Poor insight is a core feature of schizophrenia and empirical studies have demonstrated associations with important symptom domains, cognitive functions, and clinical outcomes. While recent explanatory accounts mostly focus on neuro-, social-, or meta-cognitive deficits, a complementary model from phenomenological psychopathology suggests that impaired insight in schizophrenia is tied to...
Background: Research on basic self-disorders (BSD) has expanded since the introduction of the Examination of Anomalous Self-Experience (EASE). Although originally formulated as characterizing schizophrenia spectrum disorders, EASE-defined BSD have been reported in other psychiatric conditions and in individuals at clinical high-risk for psychosis (CHR-P), raising questions about their...
IntroductionWe previously proposed a neurophenomenological model of schizophrenia, linking basic self-disturbance with neural deficits of source monitoring and aberrant salience. Baseline comparisons in ultra-high risk (UHR) and first-episode psychosis (FEP) samples indicated a relationship between basic self-disturbance and source monitoring deficits, but not aberrant salience. The current...
This paper is a French translation of the Examination of Anomalous Fantasy and Imagination (EAFI), an instrument for a semi-structured, phenomenological exploration of psychopathology of imagination, particularly within the schizophrenia-spectrum. In this paper, we provide a French translation of the EAFI together with an introduction about the phenomenology of imagination and its experiential...
The psychopathology of schizophrenia is a complex amalgamation of features that span across different dimensions. These dimensions range from the experience of altered time and space through self-disorders to perceptual, positive, and negative symptoms. The relationship between these different psychopathological dimensions remains unclear. Addressing this gap was the aim of our study. We...
Self-disorders (SD) designate a pattern of non-psychotic anomalous self-experiences, which specifically aggregate in clinical and subclinical forms of schizophrenia spectrum disorders (SSD), including familial high-risk configurations. SD have been corroborated as a valuable, quantitatively tractable, trait phenotype for indexing genetic liability to SSD, and, as a risk phenotype, they offer...
Double bookkeeping is a term introduced by Eugen Bleuler to describe a fundamental feature of schizophrenia where psychotic reality can exist side by side with shared reality even when these realities seem mutually exclusive. Despite increasing theoretical interest in this phenomenon over the recent years, there are no empirical studies addressing this issue. We have, therefore, conducted a...
Schizophrenia continues its resistance to the pathogenetic understanding. We believe that one of the reasons is an oblivion of schizophrenia's characteristic Gestalt expressive of its psychopathological structure. In this article we argue for a crucial role of disorders of selfhood in the constitution of this Gestalt. First, we present a phenomenological account of the self. This is followed by...
This study presents phenomenological features of auditory verbal hallucinations (AVH) in schizophrenia and associated anomalies of experience. The purpose is to compare the lived experience of AVH to the official definition of hallucinations as a perception without object. Furthermore, we wish to explore the clinical and research implication of the phenomenological approach to AVH. Our...
In this paper, we wish to elucidate alterations of basic existential and intersubjective configurations in schizophrenia spectrum disorders (SSD) through the phenomenon of Anderssein ("feeling different"). Anderssein is an important yet neglected notion from German psychiatry, referring to a specific sense of feeling profoundly different from others occurring in SSD. Although...
AIM: Basic self disturbance is a putative core vulnerability marker of schizophrenia spectrum disorders. The primary aims of the Self, Neuroscience and Psychosis (SNAP) study are to: (1) empirically test a previously described neurophenomenological self-disturbance model of psychosis by examining the relationship between specific clinical, neurocognitive, and neurophysiological variables in UHR...
Obsessive-compulsive symptoms are frequent in schizophrenia-spectrum disorders and often cause differential diagnostic challenges, especially in first-contact patients. Drawing upon phenomenology of cognition, we critically review classic and contemporary psychopathological notions of obsessive-compulsive phenomena and discuss their relevance for differential diagnosis between...
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,...
Eugen Bleuler, the founder of the concept of schizophrenia, pointed out that psychotic patients were able to live in two disjoint worlds (namely, the social, intersubjective world and the delusional world). He termed this phenomenon "double bookkeeping," but did not provide any conceptual elaboration of this phenomenon or its possible mechanisms. Double bookkeeping has been neglected in...
Disordered selfhood in schizophrenia was rediscovered at the turn of the millennium. In 2005, Psychopathology published the psychometric instrument, the Examination of Anomalous Self-Experience (EASE). In this article, we summarize the historical background of the creation of the EASE, explicate the notion of the disorder of basic or minimal self with the help of phenomenological philosophy,...
Anomalies 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...
In contemporary consciousness studies, a central question concerns the nature of the most primitive and fundamental features of phenomenal consciousness. Some authors (e.g., Zahavi) have argued that for-me-ness (or minimal selfhood) is a fundamental and necessary feature of phenomenal consciousness. The concept of for-me-ness articulates that experiences are first-personally manifest, i.e. they...
Self-alienation is a common characterization of various disturbing experiences in patients with schizophrenia. A vivid example comes from patient reports of not recognizing themselves when inspecting their specular image in the mirror. By applying the multisensory paradigm of the Enfacement Illusion, this study empirically addresses the specular Self-Other discrimination in patients with...
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...
In contemporary consciousness research, we have defended a position of experiential minimalism, arguing that for-me-ness (or minimal selfhood) is a necessary, universal feature of phenomenal consciousness. The concept of for-me-ness refers to the fact that experiences are given first-personally to the subject of experience. To challenge the universality of for-me-ness, several authors have...
Aim: The goal of this pilot study was to assess the association between basic self-disturbance (SD) and deficits in neurocognitive and metacognitive functioning among help-seeking adolescents with and without attenuated psychosis syndrome (APS). Methods: Sixty-one non-psychotic, help-seeking adolescents (age 13-18) were assessed with the examination of anomalous self-experience, the structured...
We present a phenomenological account of auditory verbal hallucinations (AVH) in schizophrenia. We examine the mode of articulation of AVH, their spatial and temporal characteristics, and their relation to self-alienation, reflecting an emergence of otherness (alterity) in the midst of the patient’s self. This process of self-alienation is associated with the emergence of a different reality, a...
While investigating social cognitive impairments in schizophrenia, prominent evidence has been found that patients with schizophrenia show a tendency to misclassify neutral stimuli as negatively valenced. Within this population, patients presenting delusions are more prone to this phenomenon. In a previous study, Schizophrenia spectrum (SzSp) patients rated positive, negative and neutral...
Recent findings have provided preliminary support for the notion that basic self-disturbances (SD) are related to prodromal symptoms among nonpsychotic help-seeking adolescents. As a sizable proportion of adolescents who are at risk do not seek help, this study attempts to assess the extent to which these findings can be generalized to the entire population of adolescents who are at risk for...
Mysticism and schizophrenia are different categories of human existence and experience. Nonetheless, they exhibit important phenomenological affinities, which, however, remain largely unaddressed. In this study, we explore structural analogies between key features of mysticism and major clinical-phenomenological aspects of the schizophrenia spectrum disorders-i.e. attitudes, the nature of...