Development and validation of the schedule for the assessment of insight in eating disorders (SAI-ED). (October 2020)

• Record Type: Journal Article
• Authors: Konstantakopoulos, George; Georgantopoulos, Georgios; Gonidakis, Fragiskos; Michopoulos, Ioannis; Stefanatou, Pentagiotissa; David, Anthony S.
• Is Part Of: Psychiatry research. Volume 292(2020)
• Publication Date: 2020-10
• Subjects: Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2020.113308
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: The Schedule for the Assessment of Insight in Eating Disorders (SAI-ED) is a valid and reliable, interview-based scale for the multidimensional assessment of insight in eating disorders. Three major insight components of insight were identified in patients with eating disorders: awareness of illness, awareness of symptoms, and treatment engagement. The levels of overall insight and its dimensions were found significantly lower in patients with anorexia nervosa than patients with bulimia nervosa. Abstract: This study examined the reliability, validity and internal structure of the newly developed, interview-based Schedule for the Assessment of Insight in Eating Disorders (SAI-ED) and the relationships of insight with demographic and clinical characteristics in EDs. Ninety-four female patients – 44 with anorexia nervosa (AN) and 50 with bulimia nervosa (BN) – were assessed with SAI-ED. The Brown Assessment of Beliefs Scale was used to evaluate convergent validity of SAI-ED. Hierarchical cluster analysis and multidimensional scaling were used to identify insight components and assess their inter-relationships. The final 8-item SAI-ED demonstrated good psychometric properties. Inter-rater and test-retest reliabilities were high. Three subscales of SAI-ED were identified which measure major insight components: awareness of illness, awareness of symptoms, and treatment engagement. Patients with AN had significant lower score on SAI-ED than patients with BN. Impaired insight was associated with: (a) lower current and lowest lifetime BMI and more severe dietary restrain in AN, (b) illness duration, severity of overall ED symptoms, body-related concerns and obsessionality in BN. Insight is a multidimensional construct in EDs associated with different clinical aspects in AN and BN. The SAI-ED is a valid and reliable tool for the assessment of insight in EDs patients.