Minimal Self and Timing Disorders in Schizophrenia: A Case Report

Area of Science:

• Psychiatry
• Cognitive Neuroscience
• Psychopathology

Background:

• Phenomenological psychiatry links consciousness temporality distortions to pre-schizophrenia experiences and self disturbances.
• Timing deficits are hypothesized to be a core psychopathology in schizophrenia, potentially amenable to cognitive remediation.
• Assessing timing impairments individually is crucial for targeted interventions, yet standardized methods are lacking.

Observation:

• A case study of a 22-year-old male with schizophrenia (AF), off antipsychotics, reported significant subjective difficulties with self and time perception.
• AF exhibited minimal positive/negative symptoms and normal neurocognitive assessment but high levels of Minimal Self Disorders (SDs).
• AF demonstrated a rare capacity to articulate his subjective experiences of altered self and time.

Findings:

• Objective assessment using a variable foreperiod task revealed temporal impairments in AF, including difficulty utilizing time passage for event anticipation.
• AF showed deficits in benefiting from temporal cues and adapting to changing time delays.
• These timing impairments were significant enough for individual-level analysis, supporting their clinical relevance.

Implications:

• Individual-level assessment of timing deficits in schizophrenia is feasible, even in patients with subtle cognitive impairments.
• The findings support the hypothesis connecting minimal self disorders with timing difficulties in schizophrenia.
• Further development of subjective and objective timing investigations is recommended for clinical generalization.