Hostname: page-component-848d4c4894-m9kch Total loading time: 0 Render date: 2024-05-15T01:14:59.096Z Has data issue: false hasContentIssue false
  • English
  • Français

Construct validity and factor structure of Tamil version of Beck Cognitive Insight Scale to assess cognitive insight of patients with schizophrenia

Published online by Cambridge University Press:  24 June 2014

Thanka Jemi Merlin ,
Anto P. Rajkumar ,
S. Reema ,
Sherab Tsheringla ,
S. Velvizhi  and
K. S. Jacob
Thanka Jemi Merlin
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
Anto P. Rajkumar*
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
S. Reema
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
Sherab Tsheringla
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
S. Velvizhi
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
K. S. Jacob
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
*
Anto P. Rajkumar, Center for Psychiatric Research, Aarhus University Hospital, Risskov 8240, Denmark. Tel: 45 7789 3548; Fax: 45 7789 3549; E-mail: antoprajkumar@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Extract

Objective: The ability to reflect rationally on one's own anomalous experiences and to recognise that their conclusions are incorrect is called as cognitive insight. It influences the delusion proneness of patients with schizophrenia. Structured instruments to assess cognitive insight have not been validated in any Indian languages so far. Hence, we aimed to evaluate the validity and factor structure of Tamil version of Beck Cognitive Insight Scale (BCIS-T).

Methods: One hundred and fifty consecutive patients with schizophrenia completed BCIS-T. We assessed their clinical insight with the reference standard, Schedule for Assessment of Insight-Expanded version (SAI-E). An independent psychiatrist evaluated their psychopathology using Brief Psychiatric Rating Scale (BPRS).

Results: BCIS-T was internally consistent with Cronbach's α 0.67 and Guttman's split-half coefficient as 0.63. BCIS-T composite index documented convergent validity with SAI-E total score (ρ = 0.38; p < 0.001) and discriminant validity with BPRS (ρ = −0.02; p = 0.85). Factor analysis showed a four-factor structure, namely self-certainty, self-reflectiveness, openness to external feedback and infallibility of self-reflection. BCIS-T composite index had significant linear relationship with clinical insight and treatment compliance on multivariate analyses (p < 0.01).

Conclusion: Our findings support the validity of BCIS-T to assess cognitive insight of the patients with schizophrenia. We suggest addressing the intricacies of cognitive insight beyond the traditional two-dimensional models in cross-cultural settings.

Keywords

compliancecorrelationinsightschizophrenia
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 24 , Issue 1 , February 2012 , pp. 43 - 49
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Lewis, A.The psychopathology of insight. Br J Med Psychol 1934;14:332–348.CrossRefGoogle Scholar
2.Jablensky, A, Sartorius, N, Ernberg, G, Anker, N, Koften, A, Cooper, JE.Schizophrenia: manifestations, incidence and course in different cultures. World Health Organization ten country study. Psychol Med 1992;20:1–97.Google ScholarPubMed
3.David, AS. In: Amador, XF, David, AS, eds. The clinical importance of insight. Insight and psychosis. New York: Oxford University Press, 1998: 332–351.Google Scholar
4.David, AS.Insight and psychosis. Br J Psychiatry 1990;156: 798–808.CrossRefGoogle ScholarPubMed
5.Saravanan, B, Jacob, KS, Prince, M, Bhugra, D, David, AS.Culture and insight revisited. Br J Psychiatry 2004;184: 107–109.CrossRefGoogle ScholarPubMed
6.Saravanan, B, David, AS, Bhugra, D, Prince, M, Jacob, KS.Insight in people with psychosis: the influence of culture. Int Rev Psychiatry 2005;17:83–87.CrossRefGoogle ScholarPubMed
7.Saravanan, B, Jacob, KS, Johnson, S, Prince, M, Bhugra, D, David, AS.Assessing insight in schizophrenia: East meets West. Br J Psychiatry 2007;190:243–247.CrossRefGoogle ScholarPubMed
8.Beck, AT, Baruch, E, Balter, JM, Steer, RA, Warman, DM.A new instrument for measuring insight: the Beck Cognitive Insight Scale. Schizophr Res 2004;68:319–329.CrossRefGoogle ScholarPubMed
9.Pedrelli, P, McQuaid, JR, Granholm, E et al. Measuring cognitive insight in middle-aged and older patients with psychotic disorders. Schizophr Res 2004;71:297–305.CrossRefGoogle ScholarPubMed
10.Engh, J, Friis, S, Birkenaes, A et al. Measuring cognitive insight in schizophrenia and bipolar disorder: a comparative study. BMC Psychiatry 2007;7:71.CrossRefGoogle ScholarPubMed
11.Engh, JA, Friis, S, Birkenaes, AB et al. Delusions are associated with poor cognitive insight in schizophrenia. Schizophr Bull 2010;36:830–835.CrossRefGoogle ScholarPubMed
12.Buchy, L, Czechowska, Y, Chochol, C et al. Toward a model of cognitive insight in first-episode psychosis: verbal memory and hippocampal structure. Schizophr Bull 2010;36:1040–1049.CrossRefGoogle Scholar
13.Lepage, M, Buchy, L, Bodnar, M, Bertrand, MC, Joober, R, Malla, A.Cognitive insight and verbal memory in first episode of psychosis. Eur Psychiatry 2008;2: 368–374.CrossRefGoogle Scholar
14.Kao, YC, Liu, YP.The Beck Cognitive Insight Scale (BCIS): translation and validation of the Taiwanese version. BMC Psychiatry 2010;10:27.CrossRefGoogle ScholarPubMed
15.Uchida, T, Matsumoto, K, Kikuchi, A et al. Psychometric properties of the Japanese version of the Beck Cognitive Insight Scale: relation of cognitive insight to clinical insight. Psychiatry Clin Neurosci 2009;63:291–297.CrossRefGoogle ScholarPubMed
16.Favrod, J, Zimmermann, G, Raffard, S, Pomini, V, Khazaal, Y.The Beck Cognitive Insight Scale in outpatients with psychotic disorders: further evidence from a French-speaking sample. Can J Psychiatry 2008;53: 783–787.CrossRefGoogle ScholarPubMed
17.Schoonjans, F, Zalata, A, Depuydt, CE, Comhaire, FH.MedCalc: a new computer program for medical statistics. Comput Methods Programs Biomed 1995;48:257–262.CrossRefGoogle ScholarPubMed
18World Health Organization. The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: WHO, 1992.Google Scholar
19.Sanz, M, Constable, G, Lopez-Ibor, I, Kemp, R, David, AS.A comparative study of insight scales and their relationship to psychopathological and clinical variables. Psychol Med 1998;28:437–446.CrossRefGoogle ScholarPubMed
20.Kemp, R, David, AS. In: Blackwell, B, ed. Insight and compliance. Treatment compliance and the therapeutic alliance. Newark: Gordon and Breach Publishing Group, 1997: 61–84.Google Scholar
21.Overall, JE, Gorham, DR.The brief psychiatric rating scale. Psychol Rep 1962;10:799–812.CrossRefGoogle Scholar
22.Warman, DM, Martin, JM.Cognitive insight and delusion proneness: an investigation using the Beck Cognitive Insight Scale. Schizophr Res 2006;84:297–304.CrossRefGoogle ScholarPubMed
23.Thara, R, Rajkumar, S.Gender differences in schizophrenia. Results of a follow-up study from India. Schizophr Res 1992;7:65–70.CrossRefGoogle ScholarPubMed