Phenomenology and neurobiology of self disorder in schizophrenia: Primary factors

Borda, Juan P.; Sass, Louis A.

doi:10.1016/j.schres.2015.09.024

Cited by 60 publications

(47 citation statements)

References 111 publications

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“…Borda and Sass [3] and Sass and Borda [4] propose that early perceptual and motoric disturbances that affect perceptual organization, especially intermodal or multisensory perceptual integration [5,154,155] (and perhaps especially between exteroceptive and interoceptive forms of perception, e.g., visual and kinaesthetic/proprioceptive) may lead to a "perceptual disintegration" that undermines the ability to apprehend the world in a holistic, vital, contextually grounded fashion, or to fully identify with or experience the unity of one's own body or thinking. This "primary factor" may generate an early disruption or diminishment of basic self and of the sense of existing in a coherent world.…”

Section: Discussionmentioning

confidence: 99%

“…Integration across these domains may help researchers move towards unifying principles and themes in the study of schizophrenia, which would ultimately be beneficial for diagnostic practice, treatments, and early identification-as well, of course, as for general pathogenetic understanding. Along these lines, there have been several recent attempts at a theoretical integration of phenomenological and neurocognitive research in schizophrenia [1][2][3][4][5]. We have argued in previous work that there is a convergence of recent findings across these different research domains linked around the concept of disturbance of the basic (a.k.a.…”

Section: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Nelson

Sass

2017

Current Problems of Psychiatry

Self Cite

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“…A recently updated model of self-disorders in schizophrenia, proposed by Sass and Borda [10], may be enlightening in this respect [9]. They suggest that self-disorders are partly constituted by primary and partly by secondary factors or variants of BSD.…”

Section: Discussionmentioning

confidence: 99%

“…The first is “diminished self-affection” , referring to a diminished sense of basic self-presence, i.e. existing as a vital subject of awareness or agent of action (accordingly also termed “diminished self-presence” in recent publications [9, 10]). The second is “hyperreflexivity ”, which refers to forms of exaggerated self-consciousness and heightened awareness of normally tacit or implicit aspects of experience.…”

Section: Introductionmentioning

confidence: 99%

Anomalous Self-Experiences: Markers of Schizophrenia Vulnerability or Symptoms of Depersonalization Disorder? A Phenomenological Investigation of Two Cases

2018

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Background: Basic self-disturbance (BSD) is proposed to constitute the clinical core of schizophrenia spectrum disorders, including prodromal states and schizotypy. Anomalous self-experiences (ASEs) are suggested as phenotypic variants of BSD, representing markers of schizophrenia vulnerability. However, ASEs are not restricted to the schizophrenia spectrum, but may also occur in non-psychotic states like depersonalization disorder (DPD). It is unclear to what extent the prevalence and nature of ASEs are differing between the two conditions. The main aim of this paper is to assess and compare ASEs in both conditions, based on literature and two illustrating cases. This might expand the understanding of these phenomena, and strengthen the basis for clinical differentiation. Methods: One patient with schizotypal personality disorder (SPD) and one with DPD were selected from an ongoing clinical high-risk (CHR) for psychosis study. ASEs were assessed with the Examination of Anomalous Self-Experience (EASE) and analyzed according to the two central dimensions of BSD: diminished self-affection and hyperreflexivity, as well as according to prototypical aspects of depersonalization. The cases were also analyzed and compared with respect to chronology, other symptomatology, and psychopathological pathways. Results: Both cases revealed ASEs reflecting the central dimensions of BSD as well as prototypical aspects of depersonalization. Only the SPD case however, linked ASEs to psychotic-like ideas of external influence and control. The symptoms had an insidious early childhood onset with no obvious triggers in the SPD case, and an abrupt adolescence onset triggered by second-time cannabis use and panic anxiety in the DPD case. Conclusions: The similarities and differences in ASEs, symptomatology and developmental pathways of the two cases might be accounted for by an updated model of self-disorders. The model proposes that schizophrenia manifests as a result of a combination of early “primary”-onset ASEs, reflecting disturbances in early neurodevelopment, and later occurring, “secondary” ASEs of a more defensive-protective character. In line with this, the DPD case may be characterized only by secondary ASEs and thus better protected against psychotic decompensation than the SPD case, tentatively affected by a combination of primary and secondary ASEs.

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“…En cuanto a los hallazgos neurobiológicos subyacentes a los disturbios de la ipseidad, (16,17) se ha apuntado a fallas de conectividad neuronal entre áreas dedicadas a la integración intra e intermodal de las aferencias sensoriales y las eferencias motoras, esto es, a nivel de la unión témporo-parietal derecha, el área parietal inferior y el córtex parietal posterior, además de la ínsula, y también la corteza prefontal medial y lateral. Estos últimos circuitos dan el correlato de emociones complejas y deseos a la vivencia primaria del yo.Se ha descrito asimismo, en la corteza insular del hemisferio no dominante, el sustrato neuronal para la evaluación de cómo el individuo se siente: este sistema, no hallado en otros primates, informaría no solo de la homeostasis visceral sino de la condición fisiológica del individuo y sería el primordio de la conciencia del yo.…”

Section: Rev Neuropsiquiatr 80 (3) 2017unclassified

Psicopatología de la ipseidad y la corporalidad: a propósito de un caso de esquizofrenia cenestopática.

2017

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RESUMENLa fenomenología ha dividido conceptualmente al cuerpo humano en el "cuerpo-objeto", la entidad física que puede ser percibida por uno mismo y por otros, y en el "cuerpo-vivido", que es la experiencia inmediata del propio cuerpo, tácitamente experimentado (o vivido) en una perspectiva de primera persona. El "cuerpo-vivido" origina la experiencia pre-reflexiva de la vida, adscribible al yo mínimo, core self o ipseidad que constituye el sustento nuclear de la conciencia del yo. Este modo corporal opera implícitamente en cada acción que ejecutamos en el mundo y nos permite la aprehensión y entendimiento del entorno. Sin embargo, en algunos procesos mórbidos el cuerpo puede perder su calidad de "transparencia" y volverse anormalmente explícito, tal como ocurre en la esquizofrenia. En esta patología, los pacientes sufren un distanciamiento subjetivo entre la mente y el cuerpo al que se denomina descorporalización y, como consecuencia, experimentan un debilitamiento del sentido básico del yo, alteraciones de la relación sujeto-objeto y del otorgamiento de significados, así como en la vivencia de la intersubjetividad. Anormalidades del "cuerpo-vivido" han sido identificadas previamente en los casos de esquizofrenia desorganizada, paranoide y catatónica. En este reporte analizamos cómo se manifiestan las alteraciones del cuerpo-vivido y de la ipseidad en un caso de esquizofrenia cenestopática.PALABRAS CLAVE: Esquizofrenia, cuerpo humano, estado de conciencia, psicopatología. (Fuente: DeCS BIREME). SUMMARYPhenomenology has conceptually divided the body into the "object-body", the physical entity that can be perceived by oneself and others, and the "living-body", that is the immediate experience of the body, tacitly experienced (or lived) in a first-person perspective.The "living-body" originates the pre-reflective experience of life, also ascribable to the minimal self, core self or ipseity, which constitutes the nuclear support of self-consciousness. This body mode implicitly operates in every action that we execute in the world, and allows us to grasp and understand the environment. However, in some morbid processes, the body may lose its quality of "transparency" and become anomalously explicit, as it occurs in schizophrenia. In this disorder, patients suffer a subjective estrangement between mind and body, which is called decorporalization or disembodiment, as a consequence of which, the patients experience a weakness of the basic sense of self, abnormalities of the subject-object relationship and alterations

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Phenomenology and neurobiology of self disorder in schizophrenia: Primary factors

Cited by 60 publications

References 111 publications

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

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

Anomalous Self-Experiences: Markers of Schizophrenia Vulnerability or Symptoms of Depersonalization Disorder? A Phenomenological Investigation of Two Cases

Psicopatología de la ipseidad y la corporalidad: a propósito de un caso de esquizofrenia cenestopática.

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