Schizophrenia research
January 1, 2014
Louis A Sass
216 citations
The ipseity-disturbance or self-disorder hypothesis proposes that a disruption of minimal or core self-experience is central to schizophrenia. This paper reviews and refines that model, recommending research into what is distinctive about the schizophrenia spectrum, the internal structure of self-disturbance, and testable pathways for pathogenesis and therapy. Exploratory comparisons of self-anomalies in mania, psychotic depression, depersonalization disorder, and intense introspection found similarities—such as alienation of thoughts and bodily experiences, fading of self and world—but also key differences: outside schizophrenia, severe erosion of minimal self-experience or confusion of self and other was absent. These findings support and refine the model. Future work should treat self-experience as an independent variable to study its links with cognition, affect, expression, and neural functioning.
Schizophrenia research
December 1, 2015
Louis A Sass, Juan P Borda
44 citations
Schizophrenia involves a core disturbance in the sense of self (disturbed ipseity), which can be traced to a primary disruption in how the brain integrates perceptions from different senses (perceptual dys-integration). This article describes secondary phenomenological alterations that arise either as downstream consequences of that primary disruption or as defensive compensations. These include heightened self-consciousness (hyperreflexivity), a diminished sense of self-presence, and a weakened grip on one's field of awareness. These secondary experiences vary greatly between individuals and over time, and they become more pronounced in adolescence due to developing prefrontal lobe capacities. This variability may explain much of the clinical diversity in schizophrenia while still pointing to a common underlying disturbance.
Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists
August 1, 2025
Vera A Barata, Suzie Lavoie, Łukasz Gawęda et al.
3 citations
Among 43 individuals at ultra-high risk for psychosis, those who later remitted had lower baseline levels of basic self-disturbance than those whose symptoms persisted or who transitioned to psychosis. Basic self-disturbance scores predicted worse clinical outcomes at 12 months. Source monitoring deficits were greater in first-episode psychosis patients than in those at ultra-high risk whose symptoms persisted or transitioned. The findings suggest that high levels of basic self-disturbance may serve as a predictor of poor prognosis in ultra-high risk patients.