Allé M C, d'Argembeau A, Schneider P, Potheegadoo J, Coutelle R, Danion J-M, Berna F
INSERM U-1114, 1 place de l'Hôpital, Clinique Psychiatrique, Strasbourg Cedex, France; Université de Strasbourg, Strasbourg, France; FMTS: Fédération de Médecine Translationnelle de Strasbourg, Strasbourg, France.
Department of Psychology - Cognition and Behavior, University of Liège, Liège, Belgium; Cyclotron Research Centre, University of Liège, Liège, Belgium.
Compr Psychiatry. 2016 Aug;69:53-61. doi: 10.1016/j.comppsych.2016.05.001. Epub 2016 May 6.
Disorders of the self, such as a reduced sense of personal continuity in time, are a core symptom of schizophrenia, but one that is still poorly understood. In the present study, we investigated two complementary aspects of self-continuity, namely phenomenological and narrative continuity, in 27 patients with schizophrenia, and compared them with 27 control participants.
Participants were asked to identify important past events and to narrate a story from their life that included these events. They were also asked to imagine important events that might happen in their personal future and to build a narrative of their future life. The vividness of these important life events and the proportion of self-event connections in the narratives were used as a measure of phenomenological and narrative continuity, respectively.
Our study showed patients with schizophrenia experienced less vivid representations of personally significant events (p = .02) for both temporal directions (past and future) (p < .001). In addition, their ability to make explicit connections between personal events and self-attributes in life narratives was also impaired (p = .03), but only in the case of past narratives (p < .001).
These results shed new light on the cognitive mechanisms underlying self-disorders in schizophrenia. The clinical and therapeutic implications of these findings are discussed.
自我障碍，如时间上个人连续性的降低，是精神分裂症的核心症状，但仍未得到充分理解。在本研究中，我们调查了27名精神分裂症患者自我连续性的两个互补方面，即现象学连续性和叙事连续性，并将他们与27名对照参与者进行了比较。
参与者被要求识别过去的重要事件，并讲述一个包含这些事件的人生故事。他们还被要求想象个人未来可能发生的重要事件，并构建一个关于他们未来生活的叙事。这些重要生活事件的生动程度以及叙事中自我与事件联系的比例，分别被用作现象学连续性和叙事连续性的衡量指标。
我们的研究表明，精神分裂症患者在两个时间方向（过去和未来）上对个人重要事件的生动表征都较少（p = 0.02）（p < 0.001）。此外，他们在生活叙事中明确将个人事件与自我属性建立联系的能力也受损（p = 0.03），但仅在过去叙事的情况下（p < 0.001）。
这些结果为精神分裂症自我障碍的潜在认知机制提供了新的见解。讨论了这些发现的临床和治疗意义。
