Cognitive insight in non-psychiatric individuals and individuals with psychosis: an examination using the Beck Cognitive Insight Scale.

An increasing number of studies have used the Beck Cognitive Insight Scale (BCIS) to understand the reasoning of individuals with psychotic disorders. Less is known, however, about "normal" levels of insight and how non-psychiatric individuals compare to those with psychosis. The present study examined the structure of the BCIS in a non-psychiatric population and made comparisons between the scores of non-psychiatric individuals and those with psychosis. Participants were 418 students at American universities and 93 outpatients at a VA Medical Center with SCID-confirmed diagnoses of schizophrenia or schizoaffective disorder. Confirmatory factor analysis supports the 2-factor, 15-item structure previously reported for the BCIS, with one factor called self reflectiveness and the other called self certainty. Reliability analyses suggest strong internal consistency and test-retest results. Further, the BCIS subscales and composite index reliably distinguished between non-psychiatric and patient groups, though receiver operating characteristic (ROC) analysis did not suggest a particular cutoff score for predicting patient status. These results suggest that the BCIS is a valid measure to use in a non-psychiatric population, and that it reliably distinguishes between non-psychiatric individuals and those with psychotic disorders. Copyright 2010 Elsevier B.V. All rights reserved.