From Experience to Symptoms: A Multilayer Hierarchy of Psychopathological Dimensions in Schizophrenia

Abstract

Introduction: The psychopathology of schizophrenia is a complex amalgamation of features that span across different dimensions. These dimensions range from the experience of altered time and space through self-disorders to perceptual, positive, and negative symptoms. The relationship between these different psychopathological dimensions remains unclear. Addressing this gap was the aim of our study.

Methods: We collected data on schizophrenia spectrum disorder at three medical expert centers, via semi-structured phenomenological interviews, consisting of the Scale for Space and Time Experience in Psychosis (STEP), the Positive and Negative Syndrome Scale for Schizophrenia (PANSS) and, for a subset of these data, the Examination of Anomalous Self-Experience (EASE), and the perceptual domain of the Bonn Scale for the Assessment of Basic Symptoms (BSABS or BONN). Various state-of-the-art statistical methods, including network and mediation analyses, were used to investigate the relationships between these psychopathological dimensions.

Results: We found a relationship between altered time and space experiences (STEP) and both general symptoms (PANSS) and the basic self-disorders (EASE).

Conclusion: Our various network and mediation analyses show that the basic self-disturbance is a key node in mediating the impact of the more fundamental time and space disturbances on both perceptual changes, and negative, positive, and general symptoms.

Keywords: Hierarchy; Phenomenology; Psychopathology; Schizophrenia spectrum disorder; Self-disturbance; Time and space experience.