Minimal self-disturbance—a fragility in the implicit sense of self, presence, and agency—is a core feature of schizophrenia spectrum disorders. In a test of a neurophenomenological model, source monitoring deficits explained 39.8% of the variance in minimal self-disturbance scores across 50 ultra-high risk patients, 39 first-episode psychosis patients, and 34 healthy controls. Aberrant salience explained only 6% of the variance and was more related to positive psychotic symptoms than to self-disturbance. The model may need to incorporate additional constructs like temporal processing and multisensory integration. Longitudinal analyses will follow.
Delusions in psychosis are best understood as highly individual and complex phenomena arising from a dynamic interplay of biological, personal, social, and cultural processes. A systematic review and qualitative synthesis of 24 studies representing 373 help-seeking individuals with psychosis identified three key themes: a radical shift in the lived world dominated by intense emotions; a process of doubting, losing, and rediscovering oneself within delusional realities; and a search for meaning, belonging, and coherence beyond mere dysfunction. The findings propose an Emergence Model of Delusion, suggesting that effective clinical care should account for the subjective experience and meaning of delusions, which may also address power imbalances and epistemic injustices in mental health.