Relationship between future time insight and academic procrastination among secondary vocational students： the mediating role of self-control / 四川精神卫生

ObjectiveTo explore the influence of future time insight on academic procrastination and the role of self-control among secondary vocational students， and to provide references for mental health education of them. MethodsA total of 1 419 secondary vocational students from 2 secondary vocational schools in Huangshan City Anhui Province were selected as the research objects in June 2022. The future time insight questionnaire for adolescents， the academic procrastination questionnaire for middle school students and the Self-Control Scale （SCS） were used to assess the future time insight， academic procrastination and self-control ability of secondary vocational students. The mediating effect test of PROCESS was used to analyze the mediating role of self-control between future time insight and academic procrastination. Results①There was a positive correlation between the future time insight questionnaire for adolescents score， the SCS score and the academic procrastination questionnaire of middle school students score （r=0.558， 0.470， P<0.01）. ②Both future time insight and self-control could positively predict academic procrastination （β=0.463， 0.218， P<0.01）， while future time insight could positively predict self-control （β=0.348， P<0.01）. ③Self-control partially mediated the relationship between future time insight and academic procrastination ［indirect effect=0.076 （95% CI： 0.052~0.101， P<0.01）， and the indirect effect accounted for 16.41% of the total effect］. ConclusionThe future time insight of secondary vocational students can affect academic procrastination directly or indirectly through self-control， which partially mediates the relationship between future time insight and academic procrastination.

Metacognición, insight clínico y sintomatología en pacientes ambulatorios chilenos con Esquizofrenia

Introducción: Las personas con esquizofrenia presentan graves dificultades para formar ideas complejas sobre sí mismos y otros, definidas como déficits metacognitivos, junto a menor insight clínico o capacidad para tomar conciencia de poseer un trastorno de salud mental. El presente estudio evaluó dichas alteraciones y las correlaciones entre metacognición, insight clínico y sintomatología en pacientes ambulatorios con esquizofrenia. Metodología: Se diseñó un estudio cuantitativo, relacional, prospectivo, transversal y observacional. Treinta y un pacientes ambulatorios del Centro Diurno "Luz y Esperanza" de Talca (Chile) fueron evaluados utilizando la Metacognitive Assessment Scale-Abbreviated, Scale of Unawareness of Mental Disorder y la Escala de Síndromes Positivo y Negativo, en el período 2019-2020. Resultados: Se encontraron bajos puntajes metacognitivos y de insight clínico, destacando las correlaciones estadísticamente significativas de puntaje metacognitivo total, Autorreflexividad y Maestría con escasa Conciencia de poseer un trastorno y las subescalas de síntomas negativos y desorganización. Conclusiones: Nuestros resultados respaldan la inclusión de los déficits metacognitivos y de insight clínico en los modelos de esquizofrenia. Se discute sobre su potencial aporte en el diseño de intervenciones psicoterapéuticas que promuevan estas capacidades e influyan en los síntomas negativos y de desorganización. Es necesario replicar estudios sobre estas variables en nuestro país, que incluyan un mayor número de participantes.

Introduction: People with schizophrenia have serious disturbances in forming complex ideas about themselves and others, defined as metacognitive deficits, along with less clinical insight or awareness of mental disorder The present study assessed these disturbances and the correlations between metacognition, clinical insight and symptomatology in outpatients with schizophrenia. Methods: A quantitative, relational, prospective, cross-sectional and observational study was designed. Thirty-one outpatients of the "Luz y Esperanza" Day Center in Talca (Chile) were evaluated using the Metacognitive Assessment Scale-Abbreviated, Scale of Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale, in the period 2019-2020. Results: Low metacognitive and clinical insight scores were found, highlighting statistically significant correlations of total metacognitive score, Self-Reflectivity and Mastery with low Awareness of mental disorder and the subscales of negative symptoms and disorganization. Conclusions: Our results support the inclusion of metacognitive deficits and clinical insight in schizophrenia models. Its potential contribution to the design of psychotherapeutic interventions that promote these abilities and influence negative and disorganized symptoms is discussed. It is necessary to replicate studies about these variables in our country, including a greater number of participants.

A Comparative study of insight in patients of depressive spectrum disorders attending outpatient department of tertiary care centre.

Introduction: Poor insight is a common feature of bipolar depression and unipolar depression with and without psychotic symptoms (PS) which may lead to poor clinical outcome. Studies on insight in these populations are relatively limited and the majority of studies were published over the previous decade. Methods: This was a cross-sectional, observation study conducted in Psychiatry O.P.D. of tertiary care hospital. The sample consisted cohort of 20 outpatients each with unipolar depression, unipolar depression with psychotic symptoms and bipolar disorder current episode depression with psychotic symptoms. The depression was assessed by HAM-D and insight by Item G12 of the General Psychopathology section of PANSS. Results: Significant difference in insight is seen in all three groups. Bipolar patients with PS had the poorest insight, patients with unipolar depression had best. Statistically significant correlation is present with older age and lack of insight among patients of unipolar depression with PS (rho =.599, P =.005) and bipolar depression with PS (rho =.686 P=.001). Conclusion: Insight in depressive illness is affected by multiple factors; this study shows that age, bipolarity and presence of psychotic symptoms are associated with poor insight. Management of the patients of depressive spectrum should incorporate strategies to improve insight

Evidências de Validade de Conteúdo da Beck Cognitive Insight Scale, Versão Brasileira (BCIS-BR) / Content Validity Evidence of the Beck Cognitive Insight Scale Brazilian Version (BCIS) / Evidencia de Validez de Contenido de la Beck Cognitive Insight Scale, Versión Brasileña (BCIS-BR)

O insight cognitivo ou clínico refere-se à capacidade de atribuição de sentido aos sintomas presentes em transtornos psicóticos, especialmente naqueles relacionados ao espectro da esquizofrenia. A Beck Cognitive Insight Scale (BCIS) foi desenvolvida com a finalidade de auxiliar o tratamento de pessoas com o insight comprometido. No entanto, este instrumento ainda não foi devidamente adaptado ao contexto brasileiro. Este estudo teve como objetivo fazer a adaptação transcultural da BCIS para o português do Brasil por meio da evidência de validade de conteúdo. Seis juízes avaliaram os itens desta escala quanto à clareza da linguagem, pertinência prática, relevância teórica e relação item-dimensão. A BCIS apresentou concordância satisfatória nos índices de validade de conteúdo e homogeneidade das respostas referente à análise da clareza da linguagem, pertinência prática e relevância teórica e concordância entre item-dimensão teórica, com reformulação de alguns itens. A retrotradução da escala recebeu aval positiva de uma das autoras originais. No entanto, ainda é necessária a verificação das propriedades psicométricas desta versão da BCIS.

Cognitive or clinical insight refers to the ability to assign meaning to symptoms present in psychotic disorders, especially those related to the schizophrenia spectrum. The Beck Cognitive Insight Scale (BCIS) was developed to support the treatment of people with impaired insight. However, this instrument has not yet been adapted to the Brazilian context. This study aimed to make the cross-cultural adaptation of the BCIS into Brazilian Portuguese through evidence of content validity. Six judges evaluated the items of this scale regarding clarity of language, practical relevance, theoretical relevance and item-dimension relatedness. The BCIS presented satisfactory agreement in the indices of content validity and homogeneity of responses regarding the analysis of clarity of language, practical relevance and theoretical relevance and agreement between item-theoretical dimension, reformulating some items. The back-translation of the scale received a positive endorsement from one of the original authors. However, it is still necessary to verify the psychometric properties for this version of the BCIS.

El insight cognitivo o clínico se refiere a la capacidad de asignar un significado a los síntomas presentes en los trastornos psicóticos, especialmente aquellos relacionados con el espectro de la esquizofrenia. La Escala de Insight Cognitivo de Beck (BCIS) fue desarrollada para apoyar el tratamiento de personas con insight comprometido. Sin embargo, este instrumento todavía no ha sido adaptado al contexto brasileño. Este estudio tuvo como objetivo realizar la adaptación transcultural de la BCIS al portugués brasileño mediante pruebas de validez de contenido. Seis jueces evaluaron los ítems de esta escala en cuanto a la claridad del lenguaje, la relevancia práctica, la relevancia teórica y la relación ítem-dimensión. La BCIS presentó una concordancia satisfactoria en los índices de validez de contenido y homogeneidad de respuestas en cuanto al análisis de la claridad del lenguaje, relevancia práctica y relevancia teórica, y concordancia entre ítem-dimensión teórica, reformulando algunos de los ítems. La retraducción de la escala recibió una aprobación positiva de una de las autoras. Todavía es necesario verificar las propiedades psicométricas de esta versión de la BCIS.

Passagens pela História da Gestalt: de Mach/Ehrenfels a Wertheimer, Koffka e Köhler / Passages through Gestalt History: from Mach/Ehrenfels to Wertheimer/Koffka/Köhler / Pasajes por la Historia de la Gestalt: de Mach/Ehrenfels a Wertheimer, Koffka y Köhler

O artigo pretende fazer a leitura de textos que marcaram a história da teoria da Gestalt nas suas fases iniciais de desenvolvimento. Assim, procura redescobrir as origens do termo a partir de conceitos como Tongestalt, de Ernst Mach, e Gestaltqualitäten, de Christian von Ehrenfels, para alcançar as raízes filosóficas da psicologia da Gestalt. Em seguida, focando sobre a base da psicologia da Gestalt, a pesquisa se dedica aos fatores da Gestalt descritos por Max Wertheimer como leis gerais da teoria da Gestalt, à introdução da Gestalt theory nos Estados Unidos por Kurt Koffka a partir da apresentação do ponto de vista da Gestalt sobre a teoria da percepção e ao esclarecimento sobre o conceito de insight por Wolfgang Köhler por meio da abordagem exaustiva da perspectiva do leigo. Logo, o texto tenta ser capaz de dar mostras da evolução do conceito de Gestalt ao longo do tempo e ao mesmo tempo conectar uma variedade de definições e facetas da Gestalt.

The article intends to read texts that marked the history of Gestalt theory in its early stages of development. Thus, it seeks to rediscover the origins of the term from concepts such as Ernst Mach's Tongestalt and Christian von Ehrenfels's Gestaltqualitäten in order to reach the philosophical roots of Gestalt psychology. Next, focusing on the basis of Gestalt psychology, the research focuses on the Gestalt factors described by Max Wertheimer as general laws of the Gestalt theory, the introduction of Gestalt theory into the United States by Kurt Koffka from the presentation of the point of view of Gestalt over the theory of perception, and the clarification on the concept of insight by Wolfgang Köhler by the means of an exhaustive approach in layman's terms. So the text tries to be able to show off the evolution of the concept of Gestalt over time and at the same time to connect a variety of definitions and facets of Gestalt.

El artículo pretende leer textos que marcaron la historia de la teoría de la Gestalt en sus primeras etapas de desarrollo. Así, busca redescubrir los orígenes del término a partir de conceptos como Tongestalt de Ernst Mach y Gestaltqualitäten de Christian von Ehrenfels para llegar a las raíces filosóficas de la psicología de la Gestalt. A continuación, centrándose en la psicología de la Gestalt, la investigación se concentra en los factores de la Gestalt descritos por Max Wertheimer como leyes generales de la teoría de la Gestalt, la introducción de la Gestalt-theorie en Estados Unidos por Kurt Koffka a partir de la presentación del punto de vista de la Gestalt sobre la teoría de la percepción y la clarificación acerca del concepto de insight por Wolfgang Köhler por medio de un enfoque exhaustivo en términos legos. Por lo que el texto trata de poder dar muestras de la evolución del concepto de Gestalt a lo largo del tiempo y al mismo tiempo conectar una variedad de definiciones y facetas de Gestalt.

Association of insight, avoidance behavior, indecisiveness, and inflated responsibility with other clinical characteristics in children and adolescents with obsessive-compulsive disorder

Objectives: Although the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) includes ancillary symptom dimensions - insight, avoidance, degree of indecisiveness, inflated sense of responsibility, pervasive slowness/disturbance of inertia, and pathological doubting -, we know little about their clinical/scientific utility. We examined these ancillary dimensions in childhood obsessive-compulsive disorder (OCD), and tested their associations with clinical characteristics. Methods: Treatment-seeking children and adolescents (n=173) with a DSM-5 OCD diagnosis were recruited from six centers in India and evaluated with a semi-structured proforma for sociodemographic/clinical details, the Structured Clinical Interview for DSM-5, the CY-BOCS, the Children's Depression Rating Scale, and the Family Interview for Genetic Studies. Regression analysis was used to study the associations between ancillary dimensions (independent variables) and clinical variables (dependent variables). Results: 87.9% of the sample reported at least a mild-moderate severity of ancillary dimensions, which were highly intercorrelated. Multiple ancillary dimensions were correlated with illness severity on the CY-BOCS. On regression analysis, only insight and avoidance retained significance. There were few differential associations between OCD symptom and ancillary dimensions. Conclusion: Ancillary dimensions are more a feature of illness severity than differentially associated with individual symptom dimensions in childhood OCD. Insight and avoidance should be considered for inclusion in the assessment of illness severity in childhood OCD.

Dialogia e insight: narrativas de pais e filhos sobre o transtorno de asperger / Dialogismo y insigth: narrativas de padres y hijos sobre el trastorno de asperger / Dialogism and insight: parents and children narratives about asperger disorder

Resumo O presente estudo objetivou investigar os processos de insight em sujeitos com Transtorno de Asperger (TA). Entende-se por insight o conhecimento do próprio diagnóstico e os sentidos construídos a partir deste. O desenvolvimento doinsight é aqui compreendido não como função restrita à vida mental pessoal, mas como fenômeno intersubjetivo, forjado nas relações sociais. O arcabouço teórico que subsidia a presente pesquisa é a perspectiva genética de desenvolvimento avançada pela psicologia histórico-cultural. Para tanto, foram propostas a três díades de pais e adolescentes diagnosticados com TA duas tarefas de produção narrativa que investigaram aspectos relacionados às experiências Asperger. Os resultados sugerem que a característica central dos processos de insight no TA pode ser descrita como disrupção na transição do modo monológico para o modo dialógico de pensamento. Acredita-se que os resultados aqui encontrados contribuem para a compreensão da singularidade e eventicidade da existência e da experiência subjetiva.

Resumen El presente estudio tuvo como objetivo investigar los procesos de insight en sujetos con trastorno de Asperger (TA). Insight significa el conocimiento del diagnóstico mismo y los significados construidos a partir de él. El desarrollo del insight se entiende aquí no como una función restringida a la vida mental personal, sino como un fenómeno intersubjetivo, forjado en las relaciones sociales. El marco teórico que sustenta esta investigación es la perspectiva genética del desarrollo que adelanta la psicología histórico-cultural. Para ello, a tres díadas de padres y adolescentes diagnosticados de TA se les ofrecieron dos tareas de producción narrativa que investigaban aspectos relacionados con las experiencias de Asperger. Los resultados sugieren que la característica central de los procesos de insight en TA puede describirse como una interrupción en la transición del modo de pensamiento monológico al dialógico. Se cree que los resultados encontrados aquí contribuyen a la comprensión de la singularidad y la eventualidad de la existencia y la experiencia subjetiva.

Abstract The present article aimed to investigate insight processes in people with Asperger disorder. Insight is understood as the knowledge of one's own diagnosis and the senses built from it. The insight development is understood here not as a function of personal psychological life, but as an intersubjective phenomenon, forged in social relations. The theoretical framework that subsidizes this research is the genetic perspective of development advanced by cultural-historical psychology. For this purpose, two tasks of narrative production were proposed to three dyads of parents and teenagers with AD, which investigated aspects related to Asperger experiences. The results suggest that the central characteristic of insight processes in AD can be described as a disruption in the transition of a thinking monologic mode to a thinking dialogic mode. It is believed that the results here found contribute to the comprehension of singularity and occurrence of subjective experience and existence.

A mudança em psicanálise e a psicanálise em mudança: Parte I / The change in psychoanalysis and the changing psychoanalysis: Parte I / El cambio en el ppsicoanálisis y el psicoanálisis en cambio: Parte I

O tema é como é vista a ação terapêutica em psicanálise hoje e no passado. Defendo a ideia de que se assiste com frequência a uma sobrevalorização das visões e intervenções tradicionais com desconhecimento das conceptualizações e descobertas mais recentes, e noutros casos por uma preferência pelas novas formas de conceptualização e intervenção e desvalorização excessiva das mais antigas. Conceitos-chaves no processo terapêutico como a recordação, o insight, a interpretação, a resistência, neutralidade e a transferência foram reformulados ou deixaram de ser o centro da atuação e viram diminuída a sua importância, cedendo a relevância a conceitos como a contratransferência, identificação projetiva e, mais recentemente, a relação, o enactment, a emoção, as relações interpessoais fora do setting, e o futuro do paciente. A psicanálise virou a sua atenção do paciente para analista. Discutem-se as mudanças das visões tradicionais em visões contemporâneas e as suas implicações em dois textos. Neste texto, identificado como a primeira parte, vamos abordar a recordação, o insight, interpretação, resistência e neutralidade. Os restantes serão abordados na segunda parte.

The topic is how the therapeutic action in psychoanalysis is seen today and in the past. I support the idea that there is often an overvaluation of traditional views and interventions with ignorance of the latest conceptualizations and discoveries and in some cases a preference for new forms of conceptualization and intervention and excessive devaluation of the older ones. Key concepts in the therapeutic process such as recall, insight, interpretation, resistance, neutrality, and transference have been reformulated or ceased to be the center of action and have diminished their importance, yielding relevance to concepts such as countertransference, projective identification, and more recently to relation, enactment, emotions, interpersonal relationships outside the setting, and the patient's future. Psychoanalysis turned its attention from the patient to the analyst. We discuss the changes of traditional visions in contemporary visions and their implications in two texts. In this text identified as the first part we will address recall, insight, interpretation, resistance, and neutrality. The remainder will be covered in Part Two.

El tema es cómo se ve la acción terapéutica en el psicoanálisis hoy y en el pasado. Apoyo la idea de que a menudo hay una sobrevaloración de los puntos de vista e intervenciones tradicionales con ignorancia de las últimas conceptualizaciones y descubrimientos y, en algunos casos, una preferencia por nuevas formas de conceptualización e intervención y una devaluación excesiva de las más antiguas. Los conceptos clave en el proceso terapéutico, como el recuerdo, el insight, la interpretación, la resistencia, la neutralidad y la transferencia, se han reformulado o dejado de ser el centro de acción y han disminuido su importancia, dando relevancia a conceptos como la contratransferencia, la identificación proyectiva y más recientemente, a relación, el enactment, emociones, relaciones interpersonales fuera del entorno y el futuro del paciente. El psicoanálisis dirigió su atención del paciente al analista. Discutimos los cambios de las visiones tradicionales en las visiones contemporáneas y sus implicaciones en dos textos. En este texto identificado como la primera parte, abordaremos el recuerdo, el insight, la interpretación, la resistencia y la neutralidad. El resto se cubrirá en la Parte Dos.

Private self-consciousness, self-reflection, insight and alcohol consumption among young people and adults / Autoconsciência privada, autorreflexão, insight e consumo de álcool entre jovens e adultos / Autoconciencia privada, autorreflexión, insight y consumo de alcohol entre jóvenes y adultos

Private self-consciousness is a relevant metacognitive capacity in the self-regulation process, with possible implications in alcohol consumption. This research verified the influence of self-reflection and insight, dimensions of private self-consciousness, on drinking behavior. A total of 523 Brazilians, aged from 20 to 39 years old, participated in a survey by answering the Self-Reflection and Insight Scale and the AUDIT test. The results showed that women have higher levels of self-reflection, whereas men have higher levels of insight. With regard to alcohol consumption, young people drink at higher risk levels than adults. Self-reflection and insight were negatively correlated with alcohol consumption. Age and gender differences in the intensity of the correlation between variables and the influence of environmental factors on the regulation of drinking behavior are discussed. (AU)

A autoconsciência privada é uma capacidade metacognitiva relevante no processo de autorregulação, com possível implicação no consumo de álcool. Esta pesquisa objetivou verificar a relação da autorreflexão e do insight, dimensões da autoconsciência privada, no comportamento de beber. Participaram 523 brasileiros, de 20 a 39 anos que responderam à Escala de Autorreflexão e Insight e ao teste AUDIT. Os resultados indicaram que mulheres apresentam níveis mais elevados de autorreflexão, enquanto homens, de insight. Quanto ao consumo de álcool, jovens bebem em níveis considerados mais arriscados do que adultos. A autorreflexão e o insight correlacionaram negativamente com o consumo de álcool. Diferenças etárias e de gênero na intensidade da correlação entre variáveis e a influência de fatores ambientais na regulação do beber são discutidas. (AU)

La autoconciencia privada es una capacidad metacognitiva relevante en el proceso de autorregulación, con posibles implicaciones en el consumo de alcohol. Esta investigación verificó la relación entre autorreflexión e Insight, dimensiones de la autoconciencia privada, en el comportamiento de beber. Participaron 523 brasileños (20 a 39 años) que respondieron la Escala de Autorreflexión e Insight y el test AUDIT. Los resultados estadísticos mostraron que las mujeres tienen mayores niveles de autorreflexión, mientras que los hombres de Insight. En cuanto a consumo de alcohol, los jóvenes beben en niveles considerados más arriesgados que los adultos. Autorreflexión e Insight se correlacionaron negativamente con el consumo de alcohol. Se discuten las diferencias de edad y género con relación a la intensidad de correlación entre las variables y la influencia de factores ambientales en la regulación de beber. (AU)

Factors Affecting Admission Type in Patients with Schizophrenia Spectrum / 신경정신의학

OBJECTIVES: This study examined the admission type and its related factors among patients with psychotic disorders defined based on the revised mental health welfare law. METHODS: This study was conducted on a total of 100 patients diagnosed on the schizophrenia spectrum and other psychotic disorders. The admission type and sociodemographic characteristics were examined. Social support, psychopathology, excitement, insight, and social functioning were evaluated using the Social Support Scale, Positive and Negative Syndrome Scale (PANSS), PANSS excitement component, Brief Psychiatric Rating Scale, Global Assessment Functioning Scale, Strauss-Carpenter scale, Korean version of the Scale to Assess Unawareness of Mental Disorder, and Korean version of Beck Cognitive Insight Scale. RESULTS: The severity of psychotic symptoms, excitement, social functioning, and insight were significantly different between involuntary and voluntary admissions (p<0.05). Excitement and insight were found to be factors affecting the admission type (p<0.05). CONCLUSION: Excitement and insight were factors mainly accounting for the admission type in patients with psychotic disorder. This study could be helpful in improving clinical decision-making and community mental health care.

Reliability and Validity of the Korean Version of the Birchwood Insight Scale / 신경정신의학

OBJECTIVES: In the treatment of schizophrenia, treatment compliance is an important prognostic factor. As insight has a significant impact on treatment compliance, an appropriate assessment of insight is essential in the treatment of schizophrenia. This study examined the reliability and validity of the Korean version of Birchwood Insight Scale (BIS). METHODS: Fifty seven adult patients diagnosed with schizophrenia according to DSM-5 were recruited from a university hospital. They were evaluated using the Positive and Negative Syndrome Scale (PANSS), The Scale to Assessment Unawareness of Mental Disorder (SUMD) and BIS. Explorative factor analysis was performed to examine the construct validity of the Korean version of BIS. Concurrent validity was evaluated by a comparison with the PANSS G12 item and SUMD. The test-retest correlation was evaluated to examine the test-retest reliability. Multiple regression analysis was performed to examine the variables affecting insight. RESULTS: Explorative factor analysis showed that the Korean version of BIS was composed of 2 factors, which are ‘Awareness of symptoms’ and ‘Awareness of illness and need for treatment.’ The Korean version of BIS was reliable in terms of the internal consistency. Concurrent validity with the PANSS G 12 item and SUMD was statistically significant. The test-retest reliability was also statistically significant. Multiple regression analysis showed that the PANSS negative factor affects the BIS score, indicating that negative symptoms of schizophrenia may impair insight of the illness. CONCLUSION: This study suggests that the Korean version of BIS is a valid and reliable tool for assessing the insight of patients with schizophrenia.

The Insight Paradox among Outpatients with Schizophrenia / 대한정신분열병학회지

OBJECTIVES: The primary objective was to test the phenomenon known as the insight paradox, which refers to the association between higher levels of insight and lower self-esteem, higher hopelessness, and a higher perception of social prejudice among patients with schizophrenia. METHODS: A total of 216 outpatients with schizophrenia according to the DSM-IV diagnostic criteria were recruited. All participants were receiving ongoing outpatient treatment and were in a stable phase of the disorder. The participants were divided into a good-insight (N=109) and a poor-insight (N=107) group by the direct interview and the mean score of questionnaire. The parameters used for analysis and comparison were demographic variables (age, gender, education), clinical variables (age at onset, number of hospitalizations), self-esteem, hopelessness, self-stigma, and quality of life. RESULTS: Compared with the poor-insight group, the good-insight group was found to have a lower number of hospitalizations, lower self-esteem, higher hopelessness, lower quality of life, and a higher level of internalized stigma. CONCLUSION: The insight can cause the negative consequences in patients with schizophrenia. Therefore, clinicians should pay attention to the negative aspects of insight for improving the quality of life in the treatment of patients with schizophrenia.

Brain function differences in drug-naïve first-episode auditory verbal hallucination-schizophrenia patients with versus without insight / 中华医学杂志(英文版)

Background@#Few studies have reported brain function differences in drug-naïve first-episode schizophrenia patients who had auditory verbal hallucinations (AVH) with insight vs. those without insight. This study aimed to investigate brain function differences between drug-naïve first-episode AVH-schizophrenia patients with and without insight.@*Methods@#Forty first-episode drug-naïve AVH-schizophrenia patients with or without insight and 40 healthy controls between December 2016 and December 2018 were recruited in this study. The auditory hallucinations rating scale (AHRS) was used to assess AVH severity, while the insight and treatment attitudes questionnaire was used to distinguish insight. The global functional connectivity density (gFCD) between different groups was compared using a voxel-wise one-way analysis of covariance. The relationship between gFCD and AHRS total scores were analyzed using voxel-wise multiple regression.@*Results@#Finally, 13 first-episode drug-naïve AVH-schizophrenia patients with insight, 15 AVH-schizophrenia patients without insight, and 20 healthy controls were included for analysis. Except for global assessment of functioning scores, there were no significant differences in sociodemographic information between the AVH-schizophrenia and healthy groups (P > 0.05). Compared to the healthy controls, AVH-schizophrenia patients with insight demonstrated a decreased gFCD in the supramarginal gyrus within the primary auditory cortex, while those without insight demonstrated an increased gFCD in the inferior frontal gyrus and superior temporal gyrus and decreased gFCD in the supplemental motor area. Compared to the AVH-schizophrenia patients with insight, those without insight demonstrated an increased gFCD in the supra-marginal gyrus and posterior superior temporal lobule and a decreased gFCD in the frontal lobe. No significant correlation between gFCD and AVH severity (AHRS total score: r = 0.23, P = 0.590; and frequency: r = 0.42, P = 0.820) was found in both AVH-schizophrenia groups.@*Conclusions@#The gFCD-aberrant brain regions in the AVH-schizophrenia patients without insight were wider compared to those with insight, although the AHRS scores were not significantly different. The AVH-schizophrenia patients without insight had wide functional impairment in the frontal lobule, which may underlie the lack of insight and the abnormal hyperactivity in the inferior frontal gurus and temporal lobe related to the AVH symptoms.

The mediating role of internalized stigma between insight and self-esteem among patients with schizophrenia / 中华行为医学与脑科学杂志

Objective@#To explore the relationship between internalized stigma and insight, self-esteem in patients with schizophrenia.@*Methods@#A total of 144 schizophrenic patients were investigated by the general information questionnaire, insight and treatment attitude questionnaire (ITAQ), internalized stigma of mental illness scale-Chinese version (ISMI-C) and the self-esteem scale (SES). Pearson correlative analysis and Bootstrap program mediation effect test were used to data analysis.@*Results@#There was a significantly positively correlation between insight score(11.24±4.08) and internalized stigma score(2.18±0.65) of 144 schizophrenic patients(r=0.236, P<0.05). The Self-esteem score(27.57±3.76) was negatively correlated with insight score(r=-0.177, P<0.05) and internalized stigma score(r=-0.661, P<0.05). The mediation effect test analysis showed that the internalized stigma played a full mediating role in the relationship between insight and self-esteem, and the effect size was -0.143.@*Conclusion@#Insight can indirectly affect self-esteem via internalized stigma in patients with schizophrenia.Taking measures to decrease inpatients' internalized stigma level and improve their illness awareness should be paid attention in clinical practice.

The mediating role of internalized stigma between insight and self-esteem among patients with schizo-phrenia / 中华行为医学与脑科学杂志

Objective To explore the relationship between internalized stigma and insight,self-es-teem in patients with schizophrenia. Methods A total of 144 schizophrenic patients were investigated by the general information questionnaire,insight and treatment attitude questionnaire (ITAQ),internalized stigma of mental illness scale-Chinese version (ISMI-C) and the self-esteem scale (SES). Pearson correlative analysis and Bootstrap program mediation effect test were used to data analysis. Results There was a significantly positively correlation between insight score(11. 24±4. 08) and internalized stigma score(2. 18±0. 65) of 144 schizophrenic patients(r=0. 236,P<0. 05). The Self-esteem score(27. 57±3. 76) was negatively correlated with insight score(r=-0. 177,P<0. 05) and internalized stigma score(r=-0. 661,P<0. 05). The mediation effect test analysis showed that the internalized stigma played a full mediating role in the relationship between insight and self-esteem,and the effect size was -0. 143. Conclusion Insight can indirectly affect self-es-teem via internalized stigma in patients with schizophrenia. Taking measures to decrease inpatients' internal-ized stigma level and improve their illness awareness should be paid attention in clinical practice.

A review of insight in patients with schizophrenia / 中国心理卫生杂志

Impairment of insight is considered as the hallmark of schizophrenia. Insight is a multidimensional and dynamic construct which appears to have intricate links with other symptom dimensions of the psychotic illness. A better appreciation of insight in psychosis could help us in gaining knowledge about etiology, prognosis and treatment-related facets of the disorder. This paper reviews researches on insight of schizophrenia. It focuses on the biological basis, assessment methods of insight, influencing factors and treatment methods. And outlook on future research direction.

The relationship between insight and affective temperament in bipolar disorder: an exploratory study / A relação entre insight e temperamento afetivo no transtorno bipolar: um estudo exploratório

Abstract Introduction In recent years, the association between temperament and clinical characteristics of mood disorders has been studied. Most bipolar patients show deficits in their awareness of signs and symptoms. The relationship between affective temperament and insight in bipolar patients has not been carried out in the literature so far. Objective To evaluate the relationship between affective temperament and insight in bipolar disorder. Method A group of 65 bipolar patients were followed during a year. Patients underwent a clinical assessment and were diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Insight was evaluated through the Insight Scale for Affective Disorders (ISAD), and affective temperament, through the TEMPS-Rio de Janeiro. The relationship between affective temperament and insight was explored with Spearman rho correlations between scores on each item of the ISAD and on the TEMPS-Rio de Janeiro subscales. Results In euthymic phases, bipolars with depressive temperament were associated with a higher level of insight about the consequences of the disorder; when in mania, patients showed better insight about having an affective disorder, presenting psychomotor alterations, and suffering from guilt or grandiosity. Similarly, bipolar patients with higher scores of anxious temperament, when in mania, had better insight on alterations in attention. Bipolar patients with higher scores of hyperthymic temperament, when in mania, showed the worst insight about thought disorder. Conclusion In addition to being determined by the phase of the disease and several varying symptoms, the level of insight in bipolar patients is also influenced by affective temperament.

Resumo Introdução Nos últimos anos, a associação entre temperamento e características clínicas dos transtornos de humor tem sido estudada. A maioria dos pacientes bipolares apresenta déficits na consciência de sinais e sintomas. A relação entre temperamento afetivo e insight em pacientes bipolares não tem sido relatada na literatura até o momento. Objetivo Avaliar a relação entre temperamento afetivo e insight no transtorno bipolar. Métodos Um grupo de 65 pacientes bipolares foi acompanhado por um ano. Os pacientes foram submetidos a uma avaliação clínica utilizando os critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, 5ª edição (DSM-5). O insight foi avaliado através da Escala de Insight para Transtornos Afetivos (ISAD), e o temperamento afetivo, através da TEMPS-Rio de Janeiro. A relação entre temperamento afetivo e insight foi explorada usando correlações de Spearman entre os escores de cada item da ISAD e as subescalas da TEMPS-Rio de Janeiro. Resultados Nas fases eutímicas, os bipolares com temperamento depressivo relacionaram-se com maior nível de insight sobre as consequências do transtorno; quando em mania, apresentaram melhor insight sobre ter um transtorno afetivo, apresentar alterações psicomotoras e sofrer de culpa ou grandiosidade. Da mesma forma, bipolares com maiores escores de temperamento ansioso, quando em mania, tiveram melhor percepção sobre alterações na atenção. Bipolares com escores mais altos de temperamento hipertímico, quando em mania, mostraram o pior insight sobre o curso do pensamento. Conclusão O nível de insight em pacientes bipolares, além de ser determinado pela fase da doença e por diversos sintomas, é influenciado pelo temperamento afetivo.

An Observational Study Of Clinical Profile And Cognitive Insight In Patients Of Treatment Resistant Schizophrenia

Objectives -It has been estimated that 20-50% patients with Schizophrenia can develop treatment resistance. Treatment resistance is associated with increased morbidity in these patients and it also increases the burden for the caretakers. Very few Indian studies have tried to establish the factors associated with resistance in Schizophrenia. Hence, this study was conducted to identify the socio-demographic profile, illness variables, co-morbidities and cognitive insight in patients with Treatment Resistant Schizophrenia. Methodology: The study was conducted after permission from Institutional Ethics Committee. 50 consecutive patients of Treatment Resistant Schizophrenia (treated with 2 antipsychotics from different classes with adequate doses for 6 weeks each and currently satisfying the DSM IV TR criteria for Schizophrenia) were included in the study. Patients were administered a semi-structured questionnaire to obtain details about sociodemographic status, age of onset, family history, number of episodes and treatment received. DSM-IV-TR was used to identify psychiatric comorbidities. Becks cognitive insight scale was used to assess cognitive insight. Results: The mean age of patients in the study with Treatment Resistant Schizophrenia (TRS) was found to be 33.5yrs with M: F ratio of 1.77:1. It was found that 34% of patients had an onset before 20 yrs of age. Positive family history of mental illness was present in 48% of the TRS patients. Multiple episodes (>5) were present in 36% of patients. TRS was characterized by absence of affective symptoms in 90% of patients. On applying Beck's cognitive insight scale, patients of TRS were found to have higher Self-Certainty score as compared to Self-Reflection, indicating poor awareness into their illness and treatment. Conclusions: It is important to identify Schizophrenia patients with early age of onset, positive family history, absence of affective features and poor cognitive insight to improve the long-term course of Schizophrenia

Are Mentalizing Abilities and Insight Related to the Severity of Obsessive-Compulsive Disorder

OBJECTIVE: The aim of this study is to investigate whether insight and mentalizing abilities are related to the severity of Obsessive Compulsive Disorder (OCD) in treatment resistant OCD. We look at the association between treatment resistance, insight, and mentalizing ability. METHODS: The study was conducted with 71 OCD patients; 30 of them met the criteria for treatment resistant OCD, whereas the other 41 (57.7%) were labeled as responder group. All patients were assessed with the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Reading the Mind in the Eyes Test (RMET), Brown Assessment of Beliefs Scale (BABS), Mini International Neuropsychiatric Interview, Beck Depression Inventory, and Beck Anxiety Inventory. RESULTS: The resistant group received higher depression and anxiety mean scores and had significantly longer illness duration. The RMET score was significantly higher for responders. The Y-BOCS insight score and the BABS score were significantly higher for the resistant group. BABS scores were negatively correlated with RMET total scores. RMET scores were found to be significant predictor of insight even when other potential factors were controlled for. CONCLUSION: Results suggest that better mentalizing abilities may be a predictor of better treatment outcome in patients with OCD.

Validity and Reliability of the Self-Reflection and Insight Scale for Korean Nursing Students / 기본간호학회지

PURPOSE: The purpose of this study was to translate the Self-Reflection and Insight Scale (SRIS) into Korean and test its validity and reliability. METHODS: Participants were 340 nursing students who were recruited from 5 nursing colleges in Korea. Data were collected from November 21 to December 20, 2016 and analyzed using the IBM Statistics SPSS 22.0 and AMOS 23.0 programs. Exploratory factor analysis, Confirmatory factor analysis, and concurrent validity analysis were performed. RESULTS: For the Korean-SRIS (K-SRIS) 4 items were deleted from the original SRIS. The final scale consisted of 16 items which were sorted into- the 2 factors: self-reflection (11 items), insight (5 items). The cumulative percent of variance was 50.91%. The statistically significant correlation between K-SRIS scores and the Reflection in Learning Scale (RLS) support the concurrent validity of the K-SRIS. The reliability of the scale, Cronbach's α was .83. CONCLUSION: The finding indicate that the K-SRIS has validity and reliability. Therefore it can be used for measuring and developing reflection ability in nursing students.