Impaired insight in illness in schizophrenia patients associated with social skills

More than half of schizophrenia patients have a limited insight in their illness. In an attempt to discover why some patients do not understand what is wrong with them while others do, Lisette van der Meer from the University Medical Center Groningen conducted research into the link between social skills and illness insight. The ability to recognize and understand one’s own and other people’s emotions and the ability to deal with negative experiences appear to be connected to these patients’ insight into their illness. The areas of the brain that are involved in the relevant social skills overlap and are less active in schizophrenia patients than in healthy people. Van der Meer will be awarded a PhD for her research at the University of Groningen on 25 May 2011.

Poor illness insight among schizophrenia patients can seriously hamper their recovery. It often causes therapy non-complience and leads to problems in their dealings with relations and care workers. Patients with impaired insight tend to deny or trivialize their illness and are often unwilling to attribute their symptoms to a psychiatric disorder.

Seeing yourself as others see you

Inhibiting your own perspective and taking the perspective of someone else allows you to take a look at yourself from a distance and to see yourself as others see you. In other words, seeing the symptoms you are experiencing and the consequences of your illness from someone else’s perspective will give you a better understanding of your illness. Van der Meer suggests that impaired insight in patients with schizophrenia may be connected with their ability to evaluate their own character traits and skills.

Putting negative experiences into perspective

The two main strategies that people normally use to deal with negative experiences are reappraisal (or putting things into perspective) and suppressing emotions. The ability to reappraise is thought to be a healthier strategy than suppressing emotions. In her research, Van der Meer demonstrates that patients with schizophrenia are more likely to choose the strategy of suppressing their negative emotions than healthy people. The patterns of brain activity that were measured seem to indicate that schizophrenia patients make less use of the area of the brain that is involved this process.

A better understanding

Schizophrenia is a complex disorder. Many of the brain processes work differently from the way they do in healthy people. The knowledge gleaned from this piece of research can be used to gain a better understanding of patients with schizophrenia and to help them cope with their illness more effectively.

Curriculum Vitae

Lisette van der Meer (Groningen, 1979) studied psychology at the University of Groningen. She conducted her PhD research at the Neuroimaging Center in the University Medical Center Groningen (UMCG). It was funded by a EURYI grant from the European Science Foundation. Supervisors: A. Aleman and W.A. Nolen. The title of the thesis is: ‘Knowing me, knowing you. The emotional self in schizophrenia and bipolar disorder’. Co-supervisor: G.H.M. Pijnenborg. Van der Meer will now continue her career as a researcher at the Neuroimaging Center of the UMCG and at Lentis in Zuidlaren.

A symposium has been organized in honour of her PhD ceremony. More information about the symposium is available on: www.symposium-ziekte-inzicht.nl