Examining the role of insight, social support, and barriers in treatment engagement in individuals diagnosed with psychotic disorders

Abstract

Treatment engagement for individuals with psychotic disorders is often low, and engagement is considered critical to improving outcomes and reducing chronicity of the illness. Lack of insight in psychosis has been associated with poor treatment engagement and is considered a core feature of psychotic disorders. One factor that may improve treatment engagement in psychosis, perhaps for individuals with low insight, is social support. Social support may improve treatment engagement by promoting insight or overriding the challenges of engagement related to insight, however, the relationships between insight, social support, and treatment engagement are not clear. The current study hypothesized that greater insight and social support would result in better treatment engagement, and that greater social support would enhance treatment engagement for individuals with low insight. Sixty-eight (N = 68) participants with a psychotic disorder completed clinical interview and self-report measures. A relationship between insight and treatment engagement was not found, thus, social support did not moderate a relationship between the two. Participants reported on multiple treatment barriers impacting treatment engagement. As such, the impact of barriers to treatment may require consideration before accurately measuring the above constructs.