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Insight is a useful construct in clinical assessments if used wisely

David, A; Ariyo, K; (2020) Insight is a useful construct in clinical assessments if used wisely. Journal of Medical Ethics 10.1136/medethics-2020-106128. (In press). Green open access

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Abstract

Medical ethicist, Guidry-Grimes has critically reviewed the concept of insight, voicing concerns that it lacks consensus as to its components and that it undermines patient perspectives. We respond by briefly summarising research over the last 30 years that she overlooks which has helped establish the clinical validity of the construct. This includes the adoption of standardised assessment tools-at least in research-and longitudinal and cross-sectional studies quantifying associations with psychopathological, clinical and cognitive measures. We also make the distinction between the current standards for assessing decision-making capacity leading to, where appropriate, involuntary treatment in clinical and medico-legal settings which in most legislations do not include insight assessments, and anecdotal reports of the use and misuse of 'lack of insight' as a proxy for more comprehensive evaluation. We conclude by encouraging a broader view of insight akin to self-knowledge.

Type: Article
Title: Insight is a useful construct in clinical assessments if used wisely
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/medethics-2020-106128
Publisher version: http://dx.doi.org/10.1136/medethics-2020-106128
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: capacity, decision-making, involuntary civil commitment, mentally ill and disabled persons, psychiatry
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10099322
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