Cognitive Therapy and Research

, Volume 43, Issue 2, pp 324–334 | Cite as

Establishing Clinical Cutoff Values for the Beck Cognitive Insight Scale

  • Danielle Penney
  • Geneviève Sauvé
  • Rhida Joober
  • Ashok K. Malla
  • Martin LepageEmail author
Original Article


Cognitive insight represents the ability to reflect on and criticize beliefs and thoughts, and is impaired in individuals with psychosis, relative to healthy controls. The Beck Cognitive Insight Scale is the most widely used tool to assess cognitive insight. While some studies have attempted to develop diagnostic cutoffs, clinical cutoffs differentiating levels of cognitive insight have not yet been established. We identified two clinical profiles within our psychosis sample (N = 385). Profiles represented low and high cognitive insight and were based on functioning and IQ. Composite index scores at the 33rd percentile in the low cluster and the 66th percentile in the high cluster were calculated. Composite index scores of three or lower represent low cognitive insight, between four and nine is considered moderate, and ten or above represents good cognitive insight. Clinical cutoffs will better orient clinicians and will facilitate the development of targeted interventions to improve cognitive insight.


BCIS Cognition Psychosis Schizophrenia Self-reflection Confidence 



The authors wish to thank research staff from the Martin Lepage Laboratory, especially Gabriella Buck, and PEPP-Montreal for assistance with recruitment and data collection. We are grateful to all who participated in this study.


This work was supported by the Canadian Institutes of Health Research (Grant Nos. 68961, 106634) to M.L., and the Sackler Foundation to M.L. and A.K.M. Salary awards include: the Fonds de recherche du Québec - Santé to G.S., M.L., and R.J.; the James McGill Professorship to M.L.; and the Canada Research Chairs Programme to A.K.M. M.L. reports having received financial assistance/compensation for research and educational events from Otsuka/Lundbeck Alliance.

Compliance with Ethical Standards

Conflict of Interest

Danielle Penney, Geneviève Sauvé, Rhida Joober, Ashok K. Malla and Martin Lepage declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Animal Rights

This article does not contain any studies with animals performed by any of the authors.

Supplementary material

10608_2018_9963_MOESM1_ESM.docx (22 kb)
Supplementary material 1 (DOCX 21 KB)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Douglas Mental Health University InstituteMontrealCanada
  2. 2.Department of PsychiatryMcGill UniversityMontrealCanada

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