Browsing by Author "van Donkersgoed, Rozanne J. M."

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    Predicting therapy success from the outset: The moderating effect of insight into the illness on metacognitive psychotherapy outcome among persons with schizophrenia
    (Wiley, 2019) de Jong, Steven; Hasson-Ohayon, Ilanit; van Donkersgoed, Rozanne J. M.; Timmerman, Marieke E.; van der Gaag, Mark; Aleman, Andre; Pijnenborg, G. H. Marieke; Lysaker, Paul H.; Psychiatry, School of Medicine
    The degree to which a person recognizes their mental disorder, attributes symptoms to the disorder, and recognizes that treatment may be necessary is frequently referred to as clinical insight. The current study investigates whether clinical insight at baseline moderates the effects on metacognitive capacity of 40 sessions of metacognitive reflection and insight therapy among 35 participants with psychosis. Findings showed that clinical insight did not predict drop‐out from therapy. Multilevel analyses provided support for our hypotheses that insight at baseline significantly moderates metacognitive gains at both postmeasurement and follow‐up. Our findings demonstrate that lacking clinical insight substantially hampers the effect of this psychosocial intervention. We posit that research efforts should shift from developing interventions, which enhance clinical insight, to interventions, which are effective in absence of clinical insight.
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    Self-stigma and cognitive insight in individuals at ultra-high risk for psychosis
    (Frontiers Media, 2023-04-13) Sportel, Bouwina Esther; van Enthoven, Mirjam; van Donkersgoed, Rozanne J. M.; Kuis, Daan Jan; van de Giessen, Tara; Lysaker, Paul H.; Hasson-Ohayon, Ilanit; de Jong, Steven; Boonstra, Nynke; Pijnenborg, Gerdina H. M.; Psychiatry, School of Medicine
    Background: Impaired cognitive insight and increased self-stigma have been consistently reported in individuals diagnosed with schizophrenia spectrum disorders, but little is known about its presence in individuals at ultra-high risk of developing a psychosis, although self-stigma is associated with transition to psychosis. The current study examined whether self-stigma is already present in individuals at ultra-high risk of psychosis, and whether this is associated with impaired cognitive insight. Methods: 184 participants were recruited divided over three groups, namely individuals diagnosed with a schizophrenia spectrum disorder (SSD; n = 92, 34% females), individuals at ultra-high risk for psychosis (UHR; n = 43, 59% females) and general population controls (GPC; n = 49, 27% females). All participants completed assessments on demographic information (gender, age, education), and cognitive insight. In addition, participants with SSD and individuals at UHR completed a questionnaire on self-stigma. Results: The level of self-stigma did not differ between individuals at UHR and individuals diagnosed with SSD. Cognitive insight also did not differ significantly between the three groups, but the subscale self-reflection differed between the three groups [F(2,184) = 4.20, p = 0.02], with the UHR and SSD groups showing more self-reflection. Pearson's correlation analyses showed that in individuals at UHR total cognitive insight and its self-reflection subscale were significantly associated with the alienation subscale of self-stigma, and in individuals with SSD self-certainty subscale of cognitive insight was significantly associated with stereotype endorsement. Conclusion: Findings show that self-stigma was already present in the UHR phase, to a similar degree as in individuals with a diagnosis of a SSD, and is thus not dependent of previous experience of having a label of SSD. Cognitive insight in individuals at UHR of psychosis appears to be intact, but individuals at UHR showed more self-reflectiveness, and individuals at risk with high cognitive insight also experience high levels of self-stigma. Overall findings from our study suggest that pre-emptive interventions targeting self-stigma, while considering cognitive insight, are needed early on in manifestation of psychotic illness, preferably already in the UHR phase.