Disturbance of Minimal Self (Ipseity) in Schizophrenia: Clarification and Current Status

Nelson, Barnaby; Parnas, Josef; Sass, Louis A.

doi:10.1093/schbul/sbu034

Cited by 159 publications

(151 citation statements)

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“…A body of phenomenological research, combining clinical exploration, empirical studies and philosophical perspectives, indicates that a disturbance of the basic sense of self is at the clinical core of the schizophrenia spectrum and may therefore function as a phenotypic trait marker of these disorders, including vulnerability not (yet) expressed at diagnosable levels [6][7][8][9][10][11][12][13][14][15][16][17][18][19]. What exactly is being referred to "basic" sense of self?…”

Section: The Phenomenological Domain: Basic Self-disturbance In Schizmentioning

confidence: 99%

Towards integrating phenomenology and neurocognition: Possible neurocognitive correlates of basic self-disturbance in schizophrenia

Nelson

Sass

2017

Current Problems of Psychiatry

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Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive correlates of basic selfdisturbance. In this paper, we review recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic selfdisturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of "ownership" and "mineness" (the phenomenological notion of presence) and 2. aberrant salience, and associated disturbances of memory, prediction, and attention processes, which may contribute to hyper-reflexivity, disturbed "grip" or "hold" on the perceptual and conceptual field, and disturbances of intuitive social understanding ("common sense"). These two streams of research are reviewed in turn before considering ways forward in integrative models, particularly regarding the role of early neurodevelopmental disturbances, primary versus secondary disturbances, and the state versus trait nature of such pathology. Empirical studies are required in a variety of populations in order to test the proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive domains would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies.

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Section: The Phenomenological Domain: Basic Self-disturbance In Schizmentioning

confidence: 99%

Towards integrating phenomenology and neurocognition: Possible neurocognitive correlates of basic self-disturbance in schizophrenia

Nelson

Sass

2017

Current Problems of Psychiatry

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“…Given this body of work, how exactly is a clinician to determine if the presenting attenuated psychotic symptoms can be accounted for by these other, non-psychotic disorders or are better understood as an independent comorbid condition? Certainly the concept of basic self-disturbance has shown great promise as a specific phenotype of schizophrenia spectrum disorders and may be a useful concept for identifying when psychotic symptoms are indicative of schizophrenia spectrum disorders rather than non-psychotic disorders [22], but further work needs to be done before this construct (or other phenotypic or endophenotypic markers) can be incorporated into routine clinical practice. …”

Section: The Relationship Between Attenuated Psychotic Symptoms and Nmentioning

confidence: 99%

Attenuated Psychosis Syndrome: Don't Jump the Gun

Nelson¹

2014

Psychopathology

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Attenuated psychosis syndrome (APS) was introduced in DSM-5 as a condition for further study. A number of concerns have been raised regarding APS, including its validity as a clinical entity, issues relating to stigma, the potential that it is an unnecessary diagnosis of what might be a self-limiting phase of attenuated psychotic symptoms, and treatment implications of the diagnosis. The current paper presents a number of conceptual and practical issues that should be addressed in deciding whether APS should be accepted as an official diagnosis in subsequent editions of DSM. These include the problem of transferring the established validity of ‘at-risk' criteria to APS given some non-trivial differences between the criteria sets, the relationship between attenuated psychotic symptoms and other presenting non-psychotic disorders, the difficulties of operationalising the subthreshold or ‘attenuated' concept in standard clinical practice, and the likelihood of the diagnosis leading to overprescription of antipsychotic medication for this group of patients.

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“…For instance, a disturbance of the basic sense of self (ipseity) is regarded as a trait marker of schizophrenia [6]. Ego dystonicity of thoughts and behaviours is central to the understanding and diagnosis of obsessive-compulsive disorder (OCD) [7].…”

mentioning

confidence: 99%