Person-Centered Psychopathology of Schizophrenia: Building on Karl Jaspers' Understanding of Patient's Attitude Toward His Illness

Stanghellini, Giovanni; Bolton, Derek; Fulford, William

doi:10.1093/schbul/sbs154

Cited by 66 publications

(40 citation statements)

References 26 publications

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“…This is coherent with the classic psychopathological literature [33,34] as well as with recent psychopathological analyses [35,36] . The patient's attitude to his/her ASEs, that is, the way the patient copes with and makes sense of them, may play a significant role in the development of full-blown symptoms and contribute to generating either schizophrenic or other kinds of mental symptoms, as for instance panic symptoms.…”

Section: Introductionsupporting

confidence: 91%

Basic Self-Disturbances beyond Schizophrenia: Discrepancies and Affinities in Panic Disorder - An Empirical Clinical Study

Madeira

Carmenates

Costa³

et al. 2017

Psychopathology

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Background: Anomalous self-experiences (ASEs), presumably involving alterations in “core” or “minimal self,” have been studied as manifest in schizophrenia and its spectrum, in contrast with mood disorder and personality disorder samples. This is the first study to examine ASEs in panic disorder (PD), beginning the exploration of these disturbances of subjectivity in anxiety disorders. We aimed to clarify what might, or might not, be specific to the schizophrenia spectrum domain - which, in turn, could be useful for developing pathogenetic models for various disorders. Sampling and Methods: 47 hospital outpatients with PD and no other medical and psychiatric comorbidity and 47 healthy control (HC) subjects were assessed with the Examination of Anomalous Self Experiences (EASE) and Cambridge Depersonalization Scale (CDS). Results: All our PD patients had overall ASE and EASE scores significantly higher than our HCs (mean ± SD 17.94 ± 11.88 vs. HC 1.00 ± 1.81), approaching levels found in previous schizophrenia spectrum samples. The distribution of particular EASE items and subitems in the PD sample was heterogeneous, varying from rare (<10%) or absent (termed “discrepancies” with schizophrenia spectrum: 29 items) to being present in >50% of subjects (“affinities” with schizophrenia spectrum: 7 items). EASE and CDS scores were highly correlated (r = 0.756, 95% CI 0.665-0.840). Conclusions: PD patients scored higher on items suggesting common forms of derealization and depersonalization, perhaps suggesting “secondary” and defensive psychological processes, while lacking indicators of more profound ipseity disturbance. Our study supports the basic-self-disturbance model of schizophrenia, while suggesting the possibility of transnosological “schizophrenia-like phenomena,” which might require careful phenomenological exploration to be distinguished from those of true psychotic or schizophrenic conditions.

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Section: Introductionsupporting

confidence: 91%

Basic Self-Disturbances beyond Schizophrenia: Discrepancies and Affinities in Panic Disorder - An Empirical Clinical Study

Madeira

Carmenates

Costa³

et al. 2017

Psychopathology

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“…36,37 How a phenomenological approach may be implemented in a neuroscientific and therapeutic enterprise is exemplified by recent proposals for studying delusions 6 , 17 , 25 , 38 and for developments of person-centered approaches in psychopathology. 6 , 17 , 39 …”

Section: Resultsmentioning

confidence: 99%

Rediscovering Psychopathology: The Epistemology and Phenomenology of the Psychiatric Object

Parnas

Sass

Zahavi

2012

Schizophrenia Bulletin

211

155

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Questions concerning both the ontology and epistemology of the “psychiatric object” (symptoms and signs) should be at the forefront of current concerns of psychiatry as a clinical neuroscience. We argue that neglect of these issues is a crucial source of the stagnation of psychiatric research. In honor of the centenary of Karl Jaspers’ book, General Psychopathology, we offer a critique of the contemporary “operationalist” epistemology, a critique that is consistent with Jaspers’ views. Symptoms and signs cannot be properly understood or identified apart from an appreciation of the nature of consciousness or subjectivity, which in turn cannot be treated as a collection of thing-like, mutually independent objects, accessible to context-free, “atheoretical” definitions or unproblematic forms of measurement (as is often assumed in structured interviewing). Adequate and faithful distinctions in the phenomenal or experiential realm are therefore a fundamental prerequisite for classification, treatment, and research. This requires a multidisciplinary approach, incorporating (among other things) insights provided by psychology, phenomenological philosophy, and the philosophy of mind.

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“…The nuanced descriptions of persons with lived experience of AVHs are not typically included in research designs, and consequently under-represented or absent in the scientific literature. Historically, in contrast, the exploration of subjective experience formed the contextual foundation of psychological research on psychopathology, particularly in Europe (48,49). …”

Section: Discussionmentioning

confidence: 99%

Listening to Schneiderian Voices: A Novel Phenomenological Analysis

et al. 2016

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Background/Aims: This paper reports on analyses designed to elucidate phenomenologicalcharacteristics, content and experience specifically targeting participants with Schneiderian voices conversing/commenting (VC) while exploring differences in clinical presentation and quality of life compared to those with voices not conversing (VNC). Methods: This mixed-method investigation of Schneiderian voices included standardized clinical metrics and exploratory phenomenological interviews designed to elicit in-depth information about the characteristics, content, meaning, and personification of auditory verbal hallucinations. Results: The subjective experience shows a striking pattern of VC, as they are experienced as internal at initial onset and during the longer-term course of illness when compared to VNC. Participants in the VC group were more likely to attribute the origin of their voices to an external source such as God, telepathic communication, or mediumistic sources. VC and VNC were described as characterological entities that were distinct from self (I/we vs. you). We also found an association between VC and the positive, cognitive, and depression symptom profile. However, we did not find a significant group difference in overall quality of life. Conclusions: The clinical portrait of VC is complex, multisensory, and distinct, and suggests a need for further research into the biopsychosocial interface between subjective experience, socioenvironmental constraints, individual psychology, and the biological architecture of intersecting symptoms.

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Person-Centered Psychopathology of Schizophrenia: Building on Karl Jaspers' Understanding of Patient's Attitude Toward His Illness

Cited by 66 publications

References 26 publications

Basic Self-Disturbances beyond Schizophrenia: Discrepancies and Affinities in Panic Disorder - An Empirical Clinical Study

Basic Self-Disturbances beyond Schizophrenia: Discrepancies and Affinities in Panic Disorder - An Empirical Clinical Study

Rediscovering Psychopathology: The Epistemology and Phenomenology of the Psychiatric Object

Listening to Schneiderian Voices: A Novel Phenomenological Analysis

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