Uncanny Mirroring: A Developmental Perspective on the Neurocognitive Origins of Self-Disorders in Schizophrenia

Varieties of anomalous subjective experiences, i.e. "basic self-disorders" (SDs), have been empirically demonstrated as core clinical features of schizophrenia spectrum disorders, predating full-blown psychotic symptoms. However, the clinical stage in which SDs emerge and their putative neurocognitive origins remain unsolved issues. Focusing on a prototypical anomalous mirror experience (i.e., a stable, trait-like subjective feeling of nonexisting while looking at oneself in the mirror) reported by an 11-year-old boy at familial high risk for schizophrenia and diagnosed as attenuated psychosis syndrome, we outline some possible developmental pathways leading to SDs. Such pathways are hypothesized in accordance with the documented early impairments in perceptual integration across distinct modalities in children at risk for schizophrenia spectrum disorders and to the specific features of mirror experience as provided by phenomenological and developmental psychology perspectives. We conclude that SDs could presumably have an early developmental origin, although children become progressively more aware of them. Although further hypothesis testing in clinical samples and longitudinal empirical investigation of at-risk children is badly needed, we propose that age-appropriate, phenomenologically oriented assessment of SDs could be useful for the early identification of psychotic risk.