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Disturbances of basic self and prodromal symptoms among non-psychotic help-seeking adolescents

Published online by Cambridge University Press:  23 October 2012

D. Koren ,
N. Reznik ,
M. Adres ,
R. Scheyer ,
A. Apter ,
T. Steinberg  and
J. Parnas
D. Koren*
Affiliation:
Department of Psychology, University of Haifa, Haifa, Israel Department of Psychiatry, Rambam Medical Center, Haifa, Israel
N. Reznik
Affiliation:
Department of Psychology, University of Haifa, Haifa, Israel
M. Adres
Affiliation:
Department of Psychology, University of Haifa, Haifa, Israel
R. Scheyer
Affiliation:
Department of Psychology, University of Haifa, Haifa, Israel
A. Apter
Affiliation:
Department of Psychological Medicine, The Schneider Children Medical Center, Petach Tiqua, Israel
T. Steinberg
Affiliation:
Department of Neurology, The Schneider Children Medical Center, Petach Tiqua, Israel
J. Parnas
Affiliation:
Department of Psychiatry, Psychiatric Center Hvidovre, University of Copenhagen, Copenhagen, Denmark Center for Subjectivity, University of Copenhagen, Copenhagen, Denmark
*
*Address for correspondence: D. Koren, Ph.D., Psychology Department, University of Haifa, Haifa, 31905, Israel. (Email: [email protected])
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Abstract

Background

The goal of this study was to explore the notion that anomalies of self-experience (ASE) are a core, ‘not-yet-psychotic’ clinical phenotype of emerging schizophrenia and its spectrum.

Method

To accomplish this goal, we examined the relationship between ASE and commonly accepted risk markers in a sample of 87 help-seeking, non-psychotic adolescents (aged 14–18 years). ASE were assessed with the Examination of Anomalous Self-Experience (EASE), subclinical psychotic symptoms were assessed with the Prodromal Questionnaire and the Structured Interview for Prodromal Syndromes, deterioration in psychosocial functioning was assessed with the Social and Role Functioning Scales, and level of distress with the Mood and Anxiety Symptoms Questionnaire.

Results

About 82 participants completed the entire EASE interview. The number of participants who reported ASE at a clinically meaningful level (n = 18, 22%) was smaller than that who met diagnostic criteria for a prodromal syndrome (n = 28, 34%). The degree of overlap between the two conditions was moderate but statistically significant (χ2(1) = 7.01, p = 0.008). An exploratory factor analysis revealed that ASE load on a different factor than prodromal symptoms and deterioration in functioning, but that there is a moderate correlation between the three factors.

Conclusions

These results suggest that ASE are prevalent among non-psychotic help-seeking adolescents, yet at a considerably lower rate than prodromal symptoms. In addition, they suggest that ASE and prodromal symptoms constitute distinct but moderately related dimensions of potential risk. Taken together, they provide preliminary support for the clinical usefulness of supplementing and refining the methods of early detection of risk with assessment of ASE.

Keywords

Anomalies of self-experiencephenomenologyprodromepsychosisschizophrenia
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 7 , July 2013 , pp. 1365 - 1376
Copyright
Copyright © Cambridge University Press 2012 

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References

Addington, J, Epstein, I, Reynolds, A, Furimsky, I, Rudy, L, Mancini, B, Mcmillan, S, Kirsopp, D, Zipursky, RB (2008). Early detection of psychosis: finding those at clinical high risk. Early Intervention in Psychiatry 2, 147–153.CrossRefGoogle ScholarPubMed
Cannon, TD (2005). Clinical and genetic high-risk strategies in understanding vulnerability to psychosis. Schizophrenia Research 79, 35–44.CrossRefGoogle ScholarPubMed
Cannon, TD, Cadenhead, K, Cornblatt, B, Woods, SW, Addington, J, Walker, E, Seidman, LJ, Perkins, D, Tsuang, M, Mcglashan, T, Heinssen, R (2008). Prediction of psychosis in youth at high clinical risk: a multisite longitudinal study in North America. Archives of General Psychiatry 65, 28–37.CrossRefGoogle ScholarPubMed
Cannon, TD, Cornblatt, B, McGorry, P (2007). The empirical status of the ultra high-risk (prodromal) research paradigm. Schizophrenia Bulletin 33, 661–664.CrossRefGoogle ScholarPubMed
Cornblatt, BA, Auther, AM, Niendam, T, Smith, CW, Zinberg, J, Bearden, CE, Cannon, TD (2007). Preliminary findings for two new measures of social and role functioning in the prodromal phase of schizophrenia. Schizophrenia Bulletin 33, 688–702.CrossRefGoogle ScholarPubMed
Haug, E, Lien, L, Raballo, A, Bratlien, U, Oie, M, Andreassen, OA, Melle, I, Møller, P (2012). Selective aggregation of self-disorders in first-treatment DSM-IV schizophrenia spectrum disorders. Journal of Nervous and Mental Disease 200, 632–636.CrossRefGoogle ScholarPubMed
Huber, G, Gross, G (1989). The concept of basic symptoms in schizophrenic and schizoaffective psychoses. Recenti Progressi in Medicina 80, 646–652.Google ScholarPubMed
Loewy, RL, Bearden, CE, Johnson, JK, Raine, A, Cannon, TD (2005). The prodromal questionnaire (PQ): preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophrenia Research 79, 117–125.CrossRefGoogle ScholarPubMed
Loewy, RL, Johnson, JK, Cannon, TD (2007). Self-report of attenuated psychotic experiences in a college population. Schizophrenia Research 93, 144–151.CrossRefGoogle Scholar
McGorry, PD, Edwards, J, Mihalopoulos, C, Harrigan, SM, Jackson, HJ (1996). EPPIC: an evolving system of early detection and optimal management. Schizophrenia Bulletin 22, 305–326.CrossRefGoogle ScholarPubMed
McGorry, PD, Killackey, E, Yung, A (2008). Early intervention in psychosis: concepts, evidence and future directions. World Psychiatry 7, 148–156.CrossRefGoogle ScholarPubMed
Miller, TJ, McGlashan, TH, Rosen, JL, Cadenhead, K, Cannon, T, Ventura, J, McFarlane, W, Perkins, DO, Pearlson, GD, Woods, SW (2003). Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophrenia Bulletin 29, 703–715.CrossRefGoogle ScholarPubMed
Miller, TJ, McGlashan, TH, Woods, SW, Stein, K, Driesen, N, Corcoran, CM, Hoffman, R, Davidson, L (1999). Symptom assessment in schizophrenic prodromal states. Psychiatric Quarterly 70, 273–287.CrossRefGoogle ScholarPubMed
Møller, P, Haug, E, Raballo, A, Parnas, J, Melle, I (2011). Examination of anomalous self-experience in first-episode psychosis: interrater reliability. Psychopathology 44, 386–390.CrossRefGoogle ScholarPubMed
Møller, P, Husby, R (2000). The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior. Schizophrenia Bulletin 26, 217–232.CrossRefGoogle ScholarPubMed
Nelson, B, Thompson, A, Yung, AR (2012 a). Basic self-disturbance predicts psychosis onset in the ultra high risk for psychosis ‘prodromal’ population. Schizophrenia Bulletin. Published online: 20 February 2012. doi:10.1093/schbul/sbs007.CrossRefGoogle ScholarPubMed
Nelson, B, Thompson, A, Yung, AR (2012 b). Not all first-episode psychosis is the same: preliminary evidence of greater basic self-disturbance in schizophrenia spectrum cases. Early Intervention in Psychiatry. Published online: 3 July 2012. doi:10.1111/j.1751-7893.2012.00381.x.Google ScholarPubMed
Nelson, B, Yung, AR, Bechdolf, A, McGorry, PD (2008). The phenomenological critique and self-disturbance: implications for ultra-high risk (‘prodrome’) research. Schizophrenia Bulletin 34, 381–392.CrossRefGoogle ScholarPubMed
Parnas, J (2005). Clinical detection of schizophrenia-prone individuals: critical appraisal. British Journal of Psychiatry Supplement 48, S111–S112.CrossRefGoogle ScholarPubMed
Parnas, J, Handest, P (2003). Phenomenology of anomalous self-experience in early schizophrenia. Comprehensive Psychiatry 44, 121–134.CrossRefGoogle ScholarPubMed
Parnas, J, Handest, P, Jansson, L, Saebye, D (2005 a). Anomalous subjective experience among first-admitted schizophrenia spectrum patients: empirical investigation. Psychopathology 38, 259–267.CrossRefGoogle ScholarPubMed
Parnas, J, Handest, P, Saebye, D, Jansson, L (2003). Anomalies of subjective experience in schizophrenia and psychotic bipolar illness. Acta Psychiatrica Scandinavica 108, 126–133.CrossRefGoogle ScholarPubMed
Parnas, J, Jansson, L, Sass, LA, Handest, P (1998). Self-experience in the prodromal phases of schizophrenia: a pilot study of first admissions. Neurology, Psychiatry and Brain Research 6, 97–106.Google Scholar
Parnas, J, Møller, P, Kircher, T, Thalbitzer, J, Jansson, L, Handest, P, Zahavi, D (2005 b). EASE: Examination of Anomalous Self-Experience. Psychopathology 38, 236–258.CrossRefGoogle ScholarPubMed
Parnas, J, Raballo, A, Handest, P, Jansson, L, Vollmer-Larsen, A, Sæbye, D (2011). Self-experience in the early stages of schizophrenia: 5 year follow-up in The Copenhagen Prodromal Study. World Psychiatry 10, 200–204.CrossRefGoogle Scholar
Phillips, LJ, McGorry, PD, Yung, AR, McGlashan, TH, Cornblatt, B, Klosterkotter, J (2005). Prepsychotic phase of schizophrenia and related disorders: recent progress and future opportunities. British Journal of Psychiatry Supplement 48, S33–S44.CrossRefGoogle ScholarPubMed
Poulton, R, Caspi, A, Moffitt, TE, Cannon, M, Murray, R, Harrington, H (2000). Children's self-reported psychotic symptoms and adult schizophreniform disorder: a 15-year longitudinal study. Archives of General Psychiatry 57, 1053–1058.CrossRefGoogle ScholarPubMed
Raballo, A, Parnas, J (2011). The silent side of the spectrum: schizotypy and the schizotaxic self. Schizophrenia Bulletin 37, 1017–1026.CrossRefGoogle ScholarPubMed
Raballo, A, Parnas, J (2012). Examination of anomalous self-experience: initial study of the structure of self-disorders in schizophrenia spectrum. Journal of Nervous and Mental Disease 200, 577–583.CrossRefGoogle ScholarPubMed
Raballo, A, Saebye, D, Parnas, J (2011). Looking at the schizophrenia spectrum through the prism of self-disorders: an empirical study. Schizophrenia Bulletin 37, 344–351.CrossRefGoogle ScholarPubMed
Sass, LA, Parnas, J (2003). Schizophrenia, consciousness, and the self. Schizophrenia Bulletin 29, 427–444.CrossRefGoogle ScholarPubMed
Schultze-Lutter, F, Ruhrmann, S, Berning, J, Maier, W, Klosterkotter, J (2010). Basic symptoms and ultrahigh risk criteria: symptom development in the initial prodromal state. Schizophrenia Bulletin 36, 182–191.CrossRefGoogle ScholarPubMed
Simon, AE, Dvorsky, DN, Boesch, J, Roth, B, Isler, E, Schueler, P, Petralli, C, Umbricht, D (2006). Defining subjects at risk for psychosis: a comparison of two approaches. Schizophrenia Research 81, 83–90.CrossRefGoogle ScholarPubMed
Warner, R (2005). Problems with early and very early intervention in psychosis. British Journal of Psychiatry Supplement 48, S104–S107.CrossRefGoogle ScholarPubMed
Watson, D, Clark, LA (1991). The Mood and Anxiety Symptoms Questionnaire. University of Iowa Department of Psychology: Iowa City.Google Scholar
Wigman, JT, Vollebergh, WA, Raaijmakers, QA, Iedema, J, Van Dorsselaer, S, Ormel, J, Verhulst, FC, Van Os, J (2011). The structure of the extended psychosis phenotype in early adolescence – a cross-sample replication. Schizophrenia Bulletin 37, 850–860.CrossRefGoogle ScholarPubMed
Woods, SW, Addington, J, Cadenhead, KS, Cannon, TD, Cornblatt, BA, Heinssen, R, Perkins, DO, Seidman, LJ, Tsuang, MT, Walker, EF, McGlashan, TH (2009). Validity of the prodromal risk syndrome for first psychosis: findings from The North American Prodrome Longitudinal Study. Schizophrenia Bulletin 35, 894–908.CrossRefGoogle ScholarPubMed
Yung, AR, Buckby, JA, Cotton, SM, Cosgrave, EM, Killackey, EJ, Stanford, C, Godfrey, K, McGorry, PD (2006 a). Psychotic-like experiences in nonpsychotic help-seekers: associations with distress, depression, and disability. Schizophrenia Bulletin 32, 352–359.CrossRefGoogle ScholarPubMed
Yung, AR, McGorry, PD (1996). The initial prodrome in psychosis: descriptive and qualitative aspects. Australian and New Zealand Journal of Psychiatry 30, 587–599.CrossRefGoogle ScholarPubMed
Yung, AR, Phillips, LJ, Yuen, HP, Francey, SM, McFarlane, CA, Hallgren, M, McGorry, PD (2003). Psychosis prediction: 12-month follow up of a high-risk (“prodromal”) group. Schizophrenia Research 60, 21–32.CrossRefGoogle ScholarPubMed
Yung, AR, Stanford, C, Cosgrave, E, Killackey, E, Phillips, L, Nelson, B, McGorry, PD (2006 b). Testing the ultra high risk (prodromal) criteria for the prediction of psychosis in a clinical sample of young people. Schizophrenia Research 84, 57–66.CrossRefGoogle Scholar
Yung, AR, Yuen, HP, Berger, G, Francey, S, Hung, TC, Nelson, B, Phillips, L, McGorry, P (2007). Declining transition rate in ultra high risk (prodromal) services: dilution or reduction of risk? Schizophrenia Bulletin 33, 673–681.CrossRefGoogle ScholarPubMed
Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'olio, M, Francey, SM, Cosgrave, EM, Killackey, E, Stanford, C, Godfrey, K, Buckby, J (2005). Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Australian and New Zealand Journal of Psychiatry 39, 964–971.CrossRefGoogle ScholarPubMed