Insight

In Psychiatry and Psychology, Insight means the recognition of one’s own condition. (mental illness)

It refers to:-
the conscious awareness and understanding of one’s own psychodynamics and symptoms of maladaptive behavior; highly important in effecting changes in the personality and behavior of a person.


insight,
true insight,
impaired insight,
judgement,
mental status examination,
Multi-dimensional model of Insight,
Grades of Insight, intellectual insight
assesment

1. INSIGHT Deva Pramod V B MSc Psychology Department of Psychology Bharathiar University, India [email protected] Psychodiagnostics / Psychiatry

2. Insight It is the understanding of a specific cause and effect in a specific context. It could be :- A piece of information. The act or result of understanding the inner nature of things or of seeing intuitively. ( called ‘Noesis’ in Greek) An introspection. The power of acute observation and deduction, judgment, perception called as Intellection.

3. An insight that manifests itself suddenly, such as understanding how to solve a difficult problem, is sometimes called by the German word “ Aha-Erlebnis ”. This term was coined by the German psychologist and theoretical linguist Karl Buhler .

4. Definition In Psychiatry and Psychology, Insight means the recognition of one’s own condition. (mental illness) It refers to:- the conscious awareness and understanding of one’s own psychodynamics and symptoms of maladaptive behavior; highly important in effecting changes in the personality and behavior of a person.

5. The Beginning… Work on Insight was pioneered by Aubrey Lewis (1934). Temporarily defined as:- “a correct attitude to morbid change in oneself” But warned that the words ‘correct’, ‘attitude’, ‘morbid’ and ‘change’, each called for discussion.

6. Multi-dimensional model of Insight Amador and David 1998 Awareness that one is suffering, in a general way, from a mental( as opposed to a physical) disturbance which could be an illness. More specific awareness that certain experiences including beliefs and perceptions may not be veridical, and further that they too could be a part of an illness. Acknowledgement of the medical implications of the above, a concrete token of which is informed acceptance of treatment.

7. Factors influencing Insight Cultural models of illness General intelligence and knowledge Doctor-patient relationship. Symptomatology (Delusions/Depression) Denial- Motivation Preservation of self esteem Avoidance of stigma Personality- Compliance non conformity as a trait.

8. Assessment of Insight in Clinical Practice Is the patient aware of the phenomenon that others have observed? ( ie , is the patient unusually active and elated?); If so, does the patient recognize the phenomenon as abnormal? ( eg , maintaining that the unusual activity and cheerfulness are normal high spirits.); If so, does the patient consider that they are caused by mental illness? ( eg , believing that the changes observed are due to a physical illness or poison as administered by enemies.); If so, does the patient think that he needs treatment?

9. Grades of Insight Complete denial of illness. Slight awareness of being sick and needing help but denying it at the same time. Awareness of being sick but blaming it on others, on external events, on medical or unknown organic factors. Intellectual Insight- Admission of illness and recognition that symptoms or failures in social judgment are due to irrational feelings or disturbances; without applying that knowledge to future experiences.

10. 5. True Emotional Insight- Emotional awareness of the motives and feelings within, of the underlying meaning of symptoms; and whether this awareness leads to changes in personality and future behavior , openness to new ideas and concepts about self. 6. Impaired Insight Diminished ability to understand the objective reality of a situation. A person with very poor recognition or acknowledgement is referred to as having ‘ poor insight ’ or ‘ lack of insight ’. The most extreme form is ‘ANOSOGNOSIA’ that is the total absence of insight into one’s mental illness.

11. Insight vs. Judgment Insight denotes “ Looking-in” Judgment denotes “ Looking-out” Both entail processes of appraisal or assessment of one’s own state of mind, one’s motivations and actions, or one’s relationship to others.

12. INSIGHT Self appraisal and self esteem Understanding of the current circumstances Ability to describe personal, psychological and physical status. JUDGMENT Appraisal of major social relationships Understanding of personal roles and responsibilities.

13. Insight and Judgment (Inquired/Observed) Possible questions for patient: “What brings you here today?” “ What seems to be the problem?” “ What do you think is causing your problems?” “ How do you understand your problems?” “ How would you describe your role in this situation?” “ Do you think that these thoughts, moods, perceptions, are abnormal ?” “ How do you plan to get help for this problem?”

14. Conclusion Insight signifies a variety of ways in which a person’s mental life approximates itself to the beliefs of others, ie , in terms of what constitutes an illness, what beliefs are abnormal, and what medical advice it is reasonable to follow. Psychiatrists would assess and treat patients more accurately as well as enhance patient’s adherence to treatment if they had an accurate understanding of insight. The concept of insight has stimulated research into difficult theoretical and practical areas such as self-awareness and treatment compliance, respectively.

15. Keywords Insight Intellectual Insight True Emotional Insight Impaired Insight Judgment

16. References Kaplan,H.I & Sadok,B.J (2007). Synopsis of Psychiatry – Behavioral Sciences/Clinical Psychiatry. (10 th ed ).NY: Williams & Wilkins Mental Status Examination (2014).retrieved February 28,2014, from http://www.amdc.edu.pk/

17. Thank You