Call it a monster for lack of anything else: Narrative insight in psychosis

David Roe, Ilanit Hasson-Ohayon, Shlomo Kravetz, Phil T. Yanos, Paul H. Lysaker

Research output: Contribution to journalArticlepeer-review


Individuals diagnosed with schizophrenia often appear to be unaware of having an illness or actively reject their diagnostic label. It is unclear, however, how this lack of awareness relates to important outcomes. Broadening the definition of awareness to include "narrative insight" may clarify this issue. The objective of this study was to identify profiles of narrative insight and test how these relate to standardized measure of insight. Sixty-five individuals with schizophrenia spectrum disorders participated in an assessment that included the Scale of Unawareness of Mental Disorder (SUMD) and an in-depth semi-structured interview. Qualitative analysis revealed 5 central themes related to insight on the basis of which each interview was then rated. Cluster analysis of these ratings resulted in 4 profiles of narrative insight: (1) accepts illness/rejects label, (2) rejects illness/searches for a name (3) passive insight of illness and label, and (4) integrative insight. The SUMD differentiated between individuals assigned to profile 2 who showed low insight to their illness and those assigned to the other profiles of narrative insight, but could not differentiae between them. Results support the claim that illness narratives are multifaceted and that traditional measures of insight may not be sensitive to different ways in which people understand their illness.

Original languageEnglish
Pages (from-to)859-865
Number of pages7
JournalJournal of Nervous and Mental Disease
Issue number12
StatePublished - Dec 2008


  • Insight
  • Narratives
  • Severe mental illness

ASJC Scopus subject areas

  • Psychiatry and Mental health


Dive into the research topics of 'Call it a monster for lack of anything else: Narrative insight in psychosis'. Together they form a unique fingerprint.

Cite this