Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.
The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia.
BMC Psychiatry. 2024 Mar 27;24(1):233. doi: 10.1186/s12888-024-05657-8.
Clinical insight (i.e., impaired insight into illness) is increasingly recognized by the scientific community as a significant contributor to an array of psychological and clinical outcomes in schizophrenia. Therefore, its assessment using a reliable, rapid, easy and economic tool is important for clinical practice. This study proposes to investigate the psychometric properties of an Arabic translation of the Birchwood Insight Scale (BIS) in Arabic-speaking chronic patients with schizophrenia. Our objectives were to identify the most adequate factor structure of the BIS among the several measurement models previously proposed in the literature, verify the reliability and measurement invariance of the BIS across sex groups, and explore the concurrent validity of the BIS through examining its patterns of correlations with psychotic symptoms.
One hundred seventeen Arabic-speaking chronic, remitted patients with schizophrenia took part in this study. An Arabic translated version of the BIS and the Positive and Negative Syndrome Scale (PANSS) were administered to participants.
Confirmatory factor analyses (CFA) showed that, after omitting two items with low loadings (items 1 and 2), the unidimensional factor model of the BIS showed good fit indices and a reliability of α = 0.68 and ω = 0.68. However, analyses failed to show good fit for the full-length one-, two-, and three-factor models of the BIS in its Arabic version. Measurement invariance of the Arabic 6-item one-factor BIS was established between males and females at the configural, metric and scalar levels; no statistically significant difference between males and females was found in terms of BIS scores. Finally, BIS scores correlated significantly with the PANSS scores in our sample, thus demonstrating adequate concurrent validity.
This study offers valuable additional psychometric information about the BIS based on results of CFA and other analyses in schizophrenia from a non-Western cultural environment. We believe that making the BIS available in Arabic might benefit clinicians working with Arabic-speaking patients with schizophrenia, open new avenues of research and gain a better knowledge into the nature of clinical insight and its relevance to psychopathology.
临床洞察力（即对疾病的洞察力受损）越来越被科学界认为是导致精神分裂症一系列心理和临床结果的重要因素。因此，使用可靠、快速、简便和经济的工具对其进行评估对于临床实践很重要。本研究旨在探讨阿拉伯语翻译的 Birchwood 洞察力量表（BIS）在阿拉伯语精神分裂症慢性患者中的心理测量特性。我们的目标是在文献中提出的几种测量模型中确定 BIS 的最合适因素结构，验证 BIS 在性别组之间的可靠性和测量不变性，并通过检查其与精神病症状的相关模式来探索 BIS 的同时效度。
本研究共纳入 117 名阿拉伯语慢性缓解精神分裂症患者。参与者接受了 BIS 和阳性和阴性综合征量表（PANSS）的阿拉伯语翻译版本。
验证性因素分析（CFA）表明，在删除两个低负荷项目（项目 1 和 2）后，BIS 的单维因素模型显示出良好的拟合指数和α=0.68、ω=0.68 的可靠性。然而，分析未能显示 BIS 的完整一、二、三因素模型在其阿拉伯语版本中的良好拟合。在配置、度量和标度水平上，男女之间的阿拉伯语 6 项单因素 BIS 的测量不变性得以确立；男女之间在 BIS 得分方面没有统计学上的显著差异。最后，BIS 得分与我们样本中的 PANSS 得分显著相关，从而证明了充分的同时效度。
本研究基于非西方文化环境中的 CFA 和其他分析结果，为 BIS 提供了有价值的额外心理测量信息。我们相信，BIS 阿拉伯语版本的可用性可能会使与讲阿拉伯语的精神分裂症患者合作的临床医生受益，开辟新的研究途径，并更深入地了解临床洞察力的本质及其与精神病理学的相关性。
