Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
Psychiatry. 2012 Fall;75(3):285-97. doi: 10.1521/psyc.2012.75.3.285.
The manifestation, course, and prognosis of schizophrenia are extremely variable, raising an interest in the role of personality and self-concept in the illness' outcome. Building on voluminous research attesting to the fragility and instability of the self in schizophrenia, we examined the role of four self-concept aspects--self-esteem level, self-esteem instability, self-concept clarity, and the perception of the self as ill--in schizophrenia-spectrum disorders. Eighty-nine outpatients were assessed at baseline, and five days subsequently, regarding these self-concept aspects, symptoms, stress, and quality of life. Six weeks later, participants were again assessed using the baseline battery. Self-esteem instability predicted a decrease in quality of life over the study period. Self-concept clarity predicted an increase in quality of life and in positive symptoms, particularly under low stress. Depressive symptoms predicted a decrease in self-esteem levels and an increase in the perception of the self as ill. Thus, all four self-concept aspects were shown to be pertinent to the experience of schizophrenia, albeit in different ways. Special attention should be directed to self-concept clarity, which embeds both risk and resilience.
精神分裂症的表现、病程和预后差异极大，这引起了人们对人格和自我概念在疾病结局中的作用的兴趣。基于大量研究证明精神分裂症患者的自我具有脆弱性和不稳定性，我们研究了自我概念的四个方面——自尊水平、自尊不稳定性、自我概念清晰度和自我感知患病——在精神分裂症谱系障碍中的作用。 89 名门诊患者在基线时和随后的第 5 天接受了这些自我概念方面、症状、压力和生活质量的评估。6 周后，参与者再次使用基线测试包进行评估。自尊不稳定性预示着研究期间生活质量的下降。自我概念清晰度预示着生活质量和积极症状的提高，特别是在低压力下。抑郁症状预示着自尊水平的下降和自我感知患病的增加。因此，所有四个自我概念方面都与精神分裂症的体验有关，尽管方式不同。应特别关注自我概念清晰度，它既包含风险又包含恢复力。
