Challenges of insight assessment in pediatric obsessive-compulsive disorder: Initial results and clinical considerations from a measure development study

•We developed a new 7-item Measure of Insight for OCD in youth (MI-OCD).•MI-OCD items positively correlated with the existing single-item measure of insight.•Assesses perceptions of symptoms as: A) unwanted (1–3); and B) valid/useful (4–7).•Interpretating insight remains difficult due to various confounding factors.•The MI-OCD may be useful for exploring reasons underlying poor treatment compliance.