Associations of awareness of illness in schizophrenia spectrum disorder with social cognition and cognitive perceptual organization.

Although impairment in flexibility of abstract thought has been linked to poor insight in schizophrenia, little is known about the association of other cognitive processes to insight. To explore the possibility that social cognition and perceptual organizational capacity are linked to insight, we assessed awareness of illness and administered the Thematic Apperception Test and Rorschach Inkblot Test to 31 adult participants with schizophrenia. Partial correlations controlling for perseverative errors on the Wisconsin Card Sorting Test revealed that lesser capacities to organize and make sense of ambiguous stimuli, to distinguish between one's own and other's perspectives, and to formulate logical accounts of behavior and social exchange predicted poorer awareness of psychiatric symptoms. With replication, results may suggest that to attain awareness of illness, some with schizophrenia may need assistance making sense of the social world and organizing the complexities of their experience of illness.