Self-disorders and the experiential core of schizophrenia spectrum vulnerability

An increasing amount of empirical studies demonstrates that anomalies of self-experience (self-disorders) are characteristic of schizophrenia and related spectrum conditions, indicating that self-disorders (SDs) are likely to constitute important vulnerability phenotypes. On a clinical level, SDs are non-psychotic alterations of subjective experience that include disturbances of self-awareness (e.g., fading first-person perspective, waning sense of basic identity, depersonalization and hyperreflectivity), autopsychic disorders (e.g., thought pressure or block, perceptualization of mental stream and spatialization of thoughts), loss of common sense (e.g., perplexity), and existential alterations (e.g., solipsistic grandiosity). Such experiences, define essential aspects of the clinical expressions of schizophrenia lending psychopathological coherence to its spectrum manifestations. Furthermore the experiential nature of SDs makes them amenable to the patient's introspection which can be elicited in the dialogical context of the psychiatric interview with important implication for the therapeutic relation. The aim of this presentation is to illustrate the phenomenological core of these experiential anomalies, emphasizing their topicality for the exploration of vulnerability to schizophrenia spectrum conditions and their coherence with the overall clinical picture.