Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Barcelona, Spain.
Parc Sanitari Sant Joan de Déu, Barcelona, Spain.
Clin Psychol Psychother. 2019 Nov;26(6):717-733. doi: 10.1002/cpp.2394. Epub 2019 Aug 26.
Current research and clinical practice in person-centred approaches highlight the importance of self, identity, and personal meanings in psychosis. Previous research has focused on dimensions of self, but less attention has been paid to the personal meanings involved in identity. The personal construct theory framework and the repertory grid technique (RGT) allow the study of identity and personal meanings within person-centred approaches of psychopathology and treatment in psychosis, as suggested by studies that began more than 40 years ago. However, their contributions have not yet been reviewed. We aimed to systematically review the evidence for the role of identity and personal meanings in psychotic disorders. We performed a systematic search using personal construct and RGT terms in PsycINFO, Web of Science, PubMed, EBSCO, Scopus, and Google Scholar. After identifying 2,574 articles, 15 were included. Nine studies followed an idiographic assessment, and six were nomothetic. Patients reported their subjective experience of isolation in terms of high self-ideal discrepancy and high perceived discrepancy with their significant others, which some studies associated with a lower degree of recovery or with the way in which positive symptoms were construed. Self-fragmentation either decreased with interventions or was associated with recovery. Evidence regarding interpersonal construing was less consistent, but there was a tendency for patients to show a more rigid cognitive structure than controls. To conclude, we found some evidence that self-discrepancies, fragmentation of self, and interpersonal construing are affected in psychosis and potentially modifiable through psychotherapy.
目前，以患者为中心的方法在医学专业文献中的研究和临床实践强调了自我、身份和个人意义在精神病学中的重要性。以前的研究主要集中在自我的维度上，但对身份所涉及的个人意义关注较少。个人建构理论框架和纲要技术（RGT）允许在精神病学的以患者为中心的方法和治疗中研究身份和个人意义，正如 40 多年前开始的研究所表明的那样。然而，它们的贡献尚未得到审查。我们旨在系统地回顾身份和个人意义在精神病障碍中的作用的证据。我们使用个人建构和 RGT 术语在 PsycINFO、Web of Science、PubMed、EBSCO、Scopus 和 Google Scholar 中进行了系统搜索。在确定了 2574 篇文章后，有 15 篇被纳入。其中 9 项研究采用了个体化评估，6 项研究采用了概念化评估。患者报告了他们在自我理想差异和与重要他人感知差异方面的孤立主观体验，一些研究将这种差异与较低的康复程度或阳性症状的构建方式联系起来。自我分裂要么随着干预而减少，要么与康复有关。关于人际构建的证据不太一致，但患者的认知结构比对照组更僵化。总之，我们发现一些证据表明，自我差异、自我分裂和人际构建在精神病中受到影响，并可能通过心理治疗来改变。
