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Ballerini M, Rossi E, Cassioli E, Tarchi L, Marchesi C, Tonna M, Stanghellini G, Ricca V, Castellini G. Psychotic-like anomalous self-experiences in feeding and eating disorders: Their role in eating psychopathology through the mediation of body uneasiness and embodiment and identity disorders. Early Interv Psychiatry 2024. [PMID: 38613397 DOI: 10.1111/eip.13527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 02/19/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Psychotic-like anomalous self-experiences (ASEs) are core and early features of schizophrenia spectrum disorders, which have been recently also postulated to underlie embodiment disturbance in feeding and eating disorders (FEDs). The present study was aimed at investigating the interplay between ASEs and specific psychopathology in FED. METHODS Ninety persons with Anorexia Nervosa and 41 with Bulimia Nervosa were evaluated with the inventory of psychotic-like anomalous self-experiences (IPASE), identity and eating disorders (IDEA), body uneasiness test (BUT), and eating disorder examination questionnaire (EDE-Q). The same assessment was performed for 92 subjects recruited from the general population. Structural equation modelling was employed to test the role of embodiment/identity disorders in mediating the relationship between ASEs and ED psychopathology. RESULTS Patients with FED displayed high scores on IPASE, comparable with people with schizophrenia spectrum disorders. A significant correlation was also demonstrated between IPASE, BUT and EDE-Q. All IPASE domains were strongly related to feeling extraneous from one's own body by IDEA. All IPASE domains demonstrated a high relationship with BUT Depersonalization scale. A strong correlation was also reported between total scores of IPASE and IDEA. The mediation model confirmed that ASEs impact on FED symptomatology through the mediation of both embodiment/identity disorders and body image. DISCUSSION Anomalous interoceptive processes may represent the first step of a maladaptive process-impairing embodiment, selfhood, and identity in FED. Assessment of ASEs might be a valid tool to identify an early-shared vulnerability of severe disorders characterized by embodiment alterations.
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Affiliation(s)
| | - Eleonora Rossi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Emanuele Cassioli
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Livio Tarchi
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Carlo Marchesi
- Department of Mental Health, Local Health Service, Parma, Italy
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma Ospedale Maggiore, Parma, Italy
| | - Matteo Tonna
- Department of Mental Health, Local Health Service, Parma, Italy
- Department of Medicine and Surgery, Unit of Neuroscience, University of Parma Ospedale Maggiore, Parma, Italy
| | - Giovanni Stanghellini
- Department of Health Sciences, University of Florence, Florence, Italy
- Centro de Estudios de Fenomenologìa y Psiquiatrìa, 'Diego Portales' University, Santiago, Chile
| | - Valdo Ricca
- Department of Health Sciences, University of Florence, Florence, Italy
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Mohn-Haugen CR, Møller P, Mohn C, Larøi F, Teigset CM, Øie MG, Rund BR. Anomalous self-experiences and neurocognitive functioning in adolescents at risk for psychosis: Still no significant associations found between these two vulnerability markers. Compr Psychiatry 2023; 125:152400. [PMID: 37451231 DOI: 10.1016/j.comppsych.2023.152400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 07/04/2023] [Accepted: 07/04/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Anomalous self-experiences (ASEs) and neurocognitive impairments are considered essential domains of vulnerability for developing psychotic disorders. However, little research exists of possible associations between ASEs and neurocognitive functions in individuals at-risk for psychosis. The interconnections between ASEs and neurocognitive impairments should therefore be clarified as much as possible, especially in young individuals at risk. No previous studies have investigated these two fundamental domains in non-help-seeking adolescents at risk for developing psychosis. METHODS This study is based on the Norwegian Mother, Father and Child Cohort Study (MoBa). Adolescents (N = 48, 94% females, mean age = 15.3) were invited to participate after completing a 14-year-old survey distributed by MoBA. At-risk adolescents were selected based on the 0.4% highest scores on 19 items assessing both psychotic-like experiences and ASEs. Five specifically selected and formulated items measuring ASEs were computed to an ASEs total score. Neurocognitive functioning was assessed using the MATRICS Consensus Cognitive Battery. RESULTS Regression analyses revealed no significant relationships between ASEs and any neurocognitive domain. CONCLUSIONS We did not find any significant associations between ASEs and neurocognitive functions in non-help-seeking adolescents at risk for psychotic disorders, which is in line with reports from other types of cohorts. Thus, ASEs and neurocognitive functions may be understood as two relatively separate domains that co-exist in at-risk states. These results underline the need for a wider scope when making predictions about future trajectories, e.g. the development of psychotic disorders. Including both ASEs and neurocognitive functioning in at-risk populations may increase the specificity of vulnerability criteria in this population and enhance our understanding of early psychosis psychopathology.
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Affiliation(s)
- Caroline Ranem Mohn-Haugen
- Research Department, Vestre Viken Hospital Trust, 3004 Drammen, Norway; Department of Psychology, P. O. Box 1094 Blindern, University of Oslo, 0317, Oslo, Norway.
| | - Paul Møller
- Department of Mental Health Research and Development, Division of Mental Health and Addiction, Vestre Viken Hospital Trust, 3004 Drammen, Norway
| | - Christine Mohn
- Norment Centre, Institute of Clinical Medicine, University of Oslo, P. O. Box 4956 Nydalen, 0424 Oslo, Norway
| | - Frank Larøi
- Department of Psychology, P. O. Box 1094 Blindern, University of Oslo, 0317, Oslo, Norway; Psychology and Neuroscience of Cognition Research Unit, University of Liège, B-4000, Belgium
| | | | - Merete Glenne Øie
- Department of Psychology, P. O. Box 1094 Blindern, University of Oslo, 0317, Oslo, Norway
| | - Bjørn Rishovd Rund
- Research Department, Vestre Viken Hospital Trust, 3004 Drammen, Norway; Department of Psychology, P. O. Box 1094 Blindern, University of Oslo, 0317, Oslo, Norway
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Martin JC, Clark SR, Schubert KO. Towards a Neurophenomenological Understanding of Self-Disorder in Schizophrenia Spectrum Disorders: A Systematic Review and Synthesis of Anatomical, Physiological, and Neurocognitive Findings. Brain Sci 2023; 13:845. [PMID: 37371325 DOI: 10.3390/brainsci13060845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/18/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
The concept of anomalous self-experience, also termed Self-Disorder, has attracted both clinical and research interest, as empirical studies suggest such experiences specifically aggregate in and are a core feature of schizophrenia spectrum disorders. A comprehensive neurophenomenological understanding of Self-Disorder may improve diagnostic and therapeutic practice. This systematic review aims to evaluate anatomical, physiological, and neurocognitive correlates of Self-Disorder (SD), considered a core feature of Schizophrenia Spectrum Disorders (SSDs), towards developing a neurophenomenological understanding. A search of the PubMed database retrieved 285 articles, which were evaluated for inclusion using PRISMA guidelines. Non-experimental studies, studies with no validated measure of Self-Disorder, or those with no physiological variable were excluded. In total, 21 articles were included in the review. Findings may be interpreted in the context of triple-network theory and support a core dysfunction of signal integration within two anatomical components of the Salience Network (SN), the anterior insula and dorsal anterior cingulate cortex, which may mediate connectivity across both the Default Mode Network (DMN) and Fronto-Parietal Network (FPN). We propose a theoretical Triple-Network Model of Self-Disorder characterized by increased connectivity between the Salience Network (SN) and the DMN, increased connectivity between the SN and FPN, decreased connectivity between the DMN and FPN, and increased connectivity within both the DMN and FPN. We go on to describe translational opportunities for clinical practice and provide suggestions for future research.
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Affiliation(s)
- James C Martin
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Basil Hetzel Institute, Woodville, SA 5011, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Adelaide, SA 5000, Australia
- Division of Mental Health, Northern Adelaide Local Health Network, SA Health, Adelaide, SA 5000, Australia
- Headspace Early Psychosis, Sonder, Adelaide, SA 5000, Australia
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Haug E, Øie MG, Svendsen IH, Møller P, Nelson B, Melle I. A seven-year longitudinal study of the association between neurocognitive function and basic self-disorders in schizophrenia. Front Psychol 2023; 14:1124859. [PMID: 36923145 PMCID: PMC10008929 DOI: 10.3389/fpsyg.2023.1124859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/08/2023] [Indexed: 03/03/2023] Open
Abstract
Introduction Basic self-disorders (SDs) and neurocognitive impairments are fundamental trait-like aspects of schizophrenia spectrum disorders. There has been little research on the association between SDs and neurocognitive impairments in schizophrenia, and no longitudinal studies have investigated if they are related. The aim of this study was to investigate the association between SDs and neurocognitive function in a follow-up study of patients with schizophrenia. Methods SDs and neurocognition were examined in 35 patients with schizophrenia during their first treatment and 7 years later (mean 7.1, SD 0.42). SDs were examined with the Examination of Anomalous Self-Experience (EASE) instrument. The neurocognitive examination included assessments of psychomotor speed, executive- and memory functions. Results Poorer executive functions at baseline were significantly associated with more SDs 7 years later and smaller reductions in SDs over time. There were no significant associations between other neurocognitive functions and SDs. Discussion Executive functions are important for self-regulation, and impairments in these functions in everyday life may have an impact on the development and/or persistence of SDs.
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Affiliation(s)
- Elisabeth Haug
- Department of Acute Psychiatry and Psychosis Treatment, Innlandet Hospital Trust, Brumunddal, Norway
| | - Merete G Øie
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Ingrid H Svendsen
- Department of Acute Psychiatry and Psychosis Treatment, Innlandet Hospital Trust, Brumunddal, Norway
| | - Paul Møller
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Orygen, Parkville, VIC, Australia
| | - Ingrid Melle
- Norment Centre, University of Oslo, Oslo, Norway.,Norment Centre, Oslo University Hospital, Oslo, Norway
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