Halaj, Asala;
Huppert, Jonathan D;
Konstantakopoulos, George;
David, Anthony S;
(2025)
Development and Validation of the Schedule for the
Assessment of Insight in Anxiety Disorders (SAI-A).
Depression and Anxiety
, 2025
(1)
, Article 8843975. 10.1155/da/8843975.
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Abstract
There is a growing interest in understanding insight or illness awareness in anxiety; however, most assessment instruments were designed for psychosis. The unique features of anxiety highlight the need for tailored measures to accurately evaluate insight. The aim of this study was to develop and validate the Schedule for the Assessment of Insight in Anxiety (SAI-A), a clinician-rated scale for assessing insight in anxiety disorders. We interviewed 46 participants diagnosed with anxiety disorders, conducted SAI-A interviews, and administered self-report measures. Using correlation and principal component analysis (PCA), we identified and assessed scale components, ensuring their reliability and consistency. The SAI-A demonstrated acceptable psychometric properties, including convergent validity with an established self-report measure (r = −0.39, p = 0.008) and internal consistency (Cronbach’s α = 0.70). It showed moderate to strong agreement, interrater reliability (weighted kappa = 0.53, intraclass correlation coefficient [ICC] = 0.67), and test–retest reliability (ICC = 0.65). Two distinct insight components emerged: awareness of disorder and need for treatment. Higher overall SAI-A scores correlated with symptom severity and impairment (r = 0.56, r = 0.51, p < 0.001, respectively) and medication usage. The SAI-A is a valid and reliable assessment tool, providing a comprehensive framework for understanding and addressing insight in the context of anxiety disorders.
| Type: | Article |
|---|---|
| Title: | Development and Validation of the Schedule for the Assessment of Insight in Anxiety Disorders (SAI-A) |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1155/da/8843975 |
| Publisher version: | https://doi.org/10.1155/da/8843975 |
| Language: | English |
| Additional information: | Copyright © 2025 Asala Halaj et al. Depression and Anxiety published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, https://creativecommons.org/licenses/by/4.0/, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Anxiety disorders; denial of mental disorder; illness awareness; insight into illness; need for treatment |
| 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 UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Institute of Mental Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214710 |
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