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Scale For Assessmwent of Insight

This document outlines a schedule for assessing insight in patients experiencing emotional or psychological changes. It includes 9 items that rate levels of awareness, understanding, and compliance with treatment. Scores are given for responses indicating denial of symptoms or illness, confused explanations, and reluctance or refusal of treatment. The assessment is meant to evaluate a patient's insight into their condition and willingness to participate in treatment.

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Arvind Raj
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129 views

Scale For Assessmwent of Insight

This document outlines a schedule for assessing insight in patients experiencing emotional or psychological changes. It includes 9 items that rate levels of awareness, understanding, and compliance with treatment. Scores are given for responses indicating denial of symptoms or illness, confused explanations, and reluctance or refusal of treatment. The assessment is meant to evaluate a patient's insight into their condition and willingness to participate in treatment.

Uploaded by

Arvind Raj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ANNEXURE-F

Schedule for the Assessment of Insight – Expanded version

1. “Do you think you have been experiencing any emotional or


psychological changes or difficulties?”
• Often (thought present most of the day, most days) = 2
• Sometimes (thought present occasionally) = 1
• Never (ask why doctors/others think so) = 0

2. “Do you think this means there is something wrong with you?”(eg, a
nervous condition). If previous answer was “never” or “no” ask: “If the
doctors and others think you have been experiencing emotional or
psychological changes or difficulties do you think there must be
something wrong with you don’t feel it yourself?”
• Often (thought present most of the day, most days) = 2
• Sometimes (thought present occasionally) = 1
• Never (ask why doctors/others think so) = 0

3. “Do you think your condition amounts to a mental illness or mental


disorder?"
• Often (thought present most of the day, most days) = 2
• Sometimes (thought present occasionally) = 1
• Never (ask why doctors/others think so) = 0
If positive score on previous two items, proceed to 4, otherwise go to
item 6.

4. “How do you explain your condition/disorder/illness?”


• Reasonable account given based on plausible
mechanisms(appropriate given social, cultural, educational
background, eg., excess stress, chemical imbalance, family history,
etc.,)=2
• Confused account or overhead explanation without adequate
understanding or “don’t know”=1
• Delusional or bizarre explanation=0

If positive score on items 1,2,3, proceed to 5,otherwise go to 6.

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5. “Has your nervous/emotional/psychological/mental/psychiatric condition
led to adverse consequences or problems in your life?”(eg, conflict with
others, neglect, financial or accommodation difficulties, irrational,
impulsive, or dangerous behaviour)
• Yes=2
• Unsure=1
• No=0

6. “Do you think your…condition or the problem resulting from it warrants


treatment?”
• Yes=2
• Unsure=1
• No=0

7. Pick the most prominent symptoms up to a maximum of four. Then rate


awareness of each symptom out of 4 as below.
Examples:
 “Do you think that the belief is not real/not really happening”
 “Do you think that the voices you hear are actually real people
talking, or is it something arising from your own mind?”
 “Have you been able to think clearly, or do your thoughts seem
mixed up/confused? Is your speech jumbled?”
 “Would you say you have been more
agitated/overactive/speeded/withdrawn than usual?”
 “Are you aware of any problem with
attention/concentration/memory?”
 “Have you a problem with doing what you intend/getting
going/finishing tasks/motivation?”
Symptom-1 symptom-2 Symptom-3
Symptom-4
Rating: Rating: Rating:
Rating:
• Definitely(full awareness)=4 mean:
• Probably(moderate awareness)=3
• Unsure(sometimes yes, sometimes no)=2
• Possibly(slight awareness)=1Absolutely(no awareness)=0

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8. For each symptom rated above (up to a maximum of four), ask
patient…”How do you explain…(false belief, hearing voices, thoughts
muddled, lack of drive etc.,)?”
Symptom-1 symptom-2 Symptom-3
Symptom-4
Rating: Rating: Rating:
Rating:

• Part of my illness = 4 mean:


• Due to nervous condition = 3
• Reaction to stress/fatigue = 2
• Unsure = 1
• Can’t say or delusional/bizarre explanation = 0

9. “How do you feel when people do not believe you (when you talk
about….delusion or hallucinations)?
• That’s when I know I’m sick = 4
• I wonder when something’s wrong with me = 3
• I’m confused and I don’t know what to think = 2
• I’m still sure despite what others say = 1
• They’re lying = 0

After interview go to the end of this form and fill in grid as appropriate.
Compliance to treatment / therapy /medication-patient’s primary nurse to
rate following three items (A-C)

A. How does the patient accept treatment?


• Often (may rarely question need for treatment) = 2
mean:
• Sometimes (may occasionally question need for treatment) =1
• Never (ask why) = 0
B. Does the patient ask for treatment unprompted?
• Often (excludes inappropriate request for medication, etc.,) = 2
• Sometimes (rare here if forgetfulness/disorganization leads to
occasional requests only) = 1
• Never (ask why doctors/others think so) = 0

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C. Summary of compliance to treatment/therapy/medication
• Complete refusal = 1
• Partial refusal(refusing depot drugs or accepting only the
minimum dose) = 2
• Reluctant acceptance(accepting only because treatment is
compulsory or questioning the need for treatment often, eg.,
every 2 days) = 3
• Occasional reluctance about treatment(questioning the need for
treatment once a week)=4
• Passive acceptance = 5
• Moderate participation (some knowledge of and interest in
treatment and no prompting needed to take the drugs) = 6
• Active participation (ready acceptance, and taking some
responsibility for treatment) = 7

Score summary
1.
2.
3.
4.
5.
6.
7. (mean)
8. (mean)
9.
Sub total:
A.
B.
Total: item C
(Item C is combined with other scores)

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