Psychotic disorders may arise from an abnormal deviation in the normal developmental process of forming a personal identity and worldview during late adolescence and early adulthood. Drawing on Erikson's theory, the authors argue that the typical drive to develop a meaningful sense of identity can be accelerated by aberrant salience, leading to delusion formation. This model places psychosis onset within the broader context of normal development, offering a humanistic approach to understanding new-onset psychotic disorders.
Adolescence and early adulthood involve developing cognitive and social skills for adult roles, including forging a meaningful sense of identity. This period overlaps with the typical age of onset for schizophrenia and other psychotic illnesses. The authors argue that connections between identity formation and psychosis have been underexplored in biological psychiatry, partly due to challenges in measuring personal and moral identity. They propose a conceptual framework linking normative developmental processes, moral emotions, and the phenomenology of hallucinations in schizophrenia, aiming to inspire novel research approaches.