Service engagement among patients with schizophrenia-spectrum disorders: Examining the role of insight and executive functioning

Jesse Barglow, Fordham University


This study utilized a person-centered approach to investigate the role of insight and executive functioning in service engagement among patients with schizophrenia-spectrum disorders. The sample was comprised of 61 patients with schizophrenia-spectrum and psychotic disorders who were receiving outpatient treatment at the St. Luke’s Hospital Psychiatric Recovery Center. The study addressed gaps in the literature by testing the utility of an integrative insight model for predicting short-term service engagement among this population. Findings provided limited support for study hypotheses. Two distinct groups of patients with poor insight did emerge from the cluster analysis: one characterized by poor executive functioning and poor insight, and a second characterized by average executive functioning and poor insight. However, these two groups did not differ on clinician-rated service engagement over the first three months of treatment. Instead, level of insight at baseline, regardless of level of executive functioning, predicted 3-month service engagement. The small size of the average executive functioning—poor insight group may have prevented significant differences from emerging across the two poor insight groups, and thus future research evaluating integrative insight models will benefit from larger overall sample sizes. Also, level of executive functioning was assessed using a single index. Future research exploring associations between insight, executive functioning, and service engagement will benefit from more nuanced and comprehensive assessments of executive functioning. However, current findings do highlight the association between insight and service engagement and reinforce the importance of identifying patients with poor insight and providing them with additional clinical attention.

Subject Area

Clinical psychology

Recommended Citation

Barglow, Jesse, "Service engagement among patients with schizophrenia-spectrum disorders: Examining the role of insight and executive functioning" (2015). ETD Collection for Fordham University. AAI3728974.