Momentary assessment of aberrant salience, anomalous self-experiences, and psychotic-like experiences.

Abstract

To improve understanding of emerging psychosis, researchers have identified potential precursory mechanisms that may momentarily precede psychotic-like experiences, including aberrant salience and anomalous self-experiences. Aberrant salience is the misattribution of significance to neutral stimuli and may be linked to atypical dopamine transmission. Anomalous self-experiences include changes in the experience of the self, which may alter top-down cognitive processes. The present study extends previous research on these phenomena by examining the momentary dynamics of aberrant salience, anomalous self-experiences, and psychotic-like experiences in daily life. Participants were 246 young adults who were prompted to complete 6 smartphone surveys daily for 7 days. Baseline measures of aberrant salience and anomalous self-experiences each predicted occurrence of the same phenomena in daily life, supporting the use of these measures to examine within-subject changes. Dynamic structural equation modeling was used to examine lagged effects. Both aberrant salience and anomalous self-experiences exhibited carryover effects across timepoints. Furthermore, aberrant salience and anomalous self-experiences were each associated with psychotic-like experiences at subsequent timepoints, above and beyond the carryover effects of psychotic-like experiences. These temporal relationships provide preliminary support consistent with social-cognitive models of psychosis and support further examination of the within-subject dynamics of aberrant salience and anomalous self-experiences at the momentary scale.

Aberrant Salience and Disorganized Symptoms as Mediators of Psychosis

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Restoring Trust for People With Psychosis Through Psychotherapy

“…Although symptoms contain central truths about the patient's experience and are often linked to traumatic memories (Ridenour and Garrett, 2023), the therapist should avoid the temptation of wanting to be the one who can unlock the mystery of psychosis, a mystery that can never be fully known. Such a position may parallel patient efforts to eliminate uncertainty, given that many people with psychosis are often overwhelmed by a surplus of meaning while in psychotic states (Meyer et al, 2022), sensing a world that is pregnant with possibilities as they try, and inevitably fail, to put the pieces together. Psychotic experiences can be so anomalous that language may fail to capture the alterations in the person's experience of their body, mind, and world.…”

From hallucinations to delusions: A narrative review of psychotic-like experiences and their implications

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