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
vbdevan.psy@gmail.com
Psychodiagnostics / Psychiatry

2. It is the understanding of a specific cause and effect in a specific context.
It could be:-
1. A piece of information.
2. The act or result of understanding the inner nature of things or of seeing
intuitively. ( called ‘Noesis’ in Greek)
3. An introspection.
4. 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
1. Awareness that one is suffering, in a general way, from a mental( as opposed to
a physical) disturbance which could be an illness.
2. 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.
3. Acknowledgement of the medical implications of the above, a concrete token
of which is informed acceptance of treatment.

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

8. Assessment of Insight in Clinical Practice
A. Is the patient aware of the phenomenon that others have observed?
(ie, is the patient unusually active and elated?);
B. If so, does the patient recognize the phenomenon as abnormal?
(eg, maintaining that the unusual activity and cheerfulness are normal high
spirits.);
C. 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.);
D. If so, does the patient think that he needs treatment?

9. Grades of Insight
1. Complete denial of illness.
2. Slight awareness of being sick and needing help but denying it at the same time.
3. Awareness of being sick but blaming it on others, on external events, on medical
or unknown organic factors.
4. 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. (10th ed).NY: Williams & Wilkins
Mental Status Examination (2014).retrieved February 28,2014, from
http://www.amdc.edu.pk/

17. Thank You