BECK COGNITIVE INSIGHT SCALE

The Beck Cognitive Insight Scale (BCIS) .BCIS was developed to evaluate patients selfreflectiveness and their overconfidence in their interpretations of their experiences. It consists of
a 15-item self-report questionnaire, a 9-item self- reflectiveness subscale, and a 6-item selfcertainty subscale. The first component consisted of 9 items measuring objec- tivity
reflectiveness and openness to feedback and has given the label self-reflectiveness. Under the
umbrella of decision- making and resistance to feedback, 6 items were united in a second
component of the scale, labeled self-certainty. High scores on the subscale self-reflectiveness
and low scores on subscale self-certainty are considered as normal. A composite index of the
BCIS reflecting cognitive insight was calculated by subtracting the score for the self-certainty
scale from that of the self-reflectiveness scale; a score of 10 points or more signifies good
cognitive insight. Respondents are asked to rate how much they agree with each statement by
using a 4- point scale that ranges from 0 (do not agree at all) to 3 (agree completely). No time
frame for the ratings is provided. The coefficient for the self-reflectiveness scale was 0.68 and
for self-certainty was 0.60 for the original sample.
POSITIVE AND NEGATIVE SYMPTOM SCALE
The studies on which these analyses are based were selected because of their inclusion of the
PANSS and its subscales among their primary and secondary measures of efficacy. The PANSS
is an assessment tool that measures the severity of the psychiatric symptoms of psychosis. It
consists of 30 items, each rated on a scale from 1, absent, to 7, extreme (range, 30-210).
Since the time that the PANSS was introduced, based on the original 2 symptomatic dimensions
of schizophrenia, positive and negative, several alternative sets of subscales have been proposed
based on power analysis of specific symptom clusters [17,26,27]. The current set of analyses, in
addition to assessing changes in PANSS total scores, simultaneously examines changes in the5
dimensions proposed by Davis and Chen [28]: positive (positive symptoms, items 1-3, 5, 6, 14,
23, 26, and 29); negative (negative symptoms, items 8-11, 13, 21, and 30); disorganized thought
(items 12, 18, 19, 24, 25, and 27); hostility, which includes symptoms of excitement and
impulsivity (items 4, 7, 22, and 28); and depressive, which includes symptoms of anxiety (items
15-17 and 20). The PANSS measurements were obtained from the time points that were common
to all 5 source studies, at randomization and after 2, 4, 6, 8, 16, 20, and 24 weeks of treatment.

DRUG ATTITUDE INVENTORY-10(SHORTENED VERSION)

The scale has 10 items, six of them will be scored as TRUE and four will be scored as FALSE.
A correct answer to these items will be scored as plus one. An incorrect response will be scored
as minus one. The final score is the sum of the total of pluses and the minuses. A positive total
score means a positive subjective response (compliant). A negative total score means a negative
subjective response (non-compliant).

MEDICATION ADHERENCE RATING SCALE (MARS)

This scale is based on two already existing self-report measures of compliance. The first is the
Drug Attitude Inventory (DAI) (Hogan, Awad and Eastwood, 1983), and the second is the
Medication Adherence Questionnaire (MAQ) (Morisky, Green and Levine, 1986). These
compliance measures have been combined to produce a compliance scale.
The MARS consists of 10 items that require yes/no responses. The first 4 items are based on the
MAQ, and are scored, no = 1 and yes = 0. The remaining items are from the DAI and are coded
as follows: Q5, Q6, Q9, Q10, no = 1 and yes = 0; Q7, Q8, no = 0 and yes = 1. A total score will
then reflect a greater degree of compliance if it is high, and non-compliance if it is low.
However one must always keep in mind that any measure of self-reported compliance will
overestimate compliance by approximately 30%.
HEALTH SERVICES UTILIZATION INVENTORY (HSUI)
Brief Description of Instrument Collects data regarding health services used in the past 12
months, medications, and out of pocket health costs. Scale Format Varies, yes/no, checklist,
counts, open-ended. Administration Technique Interviewer administered. Scoring and
Interpretation Counts/frequencies. Content analysis of open-ended responses. Content & Face
Validity Costs for health services determined through extensive research across Ontario.
Justifications provided for each of the listed costs. Please contact author for more information.
Strengths Standard tool that can be used by numerous studies to compare costs and health care
services utilization.
Language validity of Beck cognitive Insight Scale (BCIS), Drug Attitude Inventory
(DAI) and Medication Adherence Rating Scale (MARS) was established by translating
these tools into Hindi by Official Hindi Translator of CIP and retranslation to English
by Language experts. Since the meaning was same, no change was made.
Pretesting of the translated tools
The tools were pretested on 30 patients with schizophrenia who met the inclusion
criteria. Since no modifications were required and same tools was used. Time taken
to complete the tools was varied.

Reliability of the tools

Test, retest of BCIS, DAI-10 and MARS was established by administrating 30 patients
with schizophrenia. The test retest reliability coefficient was computed using
Cronbachs Alpha method BCIS(r= .804).DAI-10(r=.874) and MARS(r=.805).Hence
the tools were found to be reliable.