École doctorale 450, centre de recherches psychanalyse, médecine et société, université Paris-Cité, Paris, France. Electronic address: florestan.delcourt@etu.u-paris.fr.
Disturbances of the self in schizophrenia are often described at two levels: a pre-reflective, minimal sense of self and a reflective, narrative self. This integrative review examines how these two levels may be linked. Three theoretical models are presented: the Structural model, which suggests minimal self-disorders hierarchically cause narrative disturbances and the schizophrenia phenotype; the Dialectical model, which emphasizes reciprocal interactions between the two levels with both pathogenic and salutogenic effects; and the Contextual model, which considers social, territorial, and biological dimensions. Empirical studies directly testing these links are scarce and preliminary. The literature suggests promising directions for future research and clinical applications.
A French translation of the Examination of Anomalous Fantasy and Imagination (EAFI) is presented, along with an introduction to the phenomenology of imagination and its experiential alterations. The EAFI's interrater reliability was tested in a diagnostically heterogeneous sample of 20 inpatients, yielding agreement from 0.6 to 1.0 with an average κ of 0.84, and internal consistency (Cronbach's α) above 0.88. The anomalies of imagination explored by the EAFI are suggested to reflect an alteration of the structure of consciousness and belong to a fundamental, generative layer of psychopathology, with potential relevance for differential diagnosis, especially in first-contact patients.