The Self in the Spectrum: A Closer Look at the Temporal Stability of Self-Disorders in Schizophrenia

Raballo, Andrea; Preti, Antonio

doi:10.1159/000488645

Cited by 9 publications

(3 citation statements)

References 21 publications

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“…Self-disorders are longitudinally associated with development of psychosis in patients (33) and help-seeking adolescents (34) and are associated with the longitudinal unfolding of other psychopathological dimensions, particularly negative symptoms (35). Furthermore, self-disorders possess trait-like characteristics, indeed, recent studies have demonstrated stability both in degree and patterns of self-disorders across periods of five years (36)(37)(38).…”

Section: Introductionmentioning

confidence: 99%

Anomalies of Imagination, Self-Disorders, and Schizophrenia Spectrum Psychopathology: A Network Analysis

et al. 2022

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BackgroundAnomalies of imagination encompass disturbances of the basic experiential structure of fantasies and imagery that can be explored in a semi-structured way with the Examination of Anomalous Fantasy and Imagination (EAFI). We aimed (1) to examine the distribution of anomalies of imagination among different diagnostic groups and a group of healthy controls, and (2) to examine their relation with disorders of basic self, perceptual disturbances and canonical state psychopathology of the schizophrenia-spectrum (positive, negative and general symptoms).MethodsThe 81 participants included patients with schizophrenia or other non-affective psychosis (N = 32), schizotypal personality disorder (N = 15) or other mental illness (N = 16) and healthy controls (N = 18). The assessment encompassed EAFI, Examination of Anomalous Self-Experience (EASE), parts of Bonn Scale for the Assessment of Basic Symptoms (BSABS) and Positive and Negative Syndrome Scale (PANSS). For network analysis, the associations of EAFI with the other psychopathological variables were tested by Pearson's correlation coefficient and graphically represented using multidimensional clustering. Comparisons between correlations in the network were tested with Steiger's test.ResultsAnomalies of imagination aggregated significantly in schizophrenia-spectrum disorders compared to other mental illness and healthy controls with no difference between schizophrenia and schizotypal disorder. In the network analysis, anomalies of imagination were closely inter-connected with self-disorders. Although, the anomalies of imagination correlated moderately with perceptual disturbance and positive, negative and general state symptomatology, these dimensions aggregated separately and relatively distant in the network.ConclusionsThe results support that anomalies of imagination are highly characteristic of schizophrenia-spectrum disorders and closely related to self-disorders.

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Section: Introductionmentioning

confidence: 99%

Anomalies of Imagination, Self-Disorders, and Schizophrenia Spectrum Psychopathology: A Network Analysis

et al. 2022

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“…Empirical studies have consistently shown increased levels of self-disorders among SCZ patients and schizotypal patients as opposed to patients with bipolar psychosis or other non-SCZ spectrum disorders (for review and meta-analysis, see [ 10 , 11 , 12 ]). Importantly, an empirical study saw that self-disorders as measured by the EASE manifest a mono-factorial structure [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Disorder of Selfhood in Schizophrenia: A Symptom or a Gestalt?

2022

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Introduction: The concept of schizophrenia (SCZ) was originally associated with a disorder of formal strata of the self. During the last two decades, empirical studies have demonstrated a selective hyper-aggregation of self-disorders in the SCZ spectrum. As with other scientific research areas, the role of self-disturbances in SCZ has been up for debate in various disciplines including cognitive sciences, philosophy of mind, and psychopathology. Several philosophical papers have used the psychopathological phenomena of “thought insertion” as an alleged example of a complete loss of minimal selfhood. In the field of psychopathology, it has been claimed that self-disorders may comprise a transdiagnostic phenotype. Common to these approaches is the underlying assumption that self-disorders reflect well-delineated and isolated symptoms akin to the notion of symptom in the medical model. The aim of this paper was to argue that the clinical manifestation of self-disturbances is to be seen as aspects of a Gestalt of disturbed experiential selfhood. Methods: Seven videotaped interviews of patients with SCZ who were emblematic of very diverse symptomatological constellations were selected and jointly watched and discussed by the authors, who reached a consensus assessment. The interviews were semi-structured and narrative in nature in order to obtain faithful self-descriptions according to the standards of phenomenologically oriented interviews. For the purpose of this article, we chose 4 videos from which excerpts were verbatim transcribed and translated from Danish into English. Results: The patients describe unique combinations of various psychopathological phenomena such as diminished sense of embodied self-presence, loss of ego boundaries, diminished sense of self, alienation and objectification of the experiential processes, mirror-phenomena, and Schneiderian passivity phenomena. Discussion: Through an interweaving of the four vignettes and their subsequent psychopathological discussions, we argue that the invariant commonality across the different symptomatic expressions in these patients resides in a Gestalt of pervasive disturbance of self-experience. From a phenomenological perspective, these self-disturbances target a basic structure of phenomenal consciousness, namely, the first-person givenness of experience. We conclude that self-disorders reflect a trait-instability in the most basic structures of consciousness in SCZ and that its clinical manifestations are to be seen as aspects of a particular Gestalt rather than appearing as separate and well-delineated symptoms.

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“…Third, the severity of these symptoms correlates with the level of social functioning ( Haug et al, 2014 ) and with suicidality ( Skodlar and Parnas, 2010 ; Haug et al, 2012b ). Finally, the different facets of delusions of influence build a stable network structure over time ( Raballo and Preti, 2018 ). The symptoms of delusions of influence show high persistence rates over 5 years of duration of illness ( Nordgaard et al, 2017 , 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Induced feelings of external influence during instructed imaginations in healthy subjects

et al. 2022

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The psychopathological phenomenon of delusions of influence comprises variable disturbances of the self-environment-border leading to the feeling of external influence on thoughts, feelings, impulses or behaviors. Delusions of influence are a hallmark in psychotic illness, but nevertheless, attenuated forms can also appear in healthy individuals. Here we present a newly developed paradigm to induce and assess feelings of external influence during instructed imaginations in healthy individuals. In the current study, we asked 60 healthy individuals to visually imagine different objects. To induce feelings of external influence, we applied one of three different physical setups (low-amplitude transcranial direct current stimulation, eye contact, or skin-to-skin hand touch), and informed the participants whether or not an external influence was attempted during the respective trial. The physical setup (setup vs. no setup, Z = −3.847, p < 0.001, r = 0.497) as well as the information given to the participants (confirmation vs. negation, Z = −5.218, p < 0.001, r = 0.674) alone were able to modulate the feeling of external influence in all three interventions. The impact of information (whether influence was attempted or not attempted) significantly exceeded the impact of the physical setup on the ratings of experienced external influence (Z = −2.394, p = 0.016, r = 0.310). Moreover, the response latency correlated with the estimated feeling of external influence (rS = 0.392, p = 0.002). Additional analyses addressed the influence of the emotional content of imagined objects and examined the intensity and emotional valence of the imaginations. Further supplemental analyses correlated external influence estimation of the participants with other psychopathological measures (trait markers for supernatural beliefs, proneness to hallucinations, and delusions and attributional style). In conclusion, this study endorses a quantitative model of psychopathological characteristics, in this case feelings of external influence that can be induced by external cues.

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The Self in the Spectrum: A Closer Look at the Temporal Stability of Self-Disorders in Schizophrenia

Cited by 9 publications

References 21 publications

Anomalies of Imagination, Self-Disorders, and Schizophrenia Spectrum Psychopathology: A Network Analysis

Anomalies of Imagination, Self-Disorders, and Schizophrenia Spectrum Psychopathology: A Network Analysis

Disorder of Selfhood in Schizophrenia: A Symptom or a Gestalt?

Induced feelings of external influence during instructed imaginations in healthy subjects

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