Enhancing insight into clinical insight: An investigation of conceptual variations.

Abstract

Definitions of clinical insight have changed over the course of the 20th century. Indeed, when viewed from a historical lens, the clinical literature contains multiple and diverse conceptualizations of insight. Yet, in contemporary clinical discourse, insight is typically conceived as the extent to which a person identifies as having a mental disorder that requires treatment. The present study traced the evolution of the clinical insight concept during the mid-to-late 20th century. In doing so, this project demonstrated the application of psychological research methods to the study of scholarly and scientific discourses in psychology. We conducted a systematic analysis of 125 archival texts from the 1940s to the 1990s. Qualitative and quantitative data analysis revealed diverse conceptualizations of insight that evolved over time. The transition to the 1990s was marked by shifts from conceptualizations of insight as awareness of self-experience to definitions focusing on awareness of a mental disorder. Additional analyses revealed between-decade differences in the extent to which insight was viewed as continuous and diachronic, as well as in reference to mental components and mechanisms. Discussion of these findings addresses the clinical and societal implications of shifting insight definitions, including ways in which these shifts have informed clinical research and practice.