 2026Article
- Metacognitive discrepancies in schizotypy: Divergence between subjective and objective cognitive functioning.Schizophrenia research. Cognition · 2026Article
- Towards Enhancing Drug Development Methodology to Treat Cognitive Impairment Associated With Schizophrenia and Other Neuropsychiatric Conditions: Insights From 2 Decades of Clinical Trials.Schizophrenia bulletin · 2025Review
- Persons at risk for psychosis overestimate social functioning compared to persons with major depressive disorder and community controls.Journal of psychiatric research · 2025Article
- Protocol for evaluation of iTEST, a novel blended intervention to enhance introspective accuracy in psychotic disorders.NPP - digital psychiatry and neuroscience · 2025Article
- Memory Monitoring Recognition Test (MMRT), a new measurement of stimular source monitoring: Software and comprehension.PloS one · 2025Article
- Cognitive abilities and psychosocial functioning in bipolar disorder: findings from the BIPLONG study.Frontiers in human neuroscience · 2025Article
- Clinical subtypes of schizophrenia based on the discrepancies between objective performance on social cognition tasks and subjective difficulties in social cognition.Schizophrenia (Heidelberg, Germany) · 2024Article
- On Metacognition: Overconfidence in Word Recall Prediction and Its Association with Psychotic Symptoms in Patients with Schizophrenia.Brain sciences · 2024Article
- Relationships between Sleep Quality, Introspective Accuracy, and Confidence Differ among People with Schizophrenia, Schizoaffective Disorder, and Bipolar Disorder with Psychotic Features.Behavioral sciences (Basel, Switzerland) · 2024Article
- Utilizing Technology to Enhance the Ecological Validity of Cognitive and Functional Assessments in Schizophrenia: An Overview of the State-of-the-Art.Schizophrenia bulletin open · 2024Article
- The Discrepancy between Subjective and Objective Evaluations of Cognitive and Functional Ability among People with Schizophrenia: A Systematic Review.Behavioral sciences (Basel, Switzerland) · 2023Review
- Immediate post performance judgements about cognitive performance in schizophrenia and bipolar disorder: associations with test performance and subjective overall judgments regarding abilities.Cognitive neuropsychiatry · 2023Article
- Suicide Safety Plan Self-knowledge in Serious Mental Illness: Psychiatric Symptom Correlates and Effects of Brief Intervention.Community mental health journal · 2023Article
- The self-assessment scale of cognitive complaints in Schizophrenia: validation of the Arabic version among a sample of lebanese patients.BMC psychiatry · 2023Article
- Dynamics of task-based confidence in schizophrenia using seasonal decomposition approach.Schizophrenia research. Cognition · 2023Article
- Negative mood states as a correlate of cognitive performance and self-assessment of cognitive performance in bipolar disorder versus schizophrenia.Schizophrenia research · 2023Article
- Cognitive insight and introspective accuracy in individuals with bipolar disorder: A scoping review.Neuroscience applied · 2023Review
Corrections and comments
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Authors and funding
2 authors.
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Abstract
introductionIndividuals with schizophrenia present across a spectrum of symptomatology. Disability remains a debilitating reality across varying disease presentations and remains pervasive despite psychiatric medications. Cognition (neuro/social cognition) and negative symptoms have emerged as the strongest predictors of real-world disability, but account for <50% of the variance in outcomes.
methodsOur attempts to determine what accounts for the remaining 50% of variance has shown that poor introspective accuracy (IA) may be the most potent predictor of functional outcomes 25% of individuals with schizophrenia. We define IA as the adequacy of self-assessments of ability, skills, performance, or decisions. We suggest that IA is a progression of metacognition and can extend beyond cognition to include misestimation of prior and likely future performance in social or other adaptively relevant situations.
resultsAdditionally, IA is bidirectional and self-orientated. Emerging research has found that IA of neurocognitive ability better predicts everyday functional deficits than scores on performance-based measures or neurocognitive skills and has found that IA of social cognition accounts unique variance in real-world disability above social cognitive performance. DISCUSSION: We argue that impaired IA, affecting 25-50% of patients with schizophrenia, in the absence or minimal presence of other impairments might be the most powerful predictor of functional outcomes.
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