| Popis: |
Insight is impaired in the majority of patients with schizophrenia. This group of patients – more or less – does not consider themselves to be ill and does not recognize the need for treatment. The negative outcomes are immense: they have more problems sticking to medication, a lower quality of life and poorer outcome in general, compared to patients with good insight.Studies in this dissertation showed that abnormalities of numerous brain regions across the brain are associated with impaired insight. This suggests that to have good insight, several complex brain functions have to work unimpededly. That requires orchestrated communication of numerous brain regions across the brain. We also investigated an ability that might be important for having insight, namely self-reflectiveness. Our findings show that brain networks of individuals with lower self-reflectiveness abilities are less stable with regard to brain function and structure. On the other hand, one network was overly present in individuals with lower self-reflectiveness. This is a network that is activated when an individual is not engaged in a task, and that has been shown to be involved in mind wandering.The results of this thesis are important for guiding future treatments of impaired insight such as: 1) strengthening networks that are important for insight, or 2) diminishing function of mind wandering networks. The first could be achieved with the incorporation of several aspects of therapies into treatment that aim to improve neurocognitive, social cognitive and metacognitive functions, while the latter could be achieved with mindfulness meditation training. |
