The neurophenomenology of early psychosis: An integrative empirical study |
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| Affiliation: | 1. Orygen, the National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, VIC 3052, Australia;2. Centre for Youth Mental Health, The University of Melbourne, 35 Poplar road, Parkville, VIC 3052, Australia;3. School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia;4. Orygen Youth Health, Melbourne Health, 35 Poplar Road, Parkville, VIC 3052, Australia;1. Early Psychosis Intervention Center, Region Zealand, University of Copenhagen, Denmark;2. Institute of Clincal Medicine, University of Copenhagen, Denmark;3. Mental Health Centre North Zealand, University of Copenhagen, Denmark;4. Institute of Preventive Medicine, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark;5. Clinic for Forensic Psychiatry, Copenhagen, Denmark;6. Mental Health Center Hvidovre, Copenhagen, University of Copenhagen, Denmark;7. Center for Subjectivity Research, University of Copenhagen, Denmark;1. II Department of Psychiatry, Medical University of Warsaw, Poland;2. Department of Psychiatry and Psychotherapy, University Medical Center Hamburg Eppendorf, Hamburg, Germany;3. Department of Psychology, University of Freiburg, Germany;1. Innlandet Hospital Trust, Division of Mental Health, Norway;2. Department of Psychology, University of Oslo, Norway;3. KG Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, Division of Mental Health and Addiction, University of Oslo, and Oslo University Hospital, Norway;4. Department of Mental Health and Pathological Addiction, AUSL di Reggio Emilia, Reggio Emilia, Italy;5. Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne;6. Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, Norway;1. Psychology Department, University of Haifa, Haifa, Israel;2. Psychiatry Division, Rambam Medical Center, Haifa, Israel;3. Psychological Medicine Clinic, Schneider Children''s Medical Center, Petach Tiqva, Israel;4. The Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Department of Psychiatry, Harvard Medical School, United States of America |
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| Abstract: | BackgroundThe integration of various domains or levels of analysis (clinical, neurobiological, genetic, etc.) has been a challenge in schizophrenia research. A promising approach is to use the core phenomenological features of the disorder as an organising principle for other levels of analysis. Minimal self-disturbance (fragility in implicit first-person perspective, presence and agency) is emerging as a strong candidate to play this role. This approach was adopted in a previously described theoretical neurophenomenological model that proposed that source monitoring deficits and aberrant salience may be neurocognitive/neurobiological processes that correlate with minimal self-disturbance on the phenomenological level, together playing an aetiological role in the onset of schizophrenia spectrum disorders. The current paper presents full cross-sectional data from the first empirical test of this model.MethodsFifty ultra-high risk for psychosis patients, 39 first episode psychosis patients and 34 healthy controls were assessed with a variety of clinical measures, including the Examination of Anomalous Self-Experience (EASE), and neurocognitive and neurophysiological (EEG) measures of source monitoring deficits and aberrant salience.ResultsLinear regression indicated that source monitoring (composite score across neurocognitive and neurophysiological measures), with study group as an interaction term, explained 39.8% of the variance in EASE scores (R2 = 0.41, F(3,85) = 14.78, p < 0.001), whereas aberrant salience (composite score) explained only 6% of the variance in EASE scores (R2 = 0.06, F(3,85) = 1.44, p = 0.93). Aberrant salience measures were more strongly related to general psychopathology measures, particularly to positive psychotic symptoms, than to EASE scores.DiscussionA neurophenomenological model of minimal self-disturbance in schizophrenia spectrum disorders may need to be expanded from source monitoring deficits to encompass other relevant constructs such as temporal processing, intermodal/multisensory integration, and hierarchical predictive processing. The cross-sectional data reported here will be expanded with longitudinal analysis in subsequent reports. These data and other related recent research show an emerging picture of neuro-features of core phenomenological aspects of schizophrenia spectrum disorders beyond surface-level psychotic symptoms. |
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| Keywords: | Psychosis Schizophrenia Prodrome Phenomenology Neurocognition Neurophysiology |
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