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.
Aberrant salience (AS) and psychotic-like experiences (PLEs) are linked, and anxiety is common in psychosis-prone individuals and patients. In a study of 163 healthy controls and 44 psychotic patients, AS correlated with more frequent positive PLEs and higher anxiety in both groups. However, the frequency of positive PLEs mediated the relationship between AS and anxiety only among controls, not patients. The authors suggest that in patients, a progressive loss of novelty and insight may impair emotional reactivity to PLEs and the ability to recognize bodily phenomena as anxiety, explaining the difference.