Exploring identity and personal meanings in psychosis using the repertory grid technique: A systematic review

Abstract

Current research and clinical practice in person-centred approaches highlight the importance of self, identity, and personal meanings in psychosis. Previous research has focused on dimensions of self, but less attention has been paid to the personal meanings involved in identity. The personal construct theory framework and the repertory grid technique (RGT) allow the study of identity and personal meanings within person-centred approaches of psychopathology and treatment in psychosis, as suggested by studies that began more than 40 years ago. However, their contributionshave not yet been reviewed. We aimed to systematically review the evidence for the role of identity and personal meanings in psychotic disorders. We performed a systematic search using personal construct and RGT terms in PsycINFO, Web of Science, PubMed, EBSCO, Scopus, and Google Scholar. After identifying 2,574 articles, 15 were included. Nine studies followed an idiographic assessment, and six were nomothetic. Patients reported their subjective experience of isolation in terms of high self-ideal discrepancy and high perceived discrepancy with their significant others, which some studies associated with a lower degree of recovery or with the way in which positive symptoms were construed. Self-fragmentation either decreased with interventions or was associated with recovery. Evidence regarding interpersonal construing was less consistent, but there was a tendency for patients to show a more rigid cognitive structure than controls. To conclude, we found some evidence that self-discrepancies, fragmentation of self, and interpersonal construing are affected in psychosis and potentially modifiable through psychotherapy.

Placing Cognitive Rigidity in Interpersonal Context in Psychosis: Relationship With Low Cognitive Reserve and High Self-Certainty

“…It has been suggested that overconfidence in own judgments may be influenced by acquired knowledge from past experience (55), which aligns with our results. Indeed, the inner construction of self and significant other is necessary built based on basic cognition, previous experiences, and metacognitive processes (22). It is not surprising that cognitive reserve emerged as a determinant factor, as in light of recent findings, patients with higher IQ are more likely to improve under metacognitive interventions (56).…”

“…The dimension of dichotomous interpersonal thinking (polarized thinking) when interpreting the self and significant others reflects a thinking tendency to understand oneself and the others in extreme or dichotomous terms (19). People with psychosis exhibit high dichotomous interpersonal thinking as compared with controls (20)(21)(22). This is relevant because high levels of it have been linked to more severity of positive symptoms (23), to more psychopathology in general (20), and to lower social functioning (24).…”

Metacognitive training modified for negative symptoms: A feasibility study

“…Metacognitive deficits are also associated with concurrent and future negative symptoms when controlling for verbal memory and education (Faith et al, 2020; Lysaker, et al, 2020). Interestingly, self‐reflection in itself has been found to mediate the relationship between neurocognition and negative symptoms (especially for deficits in capacity to communicate about internal states, so called diminished expression) while interpersonal cognitive differentiation (i.e., the ability to construe one's experiences as either similar or different from others' experiences) has been found to mediate the pathway between self‐reflectivity and negative symptoms (García‐Mieres et al, 2019, 2020). This suggests that negative symptom reduction may at least partially depend on improved metacognitive capacity and that a metacognitive intervention specifically targeting negative symptoms may be beneficial.…”

“…sized to drive the development and maintenance of negative symptoms. It is possible that the improvements in negative symptoms and self-reflection were driven by interpersonal cognitive differentiation as suggested byGarcía-Mieres et al (2019) due to the intervention's relational focus.…”

Meaning-Making Activity in the Emotional Experience of Borderline Personalities

“…can indicate varies, especially across all psy-and phil-disciplines (including psychiatry, psychology, psychopathology, psychoanalysis, cognitive psychology, the philosophy of mind and so on). For this reason, here follows a literature that can serve as a starting point to clarify the intricacy of these expressions [42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58][59][60]. 2 In the text I will write "axiological" in a hyphened and not hyphened way.…”