Storah, ZA; (2010) Insight into offending behaviour: How professionals define, use and assess the construct in the risk assessment of mentally disordered offenders. Doctoral thesis , UCL (University College London).

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Abstract

Formal conceptualisation of the construct of insight' in general psychiatry has been a major research enterprise over the past twenty years. Debate about the construct continues, but it is generally accepted to refer to patients' understanding of their mental state. This review is prompted by the observation that the term 'insight' is also used by the forensic psychiatric community but with apparent differences in meaning. A review was undertaken to examine the use of the term in the current literature relating to the risk assessment and management of mentally disordered offenders. Seventeen papers were retrieved that referred to insight, but an important role for the construct in risk assessment was identified. It is argued that the small number of papers reflects the lack of research interest in this area. Within the identified literature, considerable variation in the use of the term insight' was noted. In many, but not all cases, insight' is used to refer to the patient's understanding of their offending behaviour, as well as, as part of, or instead of their mental illness. The models of this identified insight into offending behaviour' construct also varied. The paper concludes that there are serious ethical and public safety issues in the current non-standardised use of the insight construct within forensic psychiatric practice and calls for further empirical inquiry to formalise matters relating to its nature, value and clinical assessment.

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