Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “INSIGHT”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 109 records · Page 6Linked to original sources
PubMed2003

Testing two cognitive theories of insight.

Insight in problem solving occurs when the problem solver fails to see how to solve a problem and then--"aha!"--there is a sudden realization how to solve it. Two contemporary theories have been proposed to explain insight. The representational change theory (e.g., G. Knoblich, S. Ohlsson, & G. E. Rainey, 2001) proposes that insight occurs through relaxing self-imposed constraints on a problem and by decomposing chunked items in the problem. The progress monitoring theory (e.g., J. N. MacGregor, T. C. Ormerod, & E. P. Chronicle, 2001) proposes that insight is only sought once it becomes apparent that the distance to the goal is unachievable in the moves remaining. These 2 theories are tested in an unlimited move problem, to which neither theory has previously been applied. The results lend support to both, but experimental manipulations to the problem suggest that the representational change theory is the better indicator of performance. The findings suggest that testable opposing predictions can be made to examine theories of insight and that the use of eye movement data is a fruitful method of both examining insight and testing theories of insight.

Awareness↗
PubMed2000

The relationship between insight and clinical factors for persons with schizophrenia.

This correlational study examined the relationship of insight with positive and negative symptoms and level of functioning among persons with schizophrenia or schizoaffective disorder. Poor insight as a symptom of schizophrenia is the conceptual framework. Thirty-seven people receiving assertive community treatment, inpatient hospitalization, or outpatient treatment were assessed using 2 self-rating insight scales, the Scale for Assessment of Positive Symptoms (SAPS), the Scale for Assessment of Negative Symptoms (SANS), and the Global Assessment of Functioning (GAF). A significant negative correlation was found between insight and positive formal thought disorder. No significant relationships were found between insight and negative symptoms or level of functioning. Reactions to the self-rating insight tools suggest necessary revisions of the insight tool.

Adult↗
PubMedDate not supplied

Obsessive-compulsive disorder with poor insight.

Although a diagnosis of obsessive-compulsive disorder (OCD) can be made with the specification "poor insight" (PI), this subtype remains understudied. To investigate the subtype, 78 OCD patients were characterized by degree of insight, reevaluated after treatment, and compared with 20 schizophrenics with OCD (OCD+S). At the pretreatment assessments in OCD patients, 28 subjects with poor or delusional insight (PI; 36%) were distinguished from 50 subjects with fair or good insight (GI; 64%) using the insight question of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Compared to the OCD+S group, OCD patients were less likely to have PI, whereas OCD PI patients showed a similar degree of functional impairment as that observed in the OCD+S. After a 6-month combination of clomipramine with cognitive-behavioral treatment, 14 of 25 OCD PI patients no longer fell in the PI category, which was associated with reduced OCD severity and depressive status. Schizotypal personality disorder (SPD) was more common in patients whose insight remained poor even after the treatment. OCD patients demonstrate a range of insight with PI accompanied by significant dysfunction. Comorbid SPD in PI patients may be associated with worse prognosis.

Adult↗
PubMed2002

Insight, psychopathology, and interpersonal relationships in schizophrenia.

Insight of patients with schizophrenia seems to be a complex phenomenon that includes elements of a psychological, psychopathological, neurocognitive, and interactional nature. The purpose of this research was to study two of these areas (psychopathology and interpersonal relationships) in order to determine their influence on insight and their interrelation. Eighty-two outpatients fulfilling DSM-IV criteria for schizophrenia were studied using the Schedule for the Assessment of Insight (SAI), the Positive and Negative Syndrome Scale (PANSS), and the Social Cognitions and Object Relations Scale (SCORS). Bivariate correlations and multiple regression tests were performed. The positive component of the PANSS and the understanding of social causality (SCORS) appeared as the most significant variables related to level of insight. Positive symptoms were inversely related to insight, whereas understanding of social causality was directly associated with an appropriate awareness of illness. These results support the idea that insight is a complex and multidimensional phenomenon. In this respect, the study of the psychopathological dimension of insight should be accompanied by the consideration of interactional and social factors, because awareness of illness can be considered ultimately as an index of concordance between patients' views of the illness and cultural standards regarding mental disorders.

Adolescent↗
PubMed2004

Insight in relation to psychosocial adjustment in schizophrenia.

Insight impairment occurs commonly in patients with schizophrenia, and it can be expected that patients with impaired insight may subsequently have poorer psychosocial adjustment. The aim of the present study was to measure the relationship between insight and psychosocial adjustment in 38 inpatients with a diagnosis of DSM-IV schizophrenia. Insight was assessed using the Scale to Assess Unawareness of Mental Disorder. A comprehensive set of measures was used to assess psychosocial adjustment. No relationship was found between measures of psychosocial adjustment and insight. However, a self-rated measure of psychosocial adjustment was partially related to insight. Our results suggest that patients' insight levels may not be reliable predictors of the patients' level of psychosocial adjustment, and that these findings may need to be considered in continuous care of psychotic patients, in particular when outpatient care needs to be planned.

Adaptation, Psychological↗
PubMed2006

The relationships among insight, social support, and depression in psychosis.

We assessed the role of satisfaction with social support as a mediating factor in the relationship between insight and depression in psychosis. Forty inpatients with schizophrenia-spectrum disorders self-completed measures of insight, social support, and depression. Results showed a curvilinear relationship between insight and satisfaction with support: those with high and low insight tended to have higher satisfaction with support than those with moderate insight. Satisfaction also had a negative relationship with depression. We found no direct relationship between insight and depression. This was consistent with satisfaction with social support mediating the relationship between global insight and depression.

Adult↗
PubMed2006

Insight and recovery from acute psychotic episodes: the effects of cognitive behavior therapy and premature termination of treatment.

Research suggests that insight in schizophrenia is only weakly responsive to targeted psychosocial interventions. One of the aims of the present study was to examine the effects on insight of cognitive behavior therapy (CBT) for acutely psychotic patients. A second aim was to test predictions drawn from research on recovery styles that patients who reject psychological assistance will show a reduction in insight while those who continue to accept psychological assistance will show increases in insight over time. Patients with acute schizophrenia-spectrum disorders were assigned at random to treatment-as-usual (TAU) or TAU plus CBT. The latter were also divided into those who terminated treatment prematurely (dropouts) and those who did not (stay-ins). Insight was assessed at baseline and three follow-up assessments. Insight increased over the follow-up period, but there were no differences between the CBT and TAU groups. Within the CBT group, dropouts showed a reduction in insight at the 6-month assessment before returning to their baseline level, while the stay-ins showed linear improvement up to 12 months. Possible explanations for these contrasting patterns, in terms of resilience, attachment styles, and an insecure sense of self, are discussed.

Acute Disease↗
PubMed2006

Insight and quality of life in schizophrenia: recent findings and treatment implications.

PURPOSE OF REVIEW: Several studies have reported that patients with schizophrenia lack awareness of having a mental disorder or symptoms of a mental disorder. The concept of insight has long been considered important for engagement in treatment, psychotherapeutic progress and good prognosis. RECENT FINDINGS: Contradictory results were found regarding the relationship between insight into illness and quality of life in patients with schizophrenia. Although previous studies found an inverse or no significant association, recent studies reported that greater insight into illness is significantly associated with an increase in depression and poor subjective quality of life. SUMMARY: Patients with good insight might realize their restrictions more clearly. The stigma of being mentally ill and the need for treatment or hospitalization are serious psychological strains. The increase of depression and suicidal ideation and decrease in subjective quality of life in patients with better insight underline the importance of insight for the clinical course in schizophrenia. The inclusion of modules focussing on depressive symptoms and quality of life-related aspects to psychoeducational programmes, as well as a greater awareness of the physician for these questions and a strengthening of the therapeutic alliance, might help improve insight without the risk of deteriorating mood and quality of life.

Awareness↗
PubMed2001

Insight into mental illness and child maltreatment risk among mothers with major psychiatric disorders.

OBJECTIVES: This study examined the relationship between insight into mental illness and current child maltreatment risk among mothers who had a major psychiatric disorder and who had lost custody of a child because of abuse, neglect, or having placed the child at risk of harm. Specifically, a measure of insight was examined in relation to systematically observed parenting behaviors known to be correlated with past child maltreatment and in relation to a comprehensive clinical determination of risk. METHODS: Forty-four mothers who had a major psychiatric disorder were independently rated for their insight into their illness, the quality of mother-child interaction, and the overall clinical risk of maltreatment. RESULTS: Better insight into mental illness was associated with more sensitive mothering behavior and with lower assessed clinical risk of maltreatment. The association remained when mothers with current psychotic symptoms were excluded from the analyses. Better insight did not appear to be associated with past psychotic symptoms, maternal psychiatric diagnosis, or the mother's level of education. CONCLUSIONS: Insight into mental illness may function as a protective factor that influences the risk of child maltreatment in mothers with mental illness. Measures of insight could be usefully incorporated into comprehensive parenting assessments for mothers with psychiatric disorders.

Adult↗
PubMedDate not supplied

Insight in Alzheimer's patients: results of a longitudinal study using three assessment methods.

UNLABELLED: Three direct measures of dementia insight were administered to 20 participants in a longitudinal Alzheimer's disease (AD) rehabilitation research project and to subsets of these participants that completed one (N = 19), two (N = 12), and three (N = 6) years of program participation. The measures were: (1) responses to a discourse prompt question about AD (ADPQ); (2) endorsements of seven items on the Geriatric Depression Scale (GDS) about the effects of dementia (separate analyses were done for two of the seven items that related specifically to memory and thinking); and (3) a sentence-completion exercise. Responses to measures 1 and 2 and the subset of 2 were quantified, tracked over time, and subjected to correlational analyses with age, Mini-Mental State Exam (MMSE) score, and depression, as measured by total GDS score, and with each other. MAJOR FINDINGS: There were no decreases in insight from baseline to year 1, 2, or 3, as measured by free responses to the AD prompt question. There was a significant decline in insight from baseline to year one on the GDS measure, but no change from year 1 to year 2 and a return to baseline level at year 3. There was no correlation between insight and baseline age, between insight and MMSE score at any time point, between MMSE score and depression, as measured by total GDS score, or between MMSE score and depression score, except for the year 3 completers, where depression score was negatively correlated with MMSE score at year 3 only. GDS insight and ADPQ scores were not correlated. Several participants that showed no insight on the quantified measures did so on the sentence completions.

Aged↗
PubMed2003

Predicting engagement with services for psychosis: insight, symptoms and recovery style.

BACKGROUND: Treatment non-adherence and service disengagement are commonly attributed to impaired insight. There is evidence that recovery style (i.e. psychological adjustment) may underlie service engagement. AIMS: We examined whether insight, psychotic symptoms or individuals' recovery style ('integration' v. 'sealing-over') predicts service engagement. METHOD: Fifty patients with schizophrenia were assessed during acute psychosis and at 3-month and 6-month follow-ups. Measures included recovery style, psychosis symptoms, insight and service engagement. RESULTS: Sealing-over at 3 months following onset of an episode of psychosis predicted low service engagement at 6 months. Neither insight nor symptoms predicted engagement. The clear shift from integration to sealing-over within the first 3 months was independent of changes in symptoms or insight. Sealing-over between 3 and 6 months was associated with improvement in psychosis symptoms. CONCLUSIONS: Recovery style contributed more to engagement than did insight, appears to be dynamic in the short term and is orthogonal to insight. Overall, this study demonstrated the importance of addressing psychological adjustment to psychosis as well as illness status when investigating treatment engagement in people with psychosis.

Acute Disease↗
PubMedDate not supplied

[Insight and use of health resources in patients with schizophrenia].

INTRODUCTION: The objective of this work is to study the insight level of patients with schizophrenia and how the insight is related to sociodemographic, clinical and compliance variables. Besides, we evaluated the influence of insight level in the utilization services. PATIENTS AND METHODS: Sixty nine patients meeting schizophrenia criteria were selected. They were evaluated with a sociodemographic questionnaire, clinical and social adjustament scales (SCAN, GAF, PANSS, DAS), a services and cost questionnaire (CECE) and the insight scale of Amador (SUMD). RESULTS: The results were that gender, degree of education, type of residence and some clinical and disability variables were related to insight level. On the other hand, patients with a lower insight level attented more to emergencies and less to mental health centers. CONCLUSION: Insight level is an important determinant of adequate health service use in schizophrenia.

Adult↗
PubMed2003

Function of hippocampus in "insight" of problem solving.

Since the work of Wolfgang Kohler, the process of "insight" in problem solving has been the subject of considerable investigation. Yet, the neural correlates of "insight" remain unknown. Theoretically, "insight" means the reorientation of one's thinking, including breaking of the unwarranted "fixation" and forming of novel, task-related associations among the old nodes of concepts or cognitive skills. Processes closely related to these aspects have been implicated in the hippocampus. In this research, the neural correlates of "insight" were investigated using Japanese riddles, by imaging the answer presentation and comprehension events, just after participants failed to resolve them. The results of event-related functional magnetic resonance imaging (fMRI) analysis demonstrated that the right hippocampus was critically highlighted and that a wide cerebral cortex was also involved in this "insight" event. To the best of our knowledge, this work is the first neuroimaging study to have investigated the neural correlates of "insight" in problem solving.

Adult↗
PubMedDate not supplied

The relationship between insight and symptoms in schizophrenia.

We examined the relationship between insight and the positive, negative, active, dysphoric, and autistic dimensions of symptoms in patients with a diagnosis of schizophrenia. Ninety-six patients with a diagnosis of schizophrenia were assessed using the Scale to Assess Unawareness of Mental Disorder, Revised Version (SUMD-R) and the Positive and Negative Syndrome Scale (PANSS). The PANSS data were analyzed based on a five-factor model defined by White et al (1997). The percentage of patients having a lack of awareness was 32.7% for illness, 58.2% for symptoms, 18.4% for treatment response, and 41.8% for social consequences. Lack of awareness of symptoms was significantly correlated with all five symptom factors. Lack of awareness of the illness and its social consequences was only correlated with the positive dimension. Lack of awareness of achieved effects of medication was correlated with the autistic preoccupation factor. There was no correlation between current misattributions for symptoms and PANSS factors. We conclude that poor insight is a common feature of schizophrenia and has a complex relationship to other symptoms of the illness. Our results suggest that (1) unawareness of symptoms is related to severity of illness; (2) insight into illness and its social consequences is more closely tied to positive symptoms than other aspects of insight; and (3) insight into the effects of medication is more closely related to cognitive impairment. Treatment studies that measure insight could answer the question of whether these deficits in awareness improve along with positive and cognitive symptoms.

Adult↗
PubMed2006

Insight, symptoms and neurocognition in bipolar I patients.

BACKGROUND: Level of insight and its relationship to clinical variables and neurocognitive functions was assessed in bipolar I patients. METHODS: Verbal memory, executive functioning, sustained attention, general intelligence and other neurocognitive functions were compared between 37 chronic in- and outpatients and 31 matched normal controls. Detailed psychiatric interviews were completed to define the level of symptomatology and psychosocial functioning. Insight was assessed by the Scale to Assess Unawareness of Mental Disorder (SUMD). RESULTS: Seventy percent of the patients were classified as having impaired insight. Prevalence of impaired insight was 47% and 94% in remitted and symptomatic patients, respectively. Symptomatic patients scored significantly below remitted patients on insight and neurocognition. Illness and symptom unawareness were related to overall level of symptoms, measures of memory, conceptual ability and right hand psychomotor speed and accuracy. Misattribution of symptoms and signs was correlated to visuomotor speed and visuospatial performance in addition to affective symptoms and thought disturbance. CONCLUSIONS: Our findings support the hypothesis that impaired insight and other neurocognitive dysfunctions were present in a large percentage of cases among symptomatic as well as remitted bipolar patients. This may be of clinical relevance and raises important questions about the course and outcome of the illness.

Adult↗
PubMed1996

Portable chest radiology in intensive care: a comparison of a new dual characteristic film-screen system (Insight) incorporating a flexible grid with a standard film-screen system.

Insight (Insight, Kodak, UK) is a new dual image receptor system which utilizes an asymmetric film screen combination. Conventional radiography was compared with the Insight system, in combination with a cassette incorporating a flexible grid, in fifty patients on the intensive care unit. Radiographs were analysed by intensive care junior medical staff, nursing staff and two groups of radiologists. Insight provided better visualization of lung parenchyma, mediastinal detail and position of endotracheal tubes than conventional radiography. Central venous catheters were generally seen better on conventional radiographs than on Insight. Insight system produces a significant improvement in plain chest radiography in the intensive care unit. In the absence of digital radiography it is a suitable technique for routine radiography in the intensive care unit.

Aged↗
PubMedDate not supplied

Insight and clinical correlates in schizophrenia.

It is not clear to what extent poor insight is inherent in schizophrenic psychopathology or is related to clinical factors. It is clinically important to elucidate this point to know how some insight remains intact in schizophrenia. Sixty-three ICD-10 schizophrenics were recruited. Insight was measured by David's three-dimensional scale, which deals with the awareness of the need for treatment, of the illness, and of psychotic experiences. Clinical factors that may influence insight were grouped into objective psychopathology, subjective experience, and treatment settings, according to the normal development of insight starting from objective illness, through subjective perception of it, to seeking treatment. Psychopathology was measured by the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms (SANS), and the subjective experience was measured by a checklist of our own. Positive symptoms, especially disordered thought, hallucinations, and delusions, had a modest inverse correlation with awareness of illness and of psychotic experiences, but these were not correlated with alogia or other negative symptoms. Later age at the first onset was significantly correlated with poor awareness of psychotic experience, but no correlation of subjective experience with insight emerged. Awareness of the need for treatment was significantly higher in outpatient than in inpatient groups, and was not correlated with any other variables. Poor awareness of illness and of psychotic experience seems to be a trait of the acute rather than the chronic psychopathology of schizophrenia. Poor awareness of psychotic experience was related to later onset. Awareness of the need for treatment seems to improve, even in the absence of awareness of illness or of psychotic experience, in outpatient settings--the effects of social interaction may be relevant to this.

Adult↗
PubMedDate not supplied

Insight and recovery from psychosis in chronic schizophrenia and schizoaffective disorder patients.

Impaired insight is an important contributing factor to poor treatment response and outcome in schizophrenia. Prior studies have attempted to identify the illness characteristics that underlie these deficits, with conflicting results regarding associations with symptoms and neurocognitive deficits. These inconsistencies may be a function of a number of methodological issues, which were addressed in this study. In a prospective, longitudinal study, 50 individuals with schizophrenia or schizoaffective disorder underwent baseline assessments upon discharge from an acute inpatient unit, and again at a 6-month follow-up. Unawareness of positive and negative symptoms were studied separately, with analyses focusing on changes in insight over time as well as associations with disorganized symptoms, depression, and card sorting deficits. Subjects showed greater insight for negative symptoms than for positive symptoms. Insight for positive symptoms improved only slightly over the follow-up period, while negative symptom awareness did not change. Insight for negative symptoms showed modest associations with card sorting deficits, while awareness for positive symptoms showed stronger associations with thought disorder, depression, and card sorting deficits. Awareness for positive symptoms in schizophrenia may be distinct from awareness of negative symptoms. Clinicians should also be aware of the multidetermined nature of impaired insight, and future research should aim to isolate distinct mechanisms that give rise to these deficits.

Adolescent↗