Department of Psychology, Bar-Ilan University, Ramat-Gan 5290002, Israel.
Psychiatry Res. 2018 Aug;266:47-64. doi: 10.1016/j.psychres.2018.05.035. Epub 2018 May 26.
Multiple studies on insight into one's illness and self-stigma among patients with serious mental illness and their relatives have shown that these constructs are related to one another and that they affect outcome. However, a critical exploration of the items used to assess both constructs raises questions with regard to the possible overlapping and centrality of items. The current study used five different samples to explore the possible overlap and distinction between insight and self-stigma, and to identify central items, via network analyses and principal component factor analysis. Findings from the network analyses showed overlap between insight and self-stigma exist with a relatively clearer observational distinction between the constructs among the two parent samples in comparison to the patient samples. Principal component factor analysis constrained to two factors showed that a relatively high percentage of items were not loaded on either factor, and in a few datasets, several insight items were loaded on the self-stigma scale and vice versa. The author discusses implications for research and calls for rethinking the way insight is assessed. Clinical implications are also discussed in reference to central items of social isolation, future worries and stereotype endorsement among the different study groups.
多项关于精神疾病患者及其家属对自身疾病的认识和自我污名的研究表明，这两个结构相互关联，并且会影响结果。然而，对用于评估这两个结构的项目进行批判性探讨，会对项目的重叠和中心性提出疑问。本研究使用五个不同的样本，通过网络分析和主成分因子分析，探索了洞察力和自我污名之间可能的重叠和区别，并确定了核心项目。网络分析的结果表明，洞察力和自我污名之间存在重叠，在两个父母样本中，与患者样本相比，这两个结构之间的观察性区别相对更清晰。受限于两个因素的主成分因子分析表明，相当大比例的项目没有加载到任何一个因素上，在一些数据集，一些洞察力项目被加载到自我污名量表上，反之亦然。作者讨论了对研究的影响，并呼吁重新思考评估洞察力的方法。还讨论了与不同研究组的社会隔离、对未来的担忧和刻板印象认同等核心项目有关的临床意义。
