Abstract
The contemporary approach to detecting and studying schizophrenia, known as operational psychiatry, reduces the disease to a list of perceived and inferred signs and symptoms. Advocates of the phenomenological approach to psychiatry, however, argue that schizophrenia is a self-disorder that has a long traceable trajectory that goes back as early as a patient's childhood and precedes clinical symptoms.
If schizophrenia is a disorder of the self, then the basic self and the more advanced narrative self should be relatively impaired among those who have not experienced clinical symptoms but have an elevated risk for schizophrenia. Therefore, my overarching goal was to understand the association of self-disturbance with psychometric risk for schizophrenia (i.e., schizotypy). I undertook three studies of undergraduates, who were classified as either schizotypes (n = 39) or non-schizotypes (n = 41). These volunteers were identified from a screened pool of n = 310 undergraduates who had completed the Schizotypal Personality Questionnaire.
The aim of the first study was to examine whether schizotypes have a weaker sense of basic self than non-schizotypes. Results showed significant differences between the schizotypy and the control groups in subjective (basic symptoms and ego strength) and objective (pronoun use) measures of the basic self. Together the findings indicated that schizotypy is associated with a weak sense of basic self.
The aim of the second study was to examine the development of the narrative sense of self by examining the ways schizotypes narrate their past and imagine their future. Compared with non-schizotypes, in their past narratives, schizotypes demonstrated lower levels of self-mastery and overall agency, tended towards a lower level of overall causal coherence, and focused more on relationships. In their future narratives, schizotypes used significantly fewer words and included fewer references to leisure and occupation, and fewer future goals, than non-schizotypes. Higher levels of agency and causal coherence, as well as a greater number of words in the past narrative, were associated with a positive valence, greater number of goals, and a greater number of words in the future narrative.
The aims of the third study were first, to replicate previous evidence of an association between schizotypy and poor adjustment to tertiary study; and second, to determine the role of the basic and narrative selves in students’ emotional and academic adjustment. Results showed that schizotypes had significantly lower emotional and academic adjustment scores. The basic sense of self explained their levels of emotional and academic adjustment, but not social adjustment. The narrative self did not explain any of the adjustment scores.
The findings suggest that there are differences in sense of self in people at high risk for schizophrenia. The basic and the narrative senses of self are somewhat impaired in schizotypes as compared with non-schizotypes. Individuals experiencing these abnormalities are likely to struggle more, academically and emotionally, than their peers in adjusting to university life. It would require a developmental study to establish the causality between abnormalities in the self and schizophrenia risk. Furthermore, future research is required to determine whether the abnormalities in the self predict transition to schizophrenia.