title: Insight among people with severe mental illness, co-occurring PTSD and elevated psychotic symptoms: Correlates and relationship to treatment participation.
abstract: There is a dearth of research on what factors are predictive of insight among people with severe mental illness and co-occurring PTSD.
  
  
  
  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.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: John Jay College of Criminal Justice and the Graduate Center, City University of New York. Electronic address: pyanos@jjay.cuny.edu.
authors.forename: Philip T
authors.initials: PT
authors.lastname: Yanos
authors.affiliation: John Jay College of Criminal Justice and the Graduate Center, City University of New York.
authors.forename: Beth
authors.initials: B
authors.lastname: Vayshenker
authors.affiliation: Brooklyn College, City University of New York.
authors.forename: Pavel
authors.initials: P
authors.lastname: Pleskach
authors.affiliation: Center for Psychiatric Rehabilitation, Boston University.
authors.forename: Kim T
authors.initials: KT
authors.lastname: Mueser
mesh_terms: D000328:Adult; D001945:Breathing Exercises / Q000523:psychology / Q000639:trends; D015928:Cognitive Behavioral Therapy / Q000639:trends; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy*; D016896:Treatment Outcome