From Experience to Symptoms: A Multilayer Hierarchy of Psychopathological Dimensions in Schizophrenia

The psychopathology of schizophrenia is a complex amalgamation of features that span across different dimensions. These dimensions range from the experience of altered time and space through self-disorders to perceptual, positive, and negative symptoms. The relationship between these different psychopathological dimensions remains unclear. Addressing this gap was the aim of our study.

We collected data on schizophrenia spectrum disorder at three medical expert centers, via semi-structured phenomenological interviews, consisting of the Scale for Space and Time Experience in Psychosis (STEP), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and, for a subset of these data, the Examination of Anomalous Self-Experience (EASE), and the perceptual domain of the Bonn Scale for the Assessment of Basic Symptoms (BSABS or BONN). Various state-of-the-art statistical methods, including network and mediation analyses, were used to investigate the relationships between these psychopathological dimensions.

We found a relationship between altered time and space experiences (STEP) and both general symptoms (PANSS) and the basic self-disorders (EASE).

Our various network and mediation analyses show that the basic self-disturbance is a key node in mediating the impact of the more fundamental time and space disturbances on both perceptual changes, and negative, positive, and general symptoms.