Role of the Self in Schizophrenia: A Multidimensional Examination of Short-Term Outcomes

Abstract

The manifestation, course, and prognosis of schizophrenia are extremely variable, raising an interest in the role of personality and self-concept in the illness' outcome. Building on voluminous research attesting to the fragility and instability of the self in schizophrenia, we examined the role of four self-concept aspects--self-esteem level, self-esteem instability, self-concept clarity, and the perception of the self as ill--in schizophrenia-spectrum disorders. Eighty-nine outpatients were assessed at baseline, and five days subsequently, regarding these self-concept aspects, symptoms, stress, and quality of life. Six weeks later, participants were again assessed using the baseline battery. Self-esteem instability predicted a decrease in quality of life over the study period. Self-concept clarity predicted an increase in quality of life and in positive symptoms, particularly under low stress. Depressive symptoms predicted a decrease in self-esteem levels and an increase in the perception of the self as ill. Thus, all four self-concept aspects were shown to be pertinent to the experience of schizophrenia, albeit in different ways. Special attention should be directed to self-concept clarity, which embeds both risk and resilience.

Searching for reintegration: life experiences of people with schizophrenia

“…Weinberg et al . () reported two‐edge phenomena. Self‐concept involves clarifying subjective experience in improving personal well‐being and quality of life.…”

“…Moreover, depression is associated with a higher perception of the self as being ill (Weinberg et al . ).…”

Six minutes walk test for individuals with schizophrenia

“…To determine the effect of the level of perceived sports competence and perceived physical fitness (PSCPF, high versus low) [30,31] on 6MWD, Vancampfort et al [32] compared the distances walked by individuals with schizophrenia (n ¼ 38). The authors reported a longer distance for participants with higher levels of PSCPF (648.0 m ± 68.6 versus 538.0 m ± 89.5, p50.001).…”

Decreased Self-Concept Clarity in People with Schizophrenia

“…Previous research in people with schizophrenia has found that SCC is negatively correlated with depression and anxiety symptoms (Bigler, Neimeyer, & Brown, 2001) and internalized stigma (Hasson-Ohayon et al, 2014). However, previous work has yielded mixed results about whether SCC is associated with positive symptoms, finding that SCC is negatively correlated with positive symptoms at baseline, but positively associated with an increase in positive symptoms at a follow-up (Noyman-Veksler, Weinberg, Fennig, Davidson, & Shahar, 2013; Weinberg et al, 2012). Similarly, these studies found that SCC was negatively correlated with negative symptoms.…”