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ORIGINAL RESEARCH article

Front. Psychiatry
Sec. Schizophrenia
Volume 15 - 2024 | doi: 10.3389/fpsyt.2024.1371431

Association between cognitive insight and anxiety among community-dwelling schizophrenia patients: The chain mediating effects of family cohesion and chronotype

Provisionally accepted
Meijun Dong Meijun Dong 1Dongmei Wu Dongmei Wu 2,3*Guoju Mao Guoju Mao 2Zhangrong Yan Zhangrong Yan 1
  • 1 College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China
  • 2 Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, Sichuan Province, China
  • 3 Department of Nursing, Chengdu, Sichuan Province, China

The final, formatted version of the article will be published soon.

    Objective: To investigate the effect of cognitive insight on anxiety in community-dwelling schizophrenia patients and to construct a chain mediating model to determine the underlying mechanisms of the relationship between cognitive insight and anxiety through family cohesion and chronotype. Methods: The Beck Cognitive Insight Scale, the Chinese version of the Family Adaptability and Cohesion Scale, the Morningness-Eveningness Scale, and the Generalized Anxiety Disorder Scale were used to assess cognitive insight, family cohesion, chronotype, and anxiety in a sample of 785 individuals with schizophrenia living in the community. Spearman correlation analysis, multiple linear regression and Bootstrap methods were employed to analyze the four variables. Results: Residential region, current employment status, and family economic status impacted anxiety among community-dwelling schizophrenia patients. All variables were associated with each other, but self-certainty was not significantly associated with anxiety. Cognitive insight and selfreflection had direct effects on anxiety, as well as indirect effects on anxiety through the partial mediating effect of chronotype, the suppressing effect of family cohesion, and the chain mediating effect of family cohesion and chronotype. Conclusions: Family cohesion and chronotype can mediate the relationship between cognitive insight and anxiety. Improving family functioning, promoting emotional relationships within families, and correcting non-circadian sleep patterns can reduce anxiety in community-dwelling schizophrenia patients, with important implications for improving adverse mental health outcomes.

    Keywords: Schizophrenia, Cognitive insight, Anxiety, Family cohesion, Chronotype, Community, Mediating effect

    Received: 16 Jan 2024; Accepted: 17 Jul 2024.

    Copyright: © 2024 Dong, Wu, Mao and Yan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Dongmei Wu, Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, 610054, Sichuan Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.