| Abstract: | It is assumed that an individual suffers from obsessive-compulsive disorder (OCD) with poor insight when he or she does not recognize for most of the time that his or her obsessions/compulsions are unreasonable (American Psychiatric Association, 2000). In this critical review of research concerning insight in obsessions, overvalued ideas and delusions, we propose several factors that should be considered when evaluating insight. The instruments frequently used to evaluate insight in OCD patients are critically discussed. Often they assess insight principally in medical terms (e.g., the capacity to recognize that one's behaviour is the result of a mental disorder) without considering the cognitive dimensions. Other instruments designed specifically for OCD assess insight on the basis of the anticipated consequences of not executing one ritual but these instruments do not distinguish this from obsessional doubts. Measures of insight for OCD may need to consider that OCD has several independent components and conviction may vary according to level initial doubt as well to type of consequence. A multidimensional model that evaluates three cognitive dimensions of insight in OCD patients is presented (the Inference Based Approach). This cognitive model establishes a clear distinction between the obsessional doubts, the anticipated consequences and the degree of conviction in the need to perform the ritual. Further recommendations are presented to evaluate insight in OCD patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved) |
