Basic self-disturbance is a potential core vulnerability marker for schizophrenia spectrum disorders. The Self, Neuroscience and Psychosis (SNAP) study tests a neurophenomenological model of psychosis by examining clinical, neurocognitive, and neurophysiological variables in individuals at ultra-high risk (UHR) for psychosis. It includes 400 UHR individuals, 100 clinical controls without attenuated psychotic symptoms, and 50 healthy controls. Participants complete baseline assessments and electroencephalography; UHR participants are followed for 24 months with clinical assessments every 6 months. The protocol aims to develop a prediction model for persistence or worsening of UHR symptoms at 12 months and to determine how specific these disturbances are to attenuated psychotic symptoms.
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.