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Construct validity and factor structure of Tamil version of Beck Cognitive Insight Scale to assess cognitive insight of patients with schizophrenia

Published online by Cambridge University Press:  24 June 2014

Thanka Jemi Merlin ,
Anto P. Rajkumar ,
S. Reema ,
Sherab Tsheringla ,
S. Velvizhi  and
K. S. Jacob
Thanka Jemi Merlin
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
Anto P. Rajkumar*
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India Center for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
S. Reema
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
Sherab Tsheringla
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
S. Velvizhi
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
K. S. Jacob
Affiliation:
Department of Psychiatry, Christian Medical College, Vellore, India
*
Anto P. Rajkumar, Center for Psychiatric Research, Aarhus University Hospital, Risskov 8240, Denmark. Tel: 45 7789 3548; Fax: 45 7789 3549; E-mail: [email protected]
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Extract

Objective: The ability to reflect rationally on one's own anomalous experiences and to recognise that their conclusions are incorrect is called as cognitive insight. It influences the delusion proneness of patients with schizophrenia. Structured instruments to assess cognitive insight have not been validated in any Indian languages so far. Hence, we aimed to evaluate the validity and factor structure of Tamil version of Beck Cognitive Insight Scale (BCIS-T).

Methods: One hundred and fifty consecutive patients with schizophrenia completed BCIS-T. We assessed their clinical insight with the reference standard, Schedule for Assessment of Insight-Expanded version (SAI-E). An independent psychiatrist evaluated their psychopathology using Brief Psychiatric Rating Scale (BPRS).

Results: BCIS-T was internally consistent with Cronbach's α 0.67 and Guttman's split-half coefficient as 0.63. BCIS-T composite index documented convergent validity with SAI-E total score (ρ = 0.38; p < 0.001) and discriminant validity with BPRS (ρ = −0.02; p = 0.85). Factor analysis showed a four-factor structure, namely self-certainty, self-reflectiveness, openness to external feedback and infallibility of self-reflection. BCIS-T composite index had significant linear relationship with clinical insight and treatment compliance on multivariate analyses (p < 0.01).

Conclusion: Our findings support the validity of BCIS-T to assess cognitive insight of the patients with schizophrenia. We suggest addressing the intricacies of cognitive insight beyond the traditional two-dimensional models in cross-cultural settings.

Keywords

compliancecorrelationinsightschizophrenia
Type
Research Article
Information
Acta Neuropsychiatrica , Volume 24 , Issue 1 , February 2012 , pp. 43 - 49
Copyright
Copyright © Cambridge University Press 2011

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