Anomalous self-experience in adolescents at risk of psychosis. Clinical and conceptual elucidation

Abstract

Background: In research and clinical settings, there is a growing interest in the prodromal state of psychosis. The condition is usually operationalized by the presence of weak positive symptoms. Some studies also point to disorders of self-awareness as a core characteristic of the schizophrenia spectrum detectable before the onset of psychosis. Combining the 2 approaches is a pragmatic solution to the investigation of the role of anomalous self-experience in developing psychosis.

Methods: This clinical report describes disorders of self-experience in a small sample of 11 subjects fulfilling the Criteria of Prodromal Syndromes. All subjects were interviewed using the symptom checklist Examination of Anomalous Self-Experience. Through in-depth analysis of cases, interview excerpts have been selected for the purpose of illustrating the phenomena of anomalous self-experience.

Results: Disorders of self-experience were found in all subjects who fulfilled the prodromal criteria. There was, however, a difference in the kind and numbers of single features. Examples of disorders of self-experience which differ from the attenuated positive symptoms are illustrated by selected interview excerpts.

Conclusions: Anomalous self-experience should be further investigated in subjects at risk of psychosis and in a broader clinical population. The concept of anomalous self-experience should be further elaborated theoretically as well as empirically.