The Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE) shows strong construct validity as a self-report measure of minimal self-disturbance. In a sample of 46 participants including ultra-high risk and first-episode psychosis patients and healthy controls, the IPASE correlated very strongly (r = 0.92) with the gold-standard interview measure (EASE). It also correlated strongly with general psychopathology and positive psychotic symptoms, moderately with negative symptoms, and weakly with manic symptoms. The IPASE may serve as a screener but cannot replace the in-depth assessment of minimal self-disturbance, which requires clinical expertise.
Basic self-disturbance is a potential core vulnerability marker for schizophrenia spectrum disorders. The Self, Neuroscience and Psychosis (SNAP) study tests a neurophenomenological model of psychosis by examining clinical, neurocognitive, and neurophysiological variables in individuals at ultra-high risk (UHR) for psychosis. It includes 400 UHR individuals, 100 clinical controls without attenuated psychotic symptoms, and 50 healthy controls. Participants complete baseline assessments and electroencephalography; UHR participants are followed for 24 months with clinical assessments every 6 months. The protocol aims to develop a prediction model for persistence or worsening of UHR symptoms at 12 months and to determine how specific these disturbances are to attenuated psychotic symptoms.
Among 43 individuals at ultra-high risk for psychosis, those who later remitted had lower baseline levels of basic self-disturbance than those whose symptoms persisted or who transitioned to psychosis. Basic self-disturbance scores predicted worse clinical outcomes at 12 months. Source monitoring deficits were greater in first-episode psychosis patients than in those at ultra-high risk whose symptoms persisted or transitioned. The findings suggest that high levels of basic self-disturbance may serve as a predictor of poor prognosis in ultra-high risk patients.
People with schizophrenia who hear voices experience inner speech—the silent, internal monologue—more frequently and with a different character than healthy individuals. Using repeated daily surveys on electronic devices, researchers found that voice-hearers reported more moments of inner speech and higher intensity of evaluative, other people's voices, condensed, and positive inner speech, though not dialogic inner speech. When voice-hearers experienced more intense dialogic, evaluative, other people's, or condensed inner speech, they also reported more severe auditory verbal hallucinations. Negative emotions strengthened the link between evaluative inner speech and hallucination severity. The findings suggest inner speech contributes to voice-hearing and that emotional state may be a target for therapy.