Birchwood M, Smith J, Drury V, Healy J, Macmillan F, Slade M
Academic Department of Psychology, University of Birmingham, United Kingdom.
Acta Psychiatr Scand. 1994 Jan;89(1):62-7. doi: 10.1111/j.1600-0447.1994.tb01487.x.
Lack of insight is a frequent concomitant of psychosis and has traditionally been viewed as a binary, all or none phenomenon. Recent conceptualization has formulated insight as a continuum representing the juxtaposition of 3 factors--awareness of illness, need for treatment and attribution of symptoms. Measurement of insight has been exclusively based on interview; this method does not easily lend itself to frequent repeated measurement and requires interrater reliability to be established. A self-report Insight Scale is presented, and evidence in support of its reliability, validity and sensitivity is provided that includes a sample of 30 patients monitored during recovery from an acute psychosis. The scale is a quick and acceptable measure that may find application in investigations of acute care, cognitive therapy of psychotic symptoms and as a method of augmenting clinical judgements of insight.
缺乏自知力是精神病的常见伴随症状，传统上被视为一种二元的、全或无的现象。最近的概念化将自知力表述为一个连续体，代表三个因素的并列——对疾病的认识、对治疗的需求和症状的归因。自知力的测量一直完全基于访谈；这种方法不容易进行频繁的重复测量，并且需要建立评分者间信度。本文介绍了一种自知力自评量表，并提供了支持其信度、效度和敏感性的证据，其中包括30例急性精神病恢复过程中接受监测的患者样本。该量表是一种快速且可接受的测量方法，可用于急性护理研究、精神病症状的认知治疗，以及作为增强自知力临床判断的一种方法。
