Self-Disturbance in Schizophrenia

Vries, Rob de; Heering, Henriëtte D.; Postmes, Lot; Goedhart, Saskia; Sno, Herman N.; Haan, Lieuwe de

doi:10.4088/pcc.12m01382

Cited by 11 publications

(5 citation statements)

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“…The final component of the self-disturbance model, "disturbed grip or hold," contributes to the general feelings of unreality present in the illness. It is a lack of stability of experiences and "loss of common sense" including changes in "salience-pattern," which would fit within the entropic processing construct (de Vries et al, 2013;Sass et al, 2018). It is plausible that "a disturbed grip" may in part be due to chaotic dopaminergic signaling within midbrain regions (Kapur, 2003;Howes and Nour, 2016;Howes et al, 2020).…”

Section: B Self-disorder In Psychosismentioning

confidence: 99%

Self-Entropic Broadening Theory: Toward a New Understanding of Self and Behavior Change Informed by Psychedelics and Psychosis

Dourron

Strauss

Hendricks

2022

Pharmacological Reviews

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The extremes of human experiences, such as those occasioned by classic psychedelics and psychosis, provide a rich contrast for understanding how components of these experiences impact well-being. In recent years, research has suggested that classic psychedelics display the potential to promote positive enduring psychologic and behavioral changes in clinical and nonclinical populations. Paradoxically, classic psychedelics have been described as psychotomimetics. This review offers a putative solution to this paradox by providing a theory of how classic psychedelics often facilitate persistent increases in well-being, whereas psychosis leads down a "darker" path. This will be done by providing an overview of the overlap between the states (i.e., entropic processing) and their core differences (i.e., self-focus). In brief, entropic processing can be defined as an enhanced overall attentional scope and decreased predictability in processing stimuli facilitating a hyperassociative style of thinking. However, the outcomes of entropic states vary depending on level of self-focus, or the degree to which the associations and information being processed are evaluated in a self-referential manner. We also describe potential points of overlap with less extreme experiences, such as creative thinking and positive emotion-induction. Self-entropic broadening theory offers a heuristically valuable perspective on classic psychedelics and their lasting effects and relation to other states by creating a novel synthesis of contemporary theories in psychology.Significance Statement--Self-entropic broadening theory provides a novel theory examining the psychedelic-psychotomimetic paradox, or how classic psychedelics can be therapeutic, yet mimic symptoms of psychosis. It also posits a framework for understanding the transdiagnostic applicability of classic psychedelics. We hope this model invigorates the field to provide more rigorous comparisons between classic psychedelic-induced states and psychosis and further examinations of how classic psychedelics facilitate long-term change. As a more psychedelic future of psychiatry appears imminent, a model that addresses these long-standing questions is crucial.

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Section: B Self-disorder In Psychosismentioning

confidence: 99%

Self-Entropic Broadening Theory: Toward a New Understanding of Self and Behavior Change Informed by Psychedelics and Psychosis

Dourron

Strauss

Hendricks

2022

Pharmacological Reviews

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“…The EASE defines hyperreflectivity as an ‘occasionally excessive or frequent, even chronic, tendency to take oneself or parts of oneself or aspects of the environment as objects of intense reﬂection' [13,23]. Finally, question 12 was derived from the CAARMS: Delusional Mood and Perplexity (‘Non-Crystallized Ideas') [16] and covered the profound alteration between self and the world as described by patients as a result of experiencing self-disturbance [7,24]. Patients were asked to report on a 5-point Likert scale about the life-time frequency and level of burden of these 12 items.…”

Section: Methodsmentioning

confidence: 99%

“…Previous research has highlighted the importance of a phenomenological approach towards patients, instead of constraining them to yes or no answers, so as to fully understand their complaints and burden [7,30]. However, for routine clinical and research settings a validated short screener for self-disturbances in patients with a psychotic disorder is approachable and feasible and can be used as a first step to more comprehensive examination.…”

Section: Limitationsmentioning

confidence: 99%

“…A disturbed self-experience can be most puzzling and frightening to patients, and may lead to withdrawal from social contact [7,8]. Subtle experiences of self-disturbance have already been found in the prodromal phase of schizophrenia [9,10], and they have been recognized as a risk factor for transition to psychosis in subjects at ‘ultra-high risk' for the disorder [11].…”

Section: Introductionmentioning

confidence: 99%

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Disturbed Experience of Self: Psychometric Analysis of the Self-Experience Lifetime Frequency Scale (SELF)

Heering¹,

Goedhart²,

Bruggeman³

et al. 2016

Psychopathology

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Background: Schizophrenia is characterized by positive and negative symptoms, but recently anomalous self-experiences, e.g. exaggerated self-consciousness (hyperreflectivity), receive more attention as an important symptom domain in schizophrenia patients. The semi-structured interview, the Examination of Anomalous Self-Experience (EASE) [Psychopathology 2005;38:236-258], examines experiences of a disturbed sense of self in a sophisticated but time-consuming manner. Therefore, we proposed the Self-Experience Lifetime Frequency scale (SELF), an instrument intended to screen for self-disturbance phenomena. Here we compared scores of patients, their siblings and healthy controls on the SELF. Methods and Sampling: The SELF is composed of a validated screener for symptoms of depersonalization complemented by questions covering several other domains of self-disturbance. A total of 426 patients with a psychotic disorder, 526 of their unaffected siblings, and 297 healthy controls completed the SELF. Patients' scores on the 12 items of the SELF were subjected to an explorative principal axis factor analysis (PAF); composite scores on factor components were compared between the three participant groups. Results: The PAF revealed two components, explaining 43.9 and 9.5% of variance, respectively. The first component represents a disturbance of self-awareness; the second component reflects (milder forms of) diminished self-affection or depersonalization. The two components of the SELF revealed good internal consistency (component 1, α = 0.88; component 2, α = 0.79; ρ = 0.85). Patients showed significantly higher scores on both factor components in comparison with both siblings and controls. No significant differences were found between siblings and controls. Conclusions: The findings of the current study suggest that the SELF comprises two components of self-disturbance. Patients reported more (severe) symptoms of self-disturbance on both components, suggesting that it is feasible to screen for self-disturbance phenomena in patients with psychotic disorders with the SELF. Screening for symptoms of self-disturbance is important since these symptoms are associated with suffering and, moreover, these phenomena may mark the transition from intact to aberrant reality testing.

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“…Through a phenomenological approach, clinicians can gain insight into the inner world of patients and better comprehend their treatment needs. 8,9 Forging positive relationships with patients with schizophrenia is also particularly essential for the implementation of shared decision making (SDM). Patients with schizophrenia routinely underestimate their competency to make decisions, which may lead them to have little to no interest in taking a leading role in their own care.…”

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confidence: 99%