Insight into mental illness and child maltreatment risk among mothers withmajor psychiatric disorders

Objectives: This study examined the relationship between :insight into ment al illness and current child maltreatment risk among mothers who had a majo r psychiatric disorder and who had lost custody of a child because of abuse , neglect, or having placed the child at risk of harm. Specifically, a meas ure of insight was examined in relation to systematically observed parentin g behaviors known. to be correlated with past child maltreatment and in rel ation to a comprehensive clinical determination of risk, Methods: Forty-fou r mothers who had a major psychiatric disorder were independently rated for their insight into their illness, the quality of mother-child interaction, and the overall clinical risk of maltreatment, Results: Better insight int o mental illness was associated. with more sensitive mothering behavior and with lower assessed clinical risk of maltreatment. The association remaine d when mothers with current psychotic symptoms were excluded from the analy ses, Better insight did not appear to be associated with past psychotic sym ptoms, maternal psychiatric diagnosis, or the mother's level of education. Conclusions: Insight into mental illness may function as a protective: fact or that influences the risk of child maltreatment in mothers with mental il lness, Measures of insight could be usefully incorporated into comprehensiv e parenting assessments for mothers with psychiatric disorders.