The neurophenomenology of basic self-disturbance in early psychosis: Association with clinical outcome in an ultra-high risk sample.
Vera A Barata, Suzie Lavoie, Łukasz Gawęda, Emily Li, Louis A Sass, Danny Koren, Patrick D Mcgorry, Bradley N Jack, Josef Parnas, Andrea Polari, Kelly Allott, Jessica A Hartmann, Marija Krcmar, Andreas R Rasmussen, Thomas J Whitford, Cassandra Mj Wannan, Barnaby Nelson
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists August 1, 2025 Peer reviewed DOI: 10.1177/10398562251346619 via PubMed
Summary
People at ultra-high risk for psychosis who had stronger basic self-disturbance (a feeling of altered self-experience) were more likely to have persistent symptoms or transition to psychosis over 12 months. Among those at ultra-high risk, self-disturbance scores predicted worse outcomes. Source monitoring deficits (difficulty distinguishing self-generated from external information) were more pronounced in first-episode psychosis than in ultra-high risk cases. Aberrant salience did not show a relationship with self-disturbance.
Study at a glance
| Design | observational cohort |
|---|---|
| Sample size | 43 |
| Population | ultra-high risk for psychosis individuals |
| Key finding | Higher baseline basic self-disturbance scores predicted worse clinical outcomes at 12-month follow-up in the ultra-high risk group. |
Abstract
IntroductionWe previously proposed a neurophenomenological model of schizophrenia, linking basic self-disturbance with neural deficits of source monitoring and aberrant salience. Baseline comparisons in ultra-high risk (UHR) and first-episode psychosis (FEP) samples indicated a relationship between basic self-disturbance and source monitoring deficits, but not aberrant salience. The current paper reports on the 12-month follow-up results in the UHR group (n = 43), focusing on the association between baseline variables and clinical outcomes.MethodsOne-way ANOVA compared UHR-remitters (n = 18), UHR-persistent/transitioned to psychosis cases (n = 25) and FEP (n = 38) groups on baseline clinical and neuro-measures. Logistic regression assessed the baseline variables' predictive power for UHR outcomes.ResultsHigher baseline self-disturbance scores (EASE total) were found in the UHR persistence/transition and FEP groups compared to the UHR-remission group, and predicted worse UHR clinical outcomes. Source monitoring deficits were higher in FEP individuals compared to those with UHR persistence/transition.ConclusionHigh levels of basic self-disturbance may be a useful predictor marker of poor prognosis in UHR patients.