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Cowan HR, McAdams DP, Ouellet L, Jones CM, Mittal VA. Self-concept and Narrative Identity in Youth at Clinical High Risk for Psychosis. Schizophr Bull 2024; 50:848-859. [PMID: 37816626 PMCID: PMC11283199 DOI: 10.1093/schbul/sbad142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/12/2023]
Abstract
BACKGROUND AND HYPOTHESIS Disturbances of the narrative self and personal identity accompany the onset of psychotic disorders in late adolescence and early adulthood (a formative developmental stage for self-concept and personal narratives). However, these issues have primarily been studied retrospectively after illness onset, limiting any inferences about their developmental course. STUDY DESIGN Youth at clinical high risk for psychosis (CHR) (n = 49) and matched healthy comparison youth (n = 52) completed a life story interview (including self-defining memory, turning point, life challenge, and psychotic-like experience) and questionnaires assessing self-esteem, self-beliefs, self-concept clarity, and ruminative/reflective self-focus. Trained raters coded interviews for narrative identity themes of emotional tone, agency, temporal coherence, context coherence, self-event connections, and meaning-making (intraclass correlations >0.75). Statistical analyses tested group differences and relationships between self-concept, narrative identity, symptoms, and functioning. STUDY RESULTS CHR participants reported more negative self-esteem and self-beliefs, poorer self-concept clarity, and more ruminative self-focus, all of which related to negative symptoms. CHR participants narrated their life stories with themes of negative emotion and passivity (ie, lack of personal agency), which related to positive and negative symptoms. Reflective self-focus and autobiographical reasoning were unaffected and correlated. Autobiographical reasoning was uniquely associated with preserved role functioning. CONCLUSIONS This group of youth at CHR exhibited some, but not all, changes to self-concept and narrative identity seen in psychotic disorders. A core theme of negativity, uncertainty, and passivity ran through their semantic and narrative self-representations. Preserved self-reflection and autobiographical reasoning suggest sources of resilience and potential footholds for cognitive-behavioral and metacognitive interventions.
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Affiliation(s)
- Henry R Cowan
- Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH, USA
| | - Dan P McAdams
- Psychology, Northwestern University, Evanston, IL, USA
| | - Leah Ouellet
- Human Development and Social Policy, Northwestern University, Evanston, IL, USA
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2
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Lev Arey D, Sagi A, Blatt A. The relationship between exercise addiction, eating disorders, and insecure attachment styles among recreational exercisers. J Eat Disord 2023; 11:131. [PMID: 37550767 PMCID: PMC10408237 DOI: 10.1186/s40337-023-00855-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/01/2023] [Indexed: 08/09/2023] Open
Abstract
BACKGROUND Exercise addiction (EA) and eating disorders (ED) frequently co-occur in both professional and amateur athletes, with up to 48% of individuals with EA also exhibiting symptoms of ED. Furthermore, pathological attachment styles have been linked to both EA and ED. The current study aimed to explore the unique association between types of insecure attachment styles (i.e., anxiety or avoidance) and EA and ED. METHOD Four hundred and five Israelis (199 women, 206 men) who were recreational exercisers (i.e., exercised at least four hours a week for at least one year) with ages ranging from 18 to 78 (M = 38, SD = 12.31) completed a set of questionnaires, including the Eating Attitudes Test (EAT-26), Exercise Addiction Inventory, and the Experiences in Close Relationship Scale. Path analysis was used to simultaneously examine the associations of attachment anxiety and avoidance with EA and ED symptoms. Attachment anxiety and avoidance were specified as independent variables predicting ED and EA symptoms and were entered into the analysis as two parallel dependent variables. RESULTS The results of the study indicate that attachment anxiety is positively associated with symptoms of EDs, while the association between attachment anxiety and symptoms of EA is not significant. On the other hand, attachment avoidance shows a positive association with symptoms of exercise addiction, but no significant association with symptoms of EDs is found. CONCLUSIONS These results imply that the anxious attachment regulation strategy is highly associated with body image concerns. Furthermore, individuals characterized by avoidance attachment manifest regulation strategies through excessive exercise. Scholars and practitioners could use these results to examine dispositional risk factors for insecure attachment styles and to assess specific pathologies among the population of recreational exercisers. The study also discusses limitations, future directions, and implications in detail.
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Affiliation(s)
- Dalit Lev Arey
- School of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel.
| | - Adi Sagi
- School of Psychology, The Academic College of Tel Aviv-Yaffo, Tel Aviv, Israel
| | - Asaf Blatt
- School of Behavioral Sciences, College of Management Academic Studies, Rishon LeZion, Israel
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3
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Abstract
It is important for mental health to be able to control unwanted intrusive memories. Previous studies suggest that middle frontal gyrus (MFG) down regulates pathways underlie the suppression of retrieval of general memories. However, the neural basis of motivated forgetting of autobiographical memories is unclear. Therefore, this study used two samples to explore the neural mechanisms of motivated forgetting of self-referential memories. Every participant provided 40 life events (20 negative and 20 neutral) from their past personal experience, and then completed the Think/No-Think task while undergoing functional magnetic resonance imaging (fMRI). The first sample showed a significant reduction in recall in the No-Think condition relative to the Think condition. Attempting to exclude negative autobiographical memories from awareness was associated with increased activity in the right MFG, superior frontal gyrus (SFG), and inferior frontal gyrus (IFG), while reduced activity was observed in the bilateral Brodmann areas BA18 and BA19, bilateral medial prefrontal cortex (mPFC), bilateral precuneus, bilateral post cingulate cortex (PCC), the left parahippocampus, and the left hippocampus. Functional connectivity analyses showed that the right MFG projected into the bilateral mPFC, bilateral precuneus, and bilateral middle occipital gyrus (MOG) for negative autobiographical memories. The second sample replicated the results of the first sample at both the behavioral and brain levels. These results suggest that retrieval suppression of autobiographical memories involve the pathway between the MFG and the mPFC and precuneus to exclude self-referential memories. These results reveal how people engage in motivated forgetting of negative events in their daily lives.
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Affiliation(s)
- FengYing Lu
- Faculty of Psychology, Southwest University, Chongqing, China.,School of Education Science, Nanning Normal University, Nanning, Guangxi, China
| | - WenJing Yang
- Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiang Qiu
- Faculty of Psychology, Southwest University, Chongqing, China.,Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing, China
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Cowan HR, Mittal VA, McAdams DP. Narrative identity in the psychosis spectrum: A systematic review and developmental model. Clin Psychol Rev 2021; 88:102067. [PMID: 34274799 DOI: 10.1016/j.cpr.2021.102067] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 05/31/2021] [Accepted: 07/06/2021] [Indexed: 01/19/2023]
Abstract
Individuals with schizophrenia-spectrum disorders face profound challenges as they attempt to maintain identity through the course of illness. Narrative identity-the study of internalized, evolving life stories-provides a rich theoretical and empirical perspective on these challenges. Based on evidence from a systematic review of narrative identity in the psychosis spectrum (30 studies, combined N = 3859), we argue that the narrative identities of individuals with schizophrenia-spectrum disorders are distinguished by three features: disjointed structure, a focus on suffering, and detached narration. Psychotic disorders typically begin to emerge during adolescence and emerging adulthood, which are formative developmental stages for narrative identity, so it is particularly informative to understand identity disturbances from a developmental perspective. We propose a developmental model in which a focus on suffering emerges in childhood; disjointed structure emerges in middle and late adolescence; and detached narration emerges before or around the time of a first psychotic episode. Further research with imminent risk and early course psychosis populations would be needed to test these predictions. The disrupted life stories of individuals on the psychosis spectrum provide multiple rich avenues for further research to understand narrative self-disturbances.
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Affiliation(s)
| | - Vijay A Mittal
- Psychology, Psychiatry, Medical and Social Sciences, Institute for Policy Research, Northwestern University, United States
| | - Dan P McAdams
- Psychology, School of Education and Social Policy, Northwestern University, United States
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Kállai J, Vincze G, Török IA, Hargitai R, Rózsa S, Hartung I, Tamás I, Láng A, Herold R. Cognitive Gain or Handicap: Magical Ideation and Self-Absorption in Clinical and Non-clinical Participants. Front Psychol 2021; 12:613074. [PMID: 33716876 PMCID: PMC7952430 DOI: 10.3389/fpsyg.2021.613074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 01/18/2021] [Indexed: 11/22/2022] Open
Abstract
Background: This study aimed to examine magical ideation and absorption traits across non-clinical and clinical groups to determine their potential adaptive and maladaptive functions. Method: We enrolled 760 healthy participants from neighboring communities (female = 53.2%). Moreover, we recruited 318 patients (female = 66.5%), which included 25, 183, and 110 patients with schizophrenia spectrum disorders, anxiety disorders, and mood disorders, respectively. Potentially adaptive and maladaptive sociocognitive functions were measured to determine the role of magical ideation and self-absorption in patients with psychiatric disorders. Results: The degree of magical ideation and absorption gradually increased in the following order: anxiety disorders, mood disorders, and schizophrenia spectrum disorders. Furthermore, enhanced self-absorption-related enhanced consciousness traits were essential indicators of the presence of self-integration weakness in patients with schizophrenia spectrum disorders. Conclusion: Magical ideation and psychological absorption may be considered as mental model construction functions, which result in both gains and handicaps in social adaptation.
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Affiliation(s)
- János Kállai
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Vincze
- Pándy Kálmán Division, Department of Psychiatry, Békés Country Hospital Center, Gyula, Hungary
| | - Imre András Török
- Pándy Kálmán Division, Department of Psychiatry, Békés Country Hospital Center, Gyula, Hungary
| | - Rita Hargitai
- Institute of Psychology, Pázmány Péter Catholic University, Budapest, Hungary
| | - Sándor Rózsa
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO, United States
| | - István Hartung
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - István Tamás
- Department of Behavioural Sciences, Medical School, University of Pécs, Pécs, Hungary
| | - András Láng
- Institute of Psychology, Faculty of Humanities, University of Pécs, Pécs, Hungary
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, University of Pécs, Pécs, Hungary
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Kwok SC, Xu X, Duan W, Wang X, Tang Y, Allé MC, Berna F. Autobiographical and episodic memory deficits in schizophrenia: A narrative review and proposed agenda for research. Clin Psychol Rev 2021; 83:101956. [DOI: 10.1016/j.cpr.2020.101956] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 10/04/2020] [Accepted: 12/07/2020] [Indexed: 02/06/2023]
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Edwards CJ, Garety PA, Hardy A. Remembering the past to live better in the future: A feasibility randomised controlled trial of memory specificity training for motivation in psychosis. J Behav Ther Exp Psychiatry 2020; 68:101564. [PMID: 32143065 DOI: 10.1016/j.jbtep.2020.101564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 02/17/2020] [Accepted: 02/18/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND OBJECTIVES People with a diagnosis of psychosis often experience low motivation and reduced activity levels. Autobiographical memory deficits have been identified in people with psychosis and this may limit the role of memory retrieval in supporting motivation. This pilot study adapted a recently developed protocol, Memflex, which aims to enhance autobiographical memory and has shown promise in depression. Our brief intervention targets experiential negative symptoms of psychosis using supported autobiographical memory retrieval. METHOD A sample of 31 participants with psychosis were recruited from inpatient and community settings and randomised in a 2:1 ratio to either a basic recall control or an enhanced recall intervention group. Participants were asked to generate positive autobiographical memories linked to activities they wish to repeat in the future. The enhanced recall condition received additional prompts from the Memflex protocol, and the basic recall condition received no additional support. RESULTS The intervention delivered was acceptable (rated >80%) and feasible (94% adherence) to those who took part. Participants were able to generate positive autobiographical memories linked to their goals and experienced appropriate emotions linked to these. The controlled preliminary effect sizes (0.2-0.34) showed encouraging signals for self-efficacy, motivation and a reduction in negative mood. LIMITATIONS As this was a pilot study with a small sample size between-group tests of statistical significance were not conducted, and therefore findings should be interpreted with caution. CONCLUSIONS These findings suggest that guided autobiographical memory retrieval may be an effective way tool for targeting motivation in people with psychosis.
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Affiliation(s)
- C J Edwards
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - P A Garety
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - A Hardy
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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8
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Chen GF, Luo HY, Wu G, Zhou C, Wang K, Feng K, Xiao ZW, Huang JJ, Gan JC, Zhao P, Liu PZ, Wang Y. Improving Mental Time Travel in Schizophrenia: Do Remembering the Past and Imagining the Future Make a Difference? COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10083-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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9
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Fan F, Tan Y, Wang Z, Yang F, Fan H, Xiang H, Guo H, Hong LE, Tan S, Zuo XN. Functional fractionation of default mode network in first episode schizophrenia. Schizophr Res 2019; 210:115-121. [PMID: 31296414 DOI: 10.1016/j.schres.2019.05.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/15/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022]
Abstract
A disruption in the connectivity between brain regions may underlie the core pathology in schizophrenia. One of the most consistent observations in human functional imaging is a network of brain regions referred to as the default network (DMN) that contains core subsystem, the dorsomedial prefrontal cortex (dMPFC) subsystem and the medial temporal lobe (MTL) subsystem, with differential contributions. The goal of this study was to examine abnormalities of different DMN subsystems in first episode schizophrenia and associations between these abnormalities and individual psychopathology. We recruited 203 patients and 131 healthy controls. A seed-based resting-state functional connectivity (RSFC) analysis on the 2D surface was conducted. Individual DMN functional connectivity matrices were then obtained by calculating spatial correlations between pairs of RSFC maps, characterizing the functional fractionation of the DMN. Patients showed patterns similar to controls but markedly reduced strength of DMN fractionation, with the degree centrality of the MTL subsystem significantly reduced, including the posterior inferior parietal lobule (pIPL), parahippocampal cortex (PHC) and lateral temporal cortex (LTC). Patients also exhibited hypo-connectivity within the MTL subsystem and between the MTL and dMPFC subsystems. Clinical symptoms were negatively correlated with degree centrality of LTC, pIPL and PHC in patients. Hyper-fractionation of different DMN components implied that communication and coordination throughout the dissociated components of the DMN are functionally over-segregated in schizophrenia. The associations between the hyper-fractionation with clinical symptoms suggest a role of the high fractionation in the DMN in the abnormal neuropathology observed in schizophrenia.
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Affiliation(s)
- Fengmei Fan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China; State Key Laboratory of Cognitive Neuroscience and Learning & International Data Group/McGovern Institute for Brain Research, Center for Collaboration and Innovation in Brain and Learning Sciences, Beijing Normal University, Beijing 100875, China
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Fude Yang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Hongzhen Fan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China
| | - Hong Xiang
- Chongqing Three Gorges Central Hospital, Chongqing 404000, China
| | - Hua Guo
- Zhumadian Psychiatry Hospital, Henan Province, China
| | - L Elliot Hong
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, USA
| | - Shuping Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing 100096, China.
| | - Xi-Nian Zuo
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China; Magnetic Resonance Imaging Research Center, Institute of Psychology, Beijing, China; Research Center for Lifespan Development of Mind and Brain, Institute of Psychology, Beijing, China; Lifespan Connectomics and Behavior Team, Institute of Psychology, Beijing, China; Key Laboratory for Brain and Education Sciences, Guangxi Teachers Education University, Nanning, Guangxi, China; Center for Longevity Research, Guangxi Teachers Education University, Nanning, Guangxi, China.
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10
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Hazan H, Reese EJ, Linscott RJ. Narrative self and high risk for schizophrenia: remembering the past and imagining the future. Memory 2019; 27:1214-1223. [DOI: 10.1080/09658211.2019.1642919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Hadar Hazan
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Elaine J. Reese
- Department of Psychology, University of Otago, Dunedin, New Zealand
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11
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Allé MC, Berna F, Berntsen D. Individuals with psychotic-like experiences exhibit enhanced involuntary autobiographical memories. Psychiatry Res 2019; 273:281-287. [PMID: 30677715 DOI: 10.1016/j.psychres.2019.01.050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 12/21/2018] [Accepted: 01/12/2019] [Indexed: 10/27/2022]
Abstract
The relationship between hallucinations and stressful life events in psychosis is recognised, and has recently been supported by findings showing that the frequency of involuntary autobiographical memory and future projection predicts hallucination-proneness in the general population. To better understand the nature of this relationship, an online survey was conducted in 44 individuals with high Psychotic Like Experiences (PLE) and 44 matched controls, assessing the quantitative, qualitative and content characteristics of their involuntary autobiographical memories and future thoughts. Individuals with high PLE displayed a higher frequency of both involuntary autobiographical memory and future thought compared to controls. Moreover, the associated emotional intensity, feeling of reliving and intrusiveness were increased. Contrary to controls' memories, involuntary memories of individuals with high PLE more frequently referred to traumatic events and were associated with negative mood impact at retrieval. Taken together, these results can be seen as consistent with a relationship between involuntary memory and hallucination, by suggesting phenomenological and content related similarities between the two processes.
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Affiliation(s)
- Mélissa C Allé
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Bartholins Allé 11, Aarhus University, Aarhus C 8000, Denmark.
| | - Fabrice Berna
- Inserm U1114, Strasbourg University, University Hospital of Strasbourg, France
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Department of Psychology and Behavioural Sciences, Bartholins Allé 11, Aarhus University, Aarhus C 8000, Denmark
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12
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Kállai J, Rózsa S, Hupuczi E, Hargitai R, Birkás B, Hartung I, Martin L, Herold R, Simon M. Cognitive fusion and affective isolation: Blurred self-concept and empathy deficits in schizotypy. Psychiatry Res 2019; 271:178-186. [PMID: 30481696 DOI: 10.1016/j.psychres.2018.11.045] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/30/2018] [Accepted: 11/18/2018] [Indexed: 01/23/2023]
Abstract
This is a cross-sectional nonclinical sample study to examine the different levels of the Ipsiety Disturbance Model (IDM) for schizophrenia spectrum disorders (introduced by Sass and Parnas, 2003). Three faces of schizotypy were studied: diminished self-presence, hyper-reflexivity, and distortion in experience of own self and another person's self-discrimination. A sample of college students (N = 1312) was provided a questionnaire packet that contained the Schizotypy Personality Questionnaire Brief-Revisited (SPQ-BR), the Self-Concept Clarity Sale, the Tellegen Absorption Scale, and Interpersonal Reactivity Index measures. Results: higher absorption capabilities predict higher scores on both the SPQ-BR cognitive and SPQ-BR disorganization factors. High scores in cognitive empathy predicted a low score on both SPQ-BR cognitive and SPQ-BR interpersonal scores. In contrast, higher affective empathy predicted high scores on the SPQ-BR interpersonal factor. The deficiency in self-concept clarity predicted an elevated score on the SPQ-BR cognitive, interpersonal, and disorganization schizotypy symptoms. We argue that a lack of self-concept clarity manifested in both the hyperreflexivity level (measured by absorption) and the metallization level (measured by empathy). We argue that the IDM is a reliable way to interpret functioning with different levels of schizotypy.
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Affiliation(s)
- János Kállai
- Institute of Behavioral Sciences, Medical School, University of Pécs, Szigeti út 12, Pécs 7625, Hungary.
| | - Sándor Rózsa
- Department of Psychiatry, Washington University School of Medicine, St. Louis, USA
| | - Ernő Hupuczi
- Institute of Behavioral Sciences, Medical School, University of Pécs, Szigeti út 12, Pécs 7625, Hungary.
| | - Rita Hargitai
- Department of Personality and Clinical Psychology, Pázmány Péter Catholic University, Budapest, Hungary.
| | - Béla Birkás
- Institute of Behavioral Sciences, Medical School, University of Pécs, Szigeti út 12, Pécs 7625, Hungary.
| | - István Hartung
- Institute of Behavioral Sciences, Medical School, University of Pécs, Szigeti út 12, Pécs 7625, Hungary.
| | - László Martin
- Department of Pedagogy and Psychology, Kaposvári University, Kaposvár, Hungary.
| | - Róbert Herold
- Department of Psychiatry and Psychotherapy, Medical School, Universi of Pécs, Pécs, Hungary.
| | - Mária Simon
- Department of Psychiatry and Psychotherapy, Medical School, Universi of Pécs, Pécs, Hungary.
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13
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Gallagher S, Daly A. Dynamical Relations in the Self-Pattern. Front Psychol 2018; 9:664. [PMID: 29867642 PMCID: PMC5958307 DOI: 10.3389/fpsyg.2018.00664] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/17/2018] [Indexed: 02/02/2023] Open
Abstract
The notion of a self-pattern, as developed in the pattern theory of self (Gallagher, 2013), which holds that the self is best explained in terms of the kind of reality that pertains to a dynamical pattern, acknowledges the importance of neural dynamics, but also expands the account of self to extra-neural (embodied and enactive) dynamics. The pattern theory of self, however, has been criticized for failing to explicate the dynamical relations among elements of the self-pattern (e.g., Kyselo, 2014; Beni, 2016; de Haan et al., 2017); as such, it seems to be nothing more than a mere list of elements. We'll argue that the dynamics of a self-pattern are reflected in three significant and interrelated ways that allow for investigation. First, a self-pattern is reflectively reiterated in its narrative component. Second, studies of psychiatric or neurological disorders can help us understand the precise nature of the dynamical relations in a self-pattern, and how they can fail. Third, referencing predictive processing accounts, neuroscience can also help to explicate the dynamical relations that constitute the self-pattern.
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Affiliation(s)
- Shaun Gallagher
- Department of Philosophy, University of Memphis, Memphis, TN, United States
- Philosophy, Faculty of Law, Humanities and the Arts, University of Wollongong, Wollongong, NSW, Australia
| | - Anya Daly
- School of Philosophy, University College Dublin, Dublin, Ireland
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14
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Core beliefs in healthy youth and youth at ultra high-risk for psychosis: Dimensionality and links to depression, anxiety, and attenuated psychotic symptoms. Dev Psychopathol 2018; 31:379-392. [PMID: 29506584 DOI: 10.1017/s0954579417001912] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cognitive theory posits that core beliefs play an active role in developing and maintaining symptoms of depression, anxiety, and psychosis. This study sought to comprehensively examine core beliefs, their dimensionality, and their relationships to depression, anxiety, and attenuated psychotic symptoms in two groups of community youth: a group at ultrahigh risk for psychosis (UHR; n = 73, M age = 18.7) and a matched healthy comparison group (HC; n = 73, M age = 18.1). UHR youth reported significantly more negative beliefs about self and others, and significantly less positive beliefs about self and others. HC youth rarely endorsed negative self-beliefs. Exploratory factor analyses found that HC negative self-beliefs did not cohere as a single factor. We hypothesized specific links between core beliefs and symptoms based on cognitive models of each disorder, and tested these links through regression analyses. The results in the HC group were consistent with the proposed models of depression and anxiety. The results in the UHR group were consistent with proposed models of depression and negative psychotic symptoms, somewhat consistent with a proposed model of positive psychotic symptoms, and not at all consistent with a proposed model of anxiety. These findings add to a growing developmental literature on core beliefs and psychopathology, with important clinical implications.
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15
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Berna F, Göritz AS, Schröder J, Coutelle R, Danion JM, Cuervo-Lombard CV, Moritz S. Self-Disorders in Individuals with Autistic Traits: Contribution of Reduced Autobiographical Reasoning Capacities. J Autism Dev Disord 2017; 46:2587-2598. [PMID: 27101235 DOI: 10.1007/s10803-016-2797-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present web-based study (N = 840) aimed to illuminate the cognitive mechanisms underlying self-disorders in autism. Initially, participants selected three self-defining memories. Then, we assessed their capacity to give meaning to these events (i.e., meaning making), their tendency to scrutinize autobiographical memory to better understand themselves (i.e., self-continuity function of autobiographical memory) and their clarity of self-concept. The results showed that individuals with high autistic traits (ATs) had a lower clarity of self-concept than control participants. Meaning making was also reduced in AT individuals and mediated the relation between AT and self-concept clarity. Our results suggest that the reduced clarity of self-concept in AT individuals is related to an impaired capacity to make meaning of important past life events.
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Affiliation(s)
- Fabrice Berna
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Anja S Göritz
- Department of Occupational and Consumer Psychology, Freiburg University, Freiburg, Germany
| | - Johanna Schröder
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Romain Coutelle
- INSERM U-1114, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.,Fondation FondaMental, Créteil, France
| | - Jean-Marie Danion
- INSERM U-1114, Hôpitaux Universitaires de Strasbourg, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, Strasbourg, France.,Fondation FondaMental, Créteil, France
| | - Christine V Cuervo-Lombard
- Département de Psychiatrie, Centre Hospitalier Universitaire de Reims, Reims, France.,UFR de Psychologie, Université de Toulouse 2 Jean Jaurès, Toulouse, France
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Giersch A, Mishara AL. Is Schizophrenia a Disorder of Consciousness? Experimental and Phenomenological Support for Anomalous Unconscious Processing. Front Psychol 2017; 8:1659. [PMID: 29033868 PMCID: PMC5625017 DOI: 10.3389/fpsyg.2017.01659] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 09/08/2017] [Indexed: 12/27/2022] Open
Abstract
Decades ago, several authors have proposed that disorders in automatic processing lead to intrusive symptoms or abnormal contents in the consciousness of people with schizophrenia. However, since then, studies have mainly highlighted difficulties in patients' conscious experiencing and processing but rarely explored how unconscious and conscious mechanisms may interact in producing this experience. We report three lines of research, focusing on the processing of spatial frequencies, unpleasant information, and time-event structure that suggest that impairments occur at both the unconscious and conscious level. We argue that focusing on unconscious, physiological and automatic processing of information in patients, while contrasting that processing with conscious processing, is a first required step before understanding how distortions or other impairments emerge at the conscious level. We then indicate that the phenomenological tradition of psychiatry supports a similar claim and provides a theoretical framework helping to understand the relationship between the impairments and clinical symptoms. We base our argument on the presence of disorders in the minimal self in patients with schizophrenia. The minimal self is tacit and non-verbal and refers to the sense of bodily presence. We argue this sense is shaped by unconscious processes, whose alteration may thus affect the feeling of being a unique individual. This justifies a focus on unconscious mechanisms and a distinction from those associated with consciousness.
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Affiliation(s)
- Anne Giersch
- INSERM U1114, Pôle de Psychiatrie, Fédération de Médecine Translationnelle de Strasbourg, Centre Hospitalier Régional Universitaire of Strasbourg, Université de Strasbourg, Strasbourg, France
| | - Aaron L. Mishara
- Department of Clinical Psychology, The Chicago School of Professional Psychology, Los Angeles, CA, United States
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17
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Berna F, Evrard R, Coutelle R, Kobayashi H, Laprévote V, Danion JM. Characteristics of memories of delusion-like experiences within the psychosis continuum: Pilot studies providing new insight on the relationship between self and delusions. J Behav Ther Exp Psychiatry 2017; 56:33-41. [PMID: 27421875 DOI: 10.1016/j.jbtep.2016.07.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 06/26/2016] [Accepted: 07/02/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Delusions are usually anchored in past events associated with abnormal experiences or delusional interpretations of personal events. The characteristics of the memory of these experiences may contribute to maintain delusional beliefs by providing confirmatory evidence for the delusions. However, these aspects have not been investigated properly. METHOD Seventeen patients with schizophrenia were examined in study 1 during a face-to-face interview. The second study used a web-based design and included 83 participants without a psychotic disorder. Participants were asked to rate the vividness, emotional intensity and valence, and the centrality to the self of memories of delusion-like experiences (that were cued by means of the Peters et al. Delusional Inventory, PDI; Peters, Joseph, Day, & Garety, 2004) and positive and negative memories used as comparators. RESULTS In both studies, the memories of delusion-like experiences were less vivid, less emotionally intense than positive (but not negative) memories and emotionally neutral. Their centrality to the self did not differ from that of positive and negative memories. Moreover, the severity of delusions in study 1 and delusion-proneness in study 2 were significantly correlated with vividness, emotional intensity, and centrality of memories of delusion-like experiences. LIMITATIONS The accuracy of memories of delusion-like experiences could not be checked making it difficult to distinguish them from delusional memories. The sample size was small in study 1. CONCLUSIONS Our results point to reciprocal relationships between delusions, self, and autobiographical memories of delusion-like experiences that are similar within the psychosis continuum and that may be involved in the maintenance of delusions.
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Affiliation(s)
- Fabrice Berna
- Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, Strasbourg Cedex, France; INSERM U-1114, 1 Place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, Strasbourg, France; FMTS, Fédération de Médecine Translationnelle de Strasbourg, France.
| | - Renaud Evrard
- INTERPSY (EA 4432), Université de Lorraine, 23 Boulevard Albert 1er, Nancy, France
| | - Romain Coutelle
- Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, Strasbourg Cedex, France; INSERM U-1114, 1 Place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, Strasbourg, France; FMTS, Fédération de Médecine Translationnelle de Strasbourg, France
| | - Hiroshi Kobayashi
- Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, Strasbourg, France
| | - Vincent Laprévote
- PôleHospitalo-Universitaire de Psychiatrie du Grand Nancy, Centre Psychothérapique de Nancy, Laxou, F-54520, France; EA 7298, INGRES, Université de Lorraine, Vandoeuvre-lès-Nancy, F-54000, France; CHRU Nancy, Maison des Addictions, Nancy, F-54000, France
| | - Jean-Marie Danion
- Hôpitaux Universitaires de Strasbourg, 1 Place de l'Hôpital, Strasbourg Cedex, France; INSERM U-1114, 1 Place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Faculté de Médecine, 4 rue Kirchleger, Strasbourg, France; FMTS, Fédération de Médecine Translationnelle de Strasbourg, France
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The lonely road to paranoia. A path-analytic investigation of loneliness and paranoia. Compr Psychiatry 2017; 74:35-43. [PMID: 28092774 DOI: 10.1016/j.comppsych.2016.12.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 12/16/2016] [Accepted: 12/28/2016] [Indexed: 02/06/2023] Open
Abstract
Loneliness and paranoia are related, but the mechanisms that link them to each other remain unclear. Systematic reviews on loneliness propose a social-cognitive model in which loneliness leads to negative evaluations of other persons and a lack of interpersonal trust. However, the data discussed in these reviews are based on healthy individuals. Building on this model, the present study investigated 1) whether negative interpersonal schemata mediate the association between loneliness and paranoia and 2) whether a low level of perceived social support and less frequent social contact are related to loneliness. Using a cross-sectional design, sixty-five participants with a diagnosis of schizophrenia were recruited online and completed questionnaire-based measures of loneliness, paranoia, negative interpersonal schemata, perceived social support and frequency of social contact. Data were analyzed taking a path-analytic approach. The association between loneliness and paranoia was significantly and fully mediated by negative schemata of others. Moreover, a low level of perceived social support was significantly associated with loneliness, whereas self-reported frequency of social contact was not. The present results highlight the potential role of interpersonal negative schemata in the formation and maintenance of paranoia and elucidate the crucial role of loneliness in the way individuals construe themselves within a social environment.
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