In Reply We are grateful to Feinberg for the timely commentary that integrates our recent educational review in JAMA Psychiatry 1 from a historical perspective. The link between sensorimotor anomalies and related experiential states conferring vulnerability to schizophrenia has been thematized for long, and the seeds of its conceptual genealogy are indeed spread across several decades. 2 We fully agree with Feinberg that such intellectual history is not "hopelessly remote" and, rather, could be strategic for our future understanding of the etiopathogenesis of schizophrenia and of its spectrum conditions. Where we differ from Feinberg is that we looked at the neurodevelopment of the psychotic mind as distributed along the developmental years since early childhood and expressed through vulnerability phenotypes, including manifold prepsychotic experiential features (eg, selfdisorders, anomalies of the sense of agency). [3][4][5] Consequently, we argue for a reinvigorated focus on corollary discharge systems through the confocal lens of developmental psychology and phenomenological psychopathology. While a broader developmental perspective might suggest that, although important, neurobiological maturational processes occurring in adolescence (eg, synaptic pruning driving circuit reorganization) 2 are already relatively advanced within the neurodevelopmental trajectory leading to psychosis, phenomenology could provide better target phenotypes. This is crucial because psychiatry is dependent on the adequacy of its phenotypic descriptors. Hence to zoom in on the early manifestations of altered neurodevelopment, full-blown symptoms such as delusions and hallucinations (even in their attenuated form) are certainly less informative than nonpsychotic anomalies of subjective experience (eg, deflating sense of agency, autopsychic depersonalization, anonymization of the stream of consciousness) and subtle schizotaxic-schizotypal features (eg, interpeer averseness, hypertrophic and dereistic introspection). Such features that index a putative, broadly conceived premorbid vulnerability are already detectable in preadolescence and plausibly pave the way for the later unfolding of productive symptoms.Along these lines, the pioneering work of Feinberg together with the neuroscientific advances in the characterization of sensorimotor systems could bring us closer to the elucidation of the etiopathogenetic vectors that condition neurodevelopmental pathways to schizophrenia spectrum disorders.
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