Insight as a dual-perspective construct: Convergence between patients’ and professional evaluators’ perspective on baseline level of insight and on changes in insight

Or Front, Lirit Yaffe-Herbst, Hadas Wiseman, Polina Viksman, Haim Kaplan, Sigal Zilcha-Mano

Research output: Contribution to journalArticlepeer-review

Abstract

Insight gained by patients during treatment has been theorized to be a central mechanism of change in psychotherapy, but empirical studies examining the association between patients’ insight and psychopathological symptoms have produced mixed results. The present study addresses these inconsistencies by investigating convergence between the perspectives of patient and professional evaluator on insight and disentangling two potentially distinct components of insight: pretreatment individual differences and changes in insight during treatment. A sample of 393 patients receiving psychodynamic psychotherapy completed pre- and posttreatment measures on symptoms and insight. Professional evaluators evaluated patients’ insight based on clinical interviews pre- and posttreatment. Polynomial regression and response surface analyses were used to examine congruence. The results indicate that when there was agreement between the patient and the evaluator on insight, both baseline level of insight and the changes in insight during treatment were found to be related to symptomatic change, although showing different patterns of association. Lower baseline levels of insight were significantly associated with greater symptomatic improvement than were higher levels of insight. At the same time, greater increase in insight during treatment was moderately significantly associated with greater reduction in symptoms, as long as the changes in insight were not minimal. The findings underscore the importance of assessing the congruence between patients’ and professional observers’ perspectives on patient insight and the potentially distinct roles of between-patients baseline differences and within-patient changes in insight during treatment. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Question: What is the applied clinical practice question this article is hoping to address? Does the clinician–patient agreement regarding the patient’s level of insight and regarding the changes in insight over the course of treatment predict the severity of the patient’s psychopathology or treatment outcome? Findings: How would clinicians meaningfully use the primary findings of this article in their applied practice? In situations of clinician–patient agreement regarding the patient’s level of insight and the changes in insight over the course of treatment, the level of insight has a predictive effect on the severity of the patient’s psychopathology and on treatment outcome. Meaning: What are the key conclusions and implications for future clinical practice and research? Agreement between patients and clinicians on the patient’s level of insight is of clinical importance. Next Steps: Based on the primary findings and limitations of this article, what are future directions to be explored in clinical practice and research? The patient’s level of insight should be assessed as a dyadic construct, capturing a more dependable measure of insight than of either their evaluations. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Original languageEnglish
Pages (from-to)372-378
Number of pages32
JournalPsychotherapy
Volume58
Issue number3
DOIs
StatePublished - Sep 2021

Keywords

  • Insight (Psychotherapeutic Process)
  • Psychodynamic Psychotherapy
  • Change Strategies
  • Patients
  • Regression (Defense Mechanism)
  • Roles
  • Symptoms
  • insight
  • psychodynamic mechanism of change
  • psychodynamic treatment

Fingerprint

Dive into the research topics of 'Insight as a dual-perspective construct: Convergence between patients’ and professional evaluators’ perspective on baseline level of insight and on changes in insight'. Together they form a unique fingerprint.

Cite this