Constructing a coherent life story through the formation of self-event connections may help maintain unity in the self. We examined how positive and negative self-event connections were related to symptoms of psychopathology when controlling for two other measures of self-unity: Self-concept clarity and dissociation. While most studies of life stories use content coding, we used a self-report method and hence provide a rationale for this method. One hundred five young adults identified life story chapters and rated them on self-event connections, including questions of positive/negative self-change and self-stability connections. They also completed scales measuring self-concept clarity, dissociation, and symptoms. Higher ratings of positive and lower ratings of negative self-event connections in life stories were related to fewer symptoms of psychopathology. Positive self-change was related to fewer symptoms when controlling for selfconcept clarity and dissociation. The results suggest that positive and negative self-event connections are differentially related to symptoms of psychopathology. In addition, the results indicate that self-report measures of life stories may be a useful supplement to coding of narratives.

The present study compared life story chapters and self-defining memories in 25 patients with schizophrenia and 25 matched controls. All participants were tested on neurocognition and rated on symptoms. Participants identified and rated life story chapters and self-defining memories on emotional valence, causal coherence, and self-continuity. Temporal coherence and temporal macrostructure were also assessed. Patients rated their life story chapters as more negative compared to controls, but there were few significant differences regarding temporal coherence, temporal macrostructure, and ratings of causal coherence and self-continuity. In patients, poorer neurocognitive function and higher degree of negative symptoms were related to less causal coherence and lower self-continuity in relation to chapters. In general, few differences were found between the patients and the controls. This may be due to the highly structured method used to assess life stories or to the fact that our patient group was cognitively well-functioning.

We examined themes of agency and communion in life stories of individuals with schizophrenia. Twenty-four individuals diagnosed with schizophrenia and 24 control participants matched on age, gender, and education described their life stories in a free format. The life stories were coded for the presence of agency and communion themes and whether or not the themes captured fulfillment of agency and communion needs. In addition, the temporal macrostructure was coded. Individuals with schizophrenia described their life stories with similar levels of temporal macrostructure as controls, but they expressed more themes focusing on unfulfilled agency and communion needs. We suggest possible avenues for using these insights to improve recovery in schizophrenia.

Forty-five participants described and rated two events each week during their first term at university. After 3.5 years, we examined whether event characteristics rated in the diary predicted remembering, reliving, and life story importance at the follow-up. In addition, we examined whether ratings of life story importance were consistent across a three year interval. Approximately 60% of events were remembered, but only 20% of these were considered above medium importance to life stories. Higher unusualness, rehearsal, and planning predicted whether an event was remembered 3.5 years later. Higher goal-relevance, importance, emotional intensity, and planning predicted life story importance 3.5 years later. There was a moderate correlation between life story importance rated three months after the diary and rated at the 3.5 year follow-up. The results suggest that autobiographical memory and life stories are governed by different mechanisms and that life story memories are characterized by some degree of stability.

We found a good level of inter-rater reliability of PANSS-6 ratings obtained using the SNAPSI for seven raters with varying levels of clinical and research experience.

The sharp post-diagnosis memory decline suggests that patients find it difficult to establish new or evolve existing definitions of self. Implications for models of schizophrenia and for clinical practice are discussed.

Abstract. Holm T, Lassen JF, Husted SE, Christensen P, Heickendorff L (Aarhus University Hospital, Aarhus, Denmark). A randomized controlled trial of shared care versus routine care for patients receiving oral anticoagulant therapy. J Intern Med 2002; 252: 322-331.

Background: The six-item version of the Positive and Negative Syndrome Scale (PANSS-6) has shown promise as a brief measure of the severity of core symptoms of schizophrenia. However, since all prior analyses of the PANSS-6 were based on data extracted from studies using the full 30-item PANSS (PANSS-30), it remains unknown whether it is possible to obtain valid information for the PANSS-6 ratings via a brief interview, such as the Simplified Negative and Positive Symptoms Interview (SNAPSI). Aims: We aimed to validate the PANSS-6 ratings obtained via the SNAPSI using the PANSS-6 scores extracted from the PANSS-30 ratings obtained via the comprehensive Structured Clinical Interview for PANSS (SCI-PANSS) as the gold-standard reference. Methods: The PANSS-6 ratings based on the SNAPSI and the PANSS-30 ratings based on the SCI-PANSS were conducted by independent raters with established inter-rater reliability. Results: Seventy-seven inpatients with schizophrenia ( Mage = 35.1 ± 11.7 years; males = 57%; paranoid schizophrenia = 75%) participated in the study. The intraclass correlation coefficient (ICC) of the PANSS-6 total scores obtained using the SNAPSI and the PANSS-30-derived PANSS-6 total scores via the SCI-PANSS was 0.77 ( p < 0.001). The ICC for the PANSS-6 total score and the PANSS-30-derived PANSS-8 (Andreasen’s remission criteria) was 0.75 ( p < 0.001). Spearman’s rank correlation coefficient for changes in PANSS-6 total scores via the SNAPSI and changes in PANSS-30-derived PANSS-6 total scores was 0.70 ( p < 0.001). Conclusions: Using the SNAPSI to rate the PANSS-6 enables a focused and brief assessment of the severity of core symptoms of schizophrenia, which facilitates measurement-based care and clinical decision making in the treatment of schizophrenia.