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.
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.
These data suggest that impaired insight in anorexia nervosa is an additive outcome of true unawareness and disagreement.
Me today: “I don’t mean this like I think you’re not using good judgment…but I just really don’t think I need to be inpatient.”
My therapist: “Oh you definitely do. And if anyone else evaluated you they would say the same thing.”
(And as I’m typing this I’m thinking “No but like, I really don’t need to be inpatient. She thinks I’m much more unwell than I actually am.”
I think we are all like that to some extent. Me, at a low BMI, b/p’ing like it was my day job: Naaaah, I’m fiiiine. I feel like shit but I’m still getting A’s in my classes, so it is alll good. I am not passing out or anything.