Insight among people with severe mental illness, co-occurring PTSD and elevated psychotic symptoms: Correlates and relationship to treatment participation
Open accessAbstract
Background There is a dearth of research on what factors are predictive of insight among people with severe mental illness and co-occurring PTSD.Method Data were drawn from 146 participants with severe mental illness, co-occurring PTSD and elevated psychotic symptoms participating in a randomized controlled trial comparing two interventions for PTSD among people with severe mental illness. We examined the clinical and demographic correlates of insight at baseline, the relationship between baseline insight and treatment participation, the relationship between treatment participation and post-treatment insight, and the relationship between change in insight and change in other clinical variables.Results Impaired insight was relatively common, with roughly half the sample demonstrating mild or moderate impairment at baseline. Baseline insight was associated with fewer psychotic and disorganized symptoms, and greater emotional discomfort and PTSD knowledge, but was not associated with negative symptoms, PTSD symptoms, depression/anxiety, or treatment participation. Participation in PTSD treatment was associated with increased insight at post-treatment. Improved insight was associated with improvements in disorganization and negative symptoms, but not with knowledge of PTSD or positive symptoms.Discussion The findings suggest that engagement in treatment that includes educating people about PTSD may lead to improvements in insight and related improvements in other psychiatric symptoms.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Poor clinical insight is associated with disorganization symptoms.
“Literature supporting this includes studies correlating poor clinical insight with overall symptom severity [43][44][45] , positive symptoms 46,47 , negative symptoms 44,48,49 , disorganization symptoms 46,47,50-52 , and excitement symptoms 46,47,53 .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [52]
Good insight is correlated with depression and related constructs such as hopelessness.
“Consistent with this, studies of diverse samples continue to find good insight to be correlated with depression and related constructs such as hopelessness 29,52,74,[76][77][78][79] .”
From Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments (2018) · cites this paper as [52]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The Positive and Negative Syndrome Scale (PANSS) for schizophrenia.
Kay, S. R., Fiszbein, A., & Opler, L. A. (1987) · Schizophrenia Bulletin · doi:10.1093/schbul/13.2.261 · Cited by 21,378 · see citing works
Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.6.617 · Cited by 12,052 · see citing works
Trauma and posttraumatic stress disorder in severe mental illness.
Mueser, K. T., Goodman, L. B., Trumbetta, S. L., Rosenberg, S. D., Osher, F. C., Vidaver, R. M., Auciello, P., & Foy, D. W. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.66.3.493 · Cited by 790 · see citing works
Self-citationTrauma and posttraumatic stress disorder in severe mental illness.
Mueser, K. T., Goodman, L. B., Trumbetta, S. L., Rosenberg, S. D., Osher, F. C., Vidaver, R., Auciello, P., & Foy, D. W. (1998) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.66.3.493 · Cited by 790 · see citing works
Self-citationWeathers, F. W., Ruscio, A. M., & Keane, T. M. (1999) · Psychological Assessment · doi:10.1037/1040-3590.11.2.124 · Cited by 707 · see citing works
Lincoln, T. M., Lullmann, E., & Rief, W. (2006) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm002 · Cited by 486 · see citing works
Grubaugh, A. L., Zinzow, H. M., Paul, L., Egede, L. E., & Frueh, B. C. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.04.003 · Cited by 287 · see citing works
Longden, E., Madill, A., & Waterman, M. G. (2012) · Psychological Bulletin · doi:10.1037/a0025995 · Cited by 248 · see citing works
Rathod, S., Kingdon, D., Smith, P. W. F., & Turkington, D. (2004) · Schizophrenia Research · doi:10.1016/j.schres.2004.07.003 · Cited by 160 · see citing works
Belvederi Murri, M., Respino, M., Innamorati, M., Cervetti, A., Calcagno, P., Pompili, M., Lamis, D. A., Ghio, L., & Amore, M. (2015) · Schizophrenia Research · doi:10.1016/j.schres.2015.01.003 · Cited by 142 · see citing works
Assessment of Enduring Deficit and Negative Symptom Subtypes in Schizophrenia
Mueser, K. T., Douglas, M. S., Bellack, A. S., & Morrison, R. L. (1991) · Schizophrenia Bulletin · doi:10.1093/schbul/17.4.565 · Cited by 132 · see citing works
Self-citationMueser, K. T., Gottlieb, J. D., Xie, H., Lu, W., Yanos, P. T., Rosenberg, S. D., Silverstein, S. M., Marcello, S. C., Minsky, S. K., Wolfe, R. S., et al. (2015) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.114.147926 · Cited by 121 · see citing works
Self-citationThe aetiology of postpsychotic posttraumatic stress disorder following a psychotic episode
Shaw, K., McFARLANE, A. C., Bookless, C., & Air, T. (2002) · Journal of Traumatic Stress · doi:10.1023/a:1014331211311 · Cited by 110 · see citing works
Michel, P., Baumstarck, K., Auquier, P., AMADOR, X. F., Dumas, R., Fernandez, J., Lançon, C., & Boyer, L. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-229 · Cited by 82 · see citing works
A Randomized Controlled Clinical Trial of a Patient Decision Aid for Posttraumatic Stress Disorder
Watts, B. V., Schnurr, P. P., Zayed, M. H., Young‐Xu, Y., Stender, P., & Llewellyn‐Thomas, H. A. (2014) · Psychiatric Services · doi:10.1176/appi.ps.201400062 · Cited by 78 · see citing works
Psychotic experiences and PTSD: exploring associations in a population survey
Alsawy, S., Wood, L., Taylor, P. J., & Morrison, A. P. (2015) · Psychological Medicine · doi:10.1017/s003329171500080x · Cited by 78 · see citing works
Hermes, E. D. A., Rosenheck, R. A., Desai, R. A., & FONTANA, A. F. (2012) · Psychiatric Services · doi:10.1176/appi.ps.201100432 · Cited by 72 · see citing works
Preliminary Reliability and Validity of the Clinician-Administered PTSD Scale for Schizophrenia.
Gearon, J. S., Bellack, A. S., & Tenhula, W. N. (2004) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.72.1.121 · Cited by 54 · see citing works
Evaluation of a PTSD psychoeducational program for psychiatric inpatients
Pratt, S. I., Rosenberg, S. D., Mueser, K. T., Brancato, J., Salyers, M. P., Jankowski, M. K., & Descamps, M. J. (2005) · Journal of Mental Health · doi:10.1080/09638230500066356 · Cited by 50 · see citing works
Self-citationThe role of insight in the process of recovery from schizophrenia: A review of three views
Lysaker, P. H., Yanos, P. T., & Roe, D. (2009) · Psychosis · doi:10.1080/17522430902948175 · Cited by 48 · see citing works
Self-citationMeasuring Change in Children and Families
Hauser‐Cram, P., & Krauss, M. W. (1991) · Journal of Early Intervention · doi:10.1177/105381519101500308 · Cited by 32 · see citing works
Symptomatic determinants of insight in schizophrenia spectrum disorders
Buchy, L., Torres, I. J., Liddle, P. F., & Woodward, T. S. (2009) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2009.01.007 · Cited by 27 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [19]First MB Spitzer RL Gibbon M Williams JBW Structured Clinical Interview for DSM-IV Axis-I Disorders - Patient Edition (SCID-I/P, Version 2.0) Biometrics Research Department, New York State Psychiatric Institute 1996
Cited by
Sorted by citations
Lysaker, P. H., Pattison, M. L., Leonhardt, B. L., Phelps, S., & Vohs, J. L. (2018) · World Psychiatry · doi:10.1002/wps.20508 · Cited by 247 · see citing works
Leem, J., Cheong, M. J., Yoon, S.-H., Kim, H., Jo, H.-G., Lee, H., Kim, J., Kim, H. Y., Kim, G.-W., & Kang, H.-W. (2020) · Integrative Medicine Research · doi:10.1016/j.imr.2020.100464 · Cited by 20 · see citing works
Assuring competence or ensuring performance
Vernon, R., Chiarella, M., Papps, E., & Lark, A. (2018) · Collegian Journal of the Royal College of Nursing Australia · doi:10.1016/j.colegn.2018.10.004 · Cited by 21 · see citing works
Clinical insight in first episode psychosis: the role of metacognition
Wright, A. C., Lysaker, P. H., Fowler, D. G., & Greenwood, K. (2021) · Journal of Mental Health · doi:10.1080/09638237.2021.1922629 · Cited by 14 · see citing works
Ward, M., & Lincoln, S. H. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116424 · Cited by 4 · see citing works
Symptoms? Which Symptoms? Distorted Symptom Presentation and Its Detection
Merckelbach, H. L. G. J., & Bošković, I. (2024) · Springer eBooks · doi:10.1007/978-3-031-75875-1_7 · Cited by 2 · see citing works
Under-diagnosis and under-treatment of post traumatic stress disorder amongst major trauma patients
Quinn, D. N., McCombie, A., Jemberie, D., Logan, S., Finlayson, D., Joyce, L. R., Mulder, R., Jordan, J., & Wakeman, C. J. (2026) · Injury · doi:10.1016/j.injury.2026.113077 · Cited by 1 · see citing works
Questionnaire on Attitude towards Research and Care (QuARC): a survey of patients with psychosis
Stratta, P., Rossi, A., Rocca, P., Bucci, P., Prescenzo, S., Patriarca, S., Serrone, D., Galderisi, S., & Maj, M. (2019) · Journal of Mental Health · doi:10.1080/09638237.2019.1581341
Deliu, M. M., Soto‐Pérez, F., Aza, A., Alonso, M. Á. V., & Lettieri, A. (2025) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.70091
Brown, W. J., Graziano, R. C., Babb, Z. A., Zampogna, A. M., Wojtalik, J. A., Bruce, S. E., Eack, S. M., & Grubaugh, A. L. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116861
Cognitive insight in adults with posttraumatic stress disorder and childhood maltreatment
Byers, A., Suliman, S., Seedat, S., & van den Heuvel, L. L. (2026) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2026.107999
Siste, K., Leung, J., Murtani, B. J., Sen, L. T., Kusuma, K. S., Hanafi, E., Nainggolan, F. D., Aryani, A., Tan, C., Lubis, A., et al. (2026) · Irish Journal of Psychological Medicine · doi:10.1017/ipm.2026.10190
From subtle symptoms to disclosure: Communication in violence detection in primary care
Pivert, O., Loubrieu, C., Magret, J., Naiditch, N., & Mignot, S. (2026) · European Journal of General Practice · doi:10.1080/13814788.2026.2684128
- Authors
- Yanos, P. T., Vayshenker, B., Pleskach, P., & Mueser, K. T.
- Affiliations
- The Graduate Center, CUNY (US)
- City University of New York (US)
- Boston University (US)
- Corresponding author
- Yanos, Philip T.
- Venue
- Comprehensive Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 68
- Pages
- 172-177
- ISSN
- 0010-440X (ISSN-L)
- PMC
- PMC4890539
- OpenAlex
- W2343822065
- Cited by
- 14
- References
- 21
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2
- FWCI
- 1.78
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Comprehensive Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R01MH064662)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
- Keywords
- insight, severe mental illness, post-traumatic stress disorder, psychotic symptoms, treatment participation, PTSD treatment, disorganized symptoms, negative symptoms, emotional discomfort
- MeSH terms
- Adult, Mental Disorders, Breathing Exercises, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care, Psychotic Disorders, Severity of Illness Index, Stress Disorders, Post-Traumatic, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
