Anomalies of imagination and development of psychosis: A phenomenological account.
Schizophrenia research February 1, 2024 Peer reviewed DOI: 10.1016/j.schres.2023.12.024 via PubMed
Summary
Disturbances of imagination, discussed in 20th-century psychiatry regarding schizophrenia, have largely vanished from mainstream psychopathology. Recent work suggests these phenomena matter for differential diagnosis and early psychosis detection. This paper reviews historical literature and neurocognitive studies on imagination disturbances in schizophrenia, then discusses empirical investigations of subjective anomalies of imagination in schizophrenia-spectrum disorders. These anomalies link to disturbances of basic self. Patients' descriptions indicate that increased spatial articulation and instability of first-personal imaginative experience can contribute to delusions and hallucinations. A potential link to source monitoring deficits is also discussed.
Study at a glance
| Design | theoretical or philosophical paper |
|---|---|
| Key finding | Subjective anomalies of imagination, linked to basic self-disturbances, may play a role in the emergence of delusions and hallucinatory phenomena in schizophrenia-spectrum disorders. |
Abstract
In 20th century psychiatry, various disturbances of imagination were discussed in the context of schizophrenia. Today, these notions have almost completely vanished from mainstream psychopathology. However, recent work has suggested that specific phenomena within this area have a relevance for differential diagnosis and early detection of psychosis. This paper first provides an overview of 20th century psychopathological literature, as well as more recent neurocognitive studies, addressing disturbances of imagination and their role for symptom formation in schizophrenia. It then discusses recent empirical investigations of subjective anomalies of imagination in schizophrenia-spectrum disorders and suggests a clinical-phenomenological account of their role in the development of psychotic symptoms. Empirically and conceptually, these subjective anomalies are linked with disturbances of basic self. Patients' descriptions of the development of their anomalous experiences and symptoms indicate that increased spatial (object-like) articulation and instability of the first-personal manifestation of imaginative experience can be involved in the emergence of delusions and hallucinatory phenomena. Finally, a potential link between subjective anomalies of imagination and the neurocognitive construct of source monitoring deficits is discussed.