Cognitive insight predicts favorable outcome in cognitive behavioral therapy for psychosis

摘要

Cognitive insight includes the process of re-evaluating distorted beliefs and misinterpretations and is believed to play a mediating role in the development and maintenance of psychotic symptoms. The primary aim of this study was to examine the relationship between cognitive insight and treatment response during cognitive behavioral therapy for psychosis (GBTp). Seventy-eight outpatients with psychosis were administered the Beck Cognitive Insight Scale and the Psychotic Symptom Rating Scales on two occasions (pretreatment and posttreatment) during a course of CBTp. Higher baseline cognitive insight predicted reduced delusional severity posttreatment and gains in cognitive insight made during therapy were associated with clinically significant reductions in the severity of both delusions and auditory verbal hallucinations by the end of therapy. The findings support the validity and clinical utility of the cognitive insight construct in psychosis and suggest that cognitive insight may be a predictor and mediator of symptom reduction in CBTp.