title: Revisiting poor insight into illness in anorexia nervosa: true unawareness or conscious disagreement?
abstract: BACKGROUND
  To investigate and validate a novel approach to distinguishing between two possible sources of poor insight in anorexia nervosa: true unawareness, in which a patient is not aware that other people think there is a problem, and disagreement, in which a patient does recognize that others think there is a problem.
  
  
  METHODS
  Thirty-nine patients with anorexia nervosa or eating disorder not otherwise specified-anorexia nervosa were given two versions of the Scale of Unawareness of Mental Disorder (SUMD), one in which they were asked about their own opinion and one in which they were asked about their clinicians' opinion. Clinicians also completed the SUMD with their opinion about the patient's illness. Patients and clinicians both also completed a Visual Analog Scale assessing treatment acceptance.
  
  
  RESULTS
  About 57% of the overall level of poor insight was explained by disagreement. Prediction of treatment acceptance was significantly improved when poor insight was broken down into true unawareness and disagreement.
  
  
  CONCLUSIONS
  These data suggest that impaired insight in anorexia nervosa is an additive outcome of true unawareness and disagreement.
authors.affiliation: ARBEL: Haifa University, Haifa, Israel; LATZER and KOREN: Haifa University and Rambam Medical Center, Haifa.
authors.forename: Reout
authors.initials: R
authors.lastname: Arbel
authors.forename: Yael
authors.initials: Y
authors.lastname: Latzer
authors.forename: Danny
authors.initials: D
authors.lastname: Koren
mesh_terms: D000328:Adult; D000856:Anorexia Nervosa / Q000523:psychology*; D001364:Awareness; D003220:Conflict, Psychological; D005260:Female; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011369:Professional-Patient Relations; D015203:Reproducibility of Results; D055815:Young Adult