Introspective accuracy for social cognition across the psychosis spectrum: Influence of sleep disturbance
People with schizophrenia-spectrum and bipolar disorders can have impairments in introspective accuracy (IA; ability to accurately estimate one’s own abilities). Research suggests that positive, negative, and depressive symptoms may be related to IA, but findings are mixed. Examining sleep disturbance as a determinant of IA may help explain these mixed findings. The current study aimed to explore the relationships between sleep disturbance, symptoms, and IA in participants across the psychosis spectrum. Participants completed diagnostic, symptom, and sleep disturbance assessments. Participants also completed social cognitive tasks, estimated their performance on the tasks (used to calculate IA), and indicated their confidence in their answers. Across the sample, IA and sleep disturbance were not significantly related, and sleep disturbance did not moderate the relationships between symptoms and IA. However, significant relationships were revealed when examining diagnostic groups separately. For those with bipolar disorders and schizophrenia, lower confidence and underestimation of abilities were associated with greater sleep disturbance, while for those with schizoaffective disorder, greater sleep disturbances were associated with higher confidence and overestimation of performance. Additionally, sleep disturbance significantly moderated the relationships between positive symptoms, negative symptoms, and confidence. Findings from the current study suggest that sleep disturbance, and the interaction between sleep disturbance and symptoms, may be impacting IA and confidence in different ways. Results also indicate unique relationships between sleep disturbance, IA, and confidence between diagnostic groups. Future research is needed to further explore these complex relationships, including longitudinal work and studies incorporating assessments of functioning.
schizophrenia, bipolar disorder, confidence, self-awareness, depressive realism, insight, Clinical Psychology
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