Contemporary researchers have tended to examine dysfunction among the lives of persons with schizophrenia as a matter of the impact of biological and social forces. While this has greatly advanced the knowledge base, any account of schizophrenia without a full consideration of the illness's first-person dimensions risks missing that schizophrenia is a disorder that interrupts the lives of...
Recent years have witnessed widespread interest in the early phase of schizophrenia and other psychotic disorders. Strategies have been introduced to attempt to identify individuals in the prepsychotic or prodromal phase. The most widely used of these approaches is the ultra-high risk (UHR) approach, which combines known trait and state risk factors for psychotic disorder. However, researchers...
An autobiographical account of the author's psychotic crisis blends his own insights with relevant extant research on schizophrenia. As an investigator in the fields of paranoia and schizophrenia research, who has himself been psychotic, this may help to link the narratives of professionals and patients. The episode is interpreted as having been precipitated by abuse of a person with...
Phenomenological research suggests that pure manic and depressive states are less common than mixtures of the two and that the two poles of mood are characterized by opposite ways of experiencing time. In mania, the subjective experience of time is sped up and in depression it is slowed down, perhaps reflecting differences in circadian pathophysiology. The two classic mood states are also quite...
This is an explorative study on the values of persons with schizophrenia based on transcripts of individual therapy sessions conducted for 40 persons with chart diagnoses of schizophrenia or schizotypal disorder. Values are action-guiding attitudes that subject human activities to be worthy of praise or blame. The schizophrenic value system conveys an overall crisis of common sense. The outcome...
This selective review combines cognitive models and biological models of psychosis into a tentative integrated neuropsychiatric model. The aim of the model is to understand better, how pharmacotherapy and cognitive-behavior therapy come forward as partners in the treatment of psychosis and play complementary and mutually reinforcing roles. The article reviews the dominant models in literature....
The study describes the Cardiff Anomalous Perceptions Scale (CAPS), a new validated measure of perceptual anomalies. The 32-item CAPS measure is a reliable, self-report scale, which uses neutral language, demonstrates high content validity, and includes subscales that measure distress, intrusiveness, and frequency of anomalous experience. The CAPS was completed by a general population sample of...
In recent years, there has been much focus on the apparent heterogeneity of schizophrenic symptoms. By contrast, this article proposes a unifying account emphasizing basic abnormalities of consciousness that underlie and also antecede a disparate assortment of signs and symptoms. Schizophrenia, we argue, is fundamentally a self-disorder or ipseity disturbance (ipse is Latin for "self" or...
The term source monitoring refers to a variety of cognitive processes individuals use to determine whether an experience originated within the self or came from an external source. A belief that auditory hallucinations are real entities independent of the self may be considered an error in source monitoring. The Source Monitoring Framework (SMF) is the most developed and empirically validated...
Clinical descriptions of perceptual and attentional anomalies in schizophrenia emphasize phenomena such as flooding, or inundation, by sensory stimuli. A failure of sensory "gating" mechanisms in the brain is hypothesized to account for these symptoms, and this hypothesis has led to a marked interest in their putative psychophysiological substrates. However, there are no systematic analyses of...
Computer simulations of parallel distributed processing (PDP) neural networks have increased our understanding of brain functioning. This article reviews how PDP concepts can contribute to our understanding of schizophrenic symptoms. Psychotic states induced by phencyclidine and the adult form of metachromatic leukodystrophy, as well as neurometabolic studies, suggest that schizophrenia...
Substance abuse among schizophrenic patients is an increasingly recognized clinical phenomenon. The authors review experimental and observed clinical effects of drug abuse and patients' subjective experiences of acute intoxication. Though drug abuse may exacerbate psychotic symptoms, abused drugs may also lead to transient symptom reduction in subgroups of schizophrenic patients. Some patients...
Schizophrenia is an I am illness--one that may overtake and redefine the identity of the person. This essay explores concepts of personhood and subjectivity from social science that are useful in understanding the experiencing subject in schizophrenia. Relationships between the self and sickness have not been investigated adequately with reference to their influence on prognosis. Chronicity is...
This report develops the notion that the mental health field often ignores or avoids many aspects of patients' reports about their experiences of schizophrenia and related disorders. When closer attention is paid to patients' reports of their experiences, one key phenomenon suggested is the importance of the interaction between the person and the disorder. This interaction evolves over time and...
A standardized assessment of the subjective experience of schizophrenia and depression was developed in three stages: (1) An open-ended interview covering changes in nine areas of psychological functioning was given to acute, remitted, and chronic schizophrenic patients, and to depressed patients. (2) On the basis of their replies, a structured interview was given on two separate occasions...
Systematic investigations into the experience of schizophrenic patients as they react and adapt to social environments are rare. Yet such information is extremely useful for understanding the psychopathology of schizophrenia, the planning of treatments, as well as for creating optimal treatment and living environments. In this study, dynamic fluctuations of mental state, social context, and...
The schizophrenic experience is described as an inability to sustain an intentional focus to attention. Attention is captured by incidental details in the schizophrenic patient's environment, and this gives rise to a spurious sense of significance. The patient's inability to direct a train of thought prevents full access to long-term memory so that early components of perception, which are...
Many observers have noted similarities between dreams, hallucinogenic drug states, and schizophrenia. In the present article, certain fundamental areas of convergence between the three states are described. Consideration is given to the hallucinogenic drug model of psychosis: the reasons for its initial attractiveness, and the reasons for its current disfavor. The concept of ego boundaries is...
Autobiographical accounts of acute mystical experience and schizophrenia are compared in order to examine the similarities between the two states. The appearance of a powerful sense of noesis, heightening of perception, feelings of communion with the "divine," and exultation may be common to both. The disruption of thought seen in the acute psychoses is not a component of the accounts of...
Although psychotic symptoms are usually viewed as dichotomous events, both patients and nonpatients often report isolated psychotic experiences as well as psychotic-like experiences, the latter being attenuated versions of psychotic experiences. College students, previously identified as probably at high risk for psychosis, were interviewed using a modified Schedule for Affecting Disorders and...
The visual hallucinations experienced by a 26-year-old woman under the influence of hallucinogens and during schizophrenia are described. Three types of hallucinations are delineated: (1) superimposed hallucinations, (2) spatial and depth distortions, and (3) animations. These three types of hallucinations appear to represent consecutive gradations on a continuum of the ego function of reality...
Some of the difficulties of trying to establish an animal model of schizophrenia are first considered. Then, after a review of the evidence on the experimental psychopathology of schizophrenia, particularly that concerned with attention and arousal, it is concluded that the core feature which needs to be modeled in animals is some aspect of "input dysfunction." It is argued that, of the...