Translation into Arabic and validation of the Schedule for the Assessment of Insight–Expanded Version (SAI-E) for use in Tunisia

BackgroundThe Schedule for the Assessment of Insight–Expanded Version (SAI-E) consists of 11 items that encompass: awareness of having a mental illness, ability to rename psychotic phenomena as abnormal, and compliance with treatment.AimsTo translate into Arabic and validate the Tunisian version of this instrument.MethodThe Arabic translation of the SAI-E was obtained by the “forward/backward translation” method. Adaptations were made after a pilot study involving 20 outpatients with schizophrenia and after taking account the opinions of 15 experts in psychiatry.For validation, 150 outpatients suffering from schizophrenia were recruited by a random drawing in the psychiatric department in Sousse (Tunisia).For factor analysis, principal components analysis and Varimax rotation were adopted. Convergent validity was assessed by correlating the translated scale with the G12 item (lack of judgment and awareness of the disease) of the positive and Negative Syndrome Scale (PANSS).Internal consistency was assessed by Cronbach alpha coefficient and inter-rater reliability was assessed by the use of intra-class correlation coefficient (ICC).ResultsRegarding construct validity, factor analysis revealed three factors that were responsible for 70.2% of the variance.As for concurrent validity, we found a negative correlation between the score of the SAI-E and that of the G12 item of the PANSS (r = − 0.82 and p < 10−3).The study of internal consistency between the 11 items was found to be good (α = 0.82). The test–retest reliability was satisfactory (r = 0.8, p < 10−3), and so was inter-rater reliability (ICC = 0.84).ConclusionIn the Tunisian cultural context, the SAI-E presented three factors with good consistency and an inter-rater reliability compatible with the insight dimensions that are intended to be evaluated.