title: The Structured Interview for Insight and Judgment in Dementia: Development and validation of a new instrument to assess awareness in patients with dementia.
abstract: BACKGROUND
  Poor insight about their cognitive and functional deficits is highly prevalent in patients with Alzheimer's disease (AD); however, there is a lack of reliable, valid instrumentation to measure this construct. The aim of this study was to develop and validate a semistructured interview to assess insight and judgment in patients with AD and to provide information regarding the assessment of competency and risk in this population.
  
  
  METHODS
  We validated the Structured Clinical Interview for Insight and Judgment in Dementia (SIJID) in a consecutive series of 124 patients with probable AD. The following psychometric properties were evaluated: internal consistency, test-retest reliability, interrater reliability, and convergent and predictive validity.
  
  
  RESULTS
  The SIJID demonstrated high test-retest, interrater reliability and also showed strong discriminant and convergent validity. It showed good predictive validity based on 1-year follow-up information of the patient's clinical outcomes, with a significant association between higher SIJID total scores at baseline, and more severe neuropsychiatric symptoms and more severe caregiver distress at follow-up. Moreover, higher scores of dangerous behaviors at baseline were significantly correlated with a higher frequency of hospitalization and placement in residential care 1 year later.
  
  
  CONCLUSIONS
  The SIJID is a reliable and valid instrument to assess insight and judgment in patients with AD and is a valuable tool for assessing presence and severity of dangerous behaviors, determining risk, and providing critical information for the assessment of competency.
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Teresa
authors.initials: T
authors.lastname: Parrao
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Simone
authors.initials: S
authors.lastname: Brockman
authors.affiliation: School of Psychology, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Romola S
authors.initials: RS
authors.lastname: Bucks
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Bruce
authors.affiliation: School of Medicine and Pharmacology, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Davis
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Katherine K
authors.initials: KK
authors.lastname: Hatch
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Tammy L
authors.initials: TL
authors.lastname: Leavy
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Christine A P
authors.initials: CA
authors.lastname: Axten
authors.affiliation: School of Psychiatry and Clinical Neurosciences, University of Western Australia and Fremantle Hospital, Western Australia, Fremantle, Australia.
authors.forename: Sergio E
authors.initials: SE
authors.lastname: Starkstein
keywords: Anosognosia; Assessment; Dementia; Insight; Judgment