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The term insight is a major concept in psychiatry, which no netheless has a number of different connotations ranging from awareness of one’s disorder to achieving a clear and sudden solution of a problem or anosognosia. Although this concept is ubiquitous in the psychological literature, its definition is not clear, including in DSM-5; the most commonly used diagnostic system for mental disorders. This turns its use ambiguous, particularly for those who are not familiar with the historical background of the word. Here, we aim to a better understanding of insight in specific phobias and discuss the possible causes and implications in DSM-5 criterion changes. The historical analysis of this concept lead to conclude three main assumptions: 1) There are probably different etiopathogenic mechanisms subjacent to the deve lop ment of insight, anosognosia and possibly other “insight” related terms; 2) in the case of specific phobias, lack of insight is better seen and explained as a cognitive bias; 3) DSM use of an insight specifier for specific phobias could be of use; 4) lack of insight can be seen simply as a cognitive bias in most phobia cases.

INSIGHT IN SPECIFIC PHOBIAS: A FORGOTTEN BIAS