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Anomalous subjective experiences involving an alteration of the basic sense of self (ie, Self-disorder [SD]) are emerging as a core marker of schizophrenia spectrum disorders with potential impact on current early detection strategies as well. In this study, we wished to field-test the prevalence of SD in a clinical sample of adolescent/young adult help-seekers at putative risk for psychosis attending standard community mental health facilities in Italy. Participants (n = 47), aged between 14 and 25, underwent extensive psychopathological evaluations with current semi-structured tools to assess Clinical High Risk (CHR) state (ie, Structured Interview for Prodromal Syndromes/Scale of Prodromal Symptoms [SIPS/SOPS], Schizophrenia Proneness Instrument-Adult/Child and Youth [SPI-A/CY]). SD aggregated in CHR subjects as compared to the non-CHR and revealed substantial association with sub-psychotic symptoms (SIPS), subjective experience of cognitive and cognitive-perceptual vulnerability (basic symptoms) and functional level (Global Assessment of functioning). Moreover, a combination of the 2 approaches (ie, CHR plus SD) enabled further "closing-in" on a subgroup of CHR with lower global functioning. The results confirm SD's relevance for the early profiling of youths at potential high risk for psychosis.

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Corollary discharge (CD) impairment has been hypothesized to be a neurophysiological mechanism involved in the development of specific psychotic symptoms. 1 Corollary discharge signals are copies of motor commands used to form a prediction of the sensation from self-generated movements, thereby contributing to the sense of selfagency. In more concrete terms, individuals have a subjective experience of volitionally controlling their own acts when the predicted sensation matches the actual sensation.Corollarydischargeisalteredthroughoutmultiplesensorysystems in psychosis, 2 and psychotic states are often associated with the external misattribution of self-generated actions. For example, agency disturbances have been hypothesized as being involved in the emergence of prototypical schizophrenia spectrum psychotic phenomena, such as passivitydelusions(inwhichindividualsexperiencetheirownthoughts, feelings,oractionsasbeingunderexternalcontrol) 1 andauditoryverbal hallucinations (eg, hearing either one's thoughts spoken aloud or externalized commenting "voices"). 2 Because CD enables the differentiation of internally vs externally generated stimuli and occurs across different sensorymodalities(eg,visual,auditory,andsomatosensory),CDimpairmentsbroadlyinterferewithsensorimotorprediction,regardlessofthe specific sensory domain involved. 3 Furthermore, CD mediates sophisticatedsensorimotorandneurocognitiveoperations(eg,perceptualstabilization, motor sequencing, and sensorimotor learning) and contributes to the subliminal scaffolding of the experiential field. For example, CD grounds at a neural level the implicit sense of "mineness" in psychomotor experience and lends coherence and fluidity to our immediate interaction with the surrounding world, which is often compromised in schizophrenia and related vulnerability states.Therefore, CD and the related sensorimotor predictions offer a unique neuroscientific prism to investigate psychosis, linking its most characteristic experiential abnormalities (eg, profound distortions of the sense of self-agency and mineness of experience) with basic physiological processes. Indeed, CD signals have been identified even at the level of single neuron recordings. Such an approach has tangible clinical and translational potentials, which could be further amplified by taking into account converging heuristic perspectives from developmental psychopathology and phenomenology.From a developmental psychopathology perspective, capturing the developmental progression of CD (and, broadly speaking, of sensorimotor control) anomalies has the potential to reveal brain maturation trajectories that could uncover age-specific windows of vulnerability to schizophrenia spectrum disorders. Although basic aspects of sensorimotor control are nearly mature by childhood, other processes reach complete maturation only during adolescence (ie, when the cortical excitatory-inhibitory balance is further calibrated and optimized). For example, the executive function aspects of oculomotor control (eg, antisaccades, mem...