Testing a neurophenomenological model of basic self disturbance in early psychosis

Nelson, Barnaby; Lavoie, Suzie; Gawęda, Łukasz; Li, Emily; Sass, Louis A.; Koren, Danny; McGorry, Patrick D.; Jack, Bradley N.; Parnas, Josef; Polari, Andrea; Allott, Kelly; Hartmann, Jessica A.; Whitford, Thomas J.

doi:10.1002/wps.20597

Cited by 26 publications

(20 citation statements)

References 8 publications

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“…It is postulated in Nelson and Sass (2017) recent theoretical model that cognitive biases such as sourcemonitoring deficits could be neurocognitive correlates of SD. Preliminary data confirming their relationship in a group of ultra-high risk of psychosis as well as among first-episode schizophrenia patients has recently been published (Nelson et al, 2019).…”

Section: Discussionmentioning

confidence: 85%

“…It is postulated in Nelson and Sass () recent theoretical model that cognitive biases such as source‐monitoring deficits could be neurocognitive correlates of SD. Preliminary data confirming their relationship in a group of ultra‐high risk of psychosis as well as among first‐episode schizophrenia patients has recently been published (Nelson et al, ). With regard to depression, a consistent body of research indicates not only that this diagnosis frequently co‐occurs with psychosis (Birchwood, Iqbal, Chadwick, & Trower, ; Siris et al, ), but also depressive symptoms are associated with psychotic experiences among ultra‐high risk individuals (Yung, Phillips, Yuen, & McGorry, ) and non‐clinical groups (Armando et al, ).…”

Section: Discussionmentioning

confidence: 85%

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Prevalence, dimensionality and clinical relevance of self‐disturbances and psychotic‐like experiences in Polish young adults: a latent class analysis approach.

Pionke

Gidzgier

Nelson

et al. 2019

Int J Methods Psych Res

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Objectives We aimed to investigate latent classes of psychotic‐like experiences (PLEs) and self‐disturbances (SD) and to explore mutual overlapping between derived subgroups. Further, our goal was to investigate class membership relationship with an exposure to childhood trauma and different psychopathological factors such as cognitive biases, depression, insomnia, psychiatric diagnosis and lifetime suicidality. Methods Participants consist of 3167 non‐clinical adults. We performed two latent class analyses (LCA), for PLEs and SD separately, to identify subgroups of individuals with different profiles on PLEs and SD. Associations between psychopathological factors and latent class membership were examined using multinomial logistic regression analysis. Results LCA produced 5 classes within SD and 3 classes within PLEs. Class of the highest endorsement of SD showed 53% overlap with class of the highest endorsement of PLEs. The highest risk of belonging to High Class for both SD and PLEs was associated in particular with depression, cognitive biases and insomnia. Trauma emerged as a significant predictor only for PLEs classes. Conclusions Our findings confirm that high PLEs and SD co‐occur and are concentrated in a relatively small number of individuals, at least in the general population. Their combination may capture the highest risk of psychosis in the general population.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 85%

Prevalence, dimensionality and clinical relevance of self‐disturbances and psychotic‐like experiences in Polish young adults: a latent class analysis approach.

Pionke

Gidzgier

Nelson

et al. 2019

Int J Methods Psych Res

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“…, difficulties in making attributions about the origins of mental experiences, e.g. , whether an experience was real or imagined, or whether its origin was internal [self-generated] or external [other-generated]) explained 39.8% of the variance in Examination of Anomalous Self-Experience scores, showing an increasing gradient of severity from healthy control participants to high-risk patients to first-episode psychosis patients (first-episode psychosis < high risk < healthy control; Nelson et al, 2019 ; Nelson et al, 2020 ).…”

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confidence: 99%

Defense mechanisms in adolescents at high risk of developing psychosis: An empirical investigation

Boldrini

Buglio

Giovanardi

et al. 2020

ResPsy

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Research within psychotherapy and psychopathology frameworks has been inspired by the central concept of defense mechanisms, which play a pivotal role in psychoanalysis. Defense specificities have only recently been studied systematically in the context of several clinical diagnoses. The present study aimed to explore the specificities of defense mechanisms in adolescents at ultra-high risk of developing psychosis and test the relationship between defensive functioning and attenuated psychotic symptoms. Twenty-six adolescent inpatients at ultra-high risk of developing psychosis and a matched clinical control group of inpatients not at risk of psychosis were interviewed. Two observer-rater methods, the Defense Mechanism Rating Scales and the Psychotic-Defense Mechanism Rating Scales were applied to interview transcripts to assess the individual use of defenses. Ultra-high-risk patients demonstrated lower defense mechanisms (i.e., total instances of defense mechanisms observed) and lower overall adaptiveness of the defenses presented. When specific differences between groups were observed, psychotic defenses were the sole defenses that could partially discriminate between ultra-high-risk and not at-risk patients. Regarding the relationship between defense mechanisms and subthreshold psychotic symptoms, psychotic defenses were associated with negative and disorganization symptoms, rather than with positive symptoms. The psychological vulnerability of ultra-high-risk patients is discussed and treatment implications for psychotherapy with such challenging patients are addressed.

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“…This research was part of a baseline clinical assessment in a larger longitudinal study (Self and Neurocognition Study; SANE [Nelson, Lavoie, et al, ]) designed to investigate the relationship between basic self‐disturbance and neurocognitive and neurophysiological variables. Sixty‐seven individuals aged 15 to 24 with a status of UHR or FEP were recruited from outpatient clinics at Orygen Youth Health (OYH), a mental health service for youth located in the north‐western metropolitan region of Melbourne, Australia.…”

Section: Methodsmentioning

confidence: 99%

“…This research was part of a baseline clinical assessment in a larger longitudinal study (Self and Neurocognition Study; SANE [Nelson, Lavoie, et al, 2018]) designed to investigate the relationship between basic self-disturbance and neurocognitive and neurophysiological variables.…”

Section: Samplementioning

confidence: 99%

The relation of basic self‐disturbance to self‐harm, eating disorder symptomatology and other clinical features: Exploration in an early psychosis sample

Rasmussen

Reich

Lavoie

et al. 2019

Early Intervention Psych

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Background and Aims: The notion of basic self-disturbance has been proposed as a core feature of schizophrenia-spectrum disorders and as an indicator of future transition to psychosis in high-risk populations. However, the relation of this notion to many clinical characteristics has not been explored. The aim of this study was: (a) to investigate the distribution of self-disturbance and other symptoms dimensions in ultra-high risk (UHR), first-episode psychosis (FEP) and healthy control groups; and (b) to explore the association of self-disturbance with a history of self-harm, suicidal attempt, eating disorder symptomatology, school bullying victimization and sexual or physical abuse.Methods: Patients with UHR status (n = 38) or FEP (n = 26) and healthy controls (n = 33) were assessed with the Examination of Anomalous Self-Experience (EASE) and the Comprehensive Assessment of at Risk Mental States (CAARMS). The clinicalhistorical variables were assessed through medical records.Results: The FEP group scored significantly higher on the EASE than the UHR group, which scored significantly higher than the healthy control group, which had a very low score. Multivariate logistic regression analyses revealed that higher EASE score was significantly associated with a history of self-harm, disordered eating and bullying victimization (but not with suicide attempts or sexual/physical abuse) after controlling for positive, negative and depressive symptoms.Conclusion: These novel findings suggest that self-disturbance may be related to a history of school bullying victimization, self-harm and eating disorder symptomatology in patients with or at-risk of psychosis. If further confirmed, these findings are potentially relevant to clinical risk assessment and therapy. K E Y W O R D Sbullying, childhood trauma, first episode psychosis, self-disorder, suicide, ultra-high risk

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Testing a neurophenomenological model of basic self disturbance in early psychosis

Cited by 26 publications

References 8 publications

Prevalence, dimensionality and clinical relevance of self‐disturbances and psychotic‐like experiences in Polish young adults: a latent class analysis approach.

Prevalence, dimensionality and clinical relevance of self‐disturbances and psychotic‐like experiences in Polish young adults: a latent class analysis approach.

Defense mechanisms in adolescents at high risk of developing psychosis: An empirical investigation

The relation of basic self‐disturbance to self‐harm, eating disorder symptomatology and other clinical features: Exploration in an early psychosis sample

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