Structure of Personal Identity Related to Positive, Negative Symptoms in Psychosis

Psychiatry Advisor Contributing Writer
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blurred image of woman.
blurred image of woman.
In Barcelona, Spain, researchers used the Repertory Grid Technique and cognitive factors to assess personal identity relative to symptoms in outpatients with psychosis with an emphasis on a person-centered approach to schizophrenia.

Interventions that are targeted at improving self-discrepancies, interpersonal dichotomous thinking, interpersonal cognitive differentiation, and interpersonal cognitive richness may be beneficial in the improvement of psychiatric symptoms. A first-of-its-kind study was conducted in Barcelona, Spain, to examine the structure of personal identity relative to positive and negative symptoms among patients with psychosis. Results of the analysis were published in Schizophrenia Bulletin.

The investigators sought to explore the role of distinct dimensions of personal identity within other well-known factors hypothesized in psychological models of psychotic symptoms. They suggested that these dimensions might play different, independent roles in the expression of both positive and negative symptoms. With use of the Personal Construct Theory, they evaluated whether certain dimensions of personal identity, as measured with the Repertory Grid Technique together with other cognitive factors, might influence psychotic symptomatology.

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Regarding the model of positive symptoms, they tested the hypothesis that interpersonal dichotomous thinking is linked directly to positive symptomatology. The researchers also evaluated whether self-discrepancies and depressive symptoms function as direct or indirect predictors of positive symptoms, exploring their associations with cognitive insight or depression. With respect to negative symptoms, they examined the hypothesis that poor structural qualities of the construct system act as a mediator between certain cognitive factors and negative symptomatology.

A total of 85 outpatients with a confirmed diagnosis of a schizophrenia spectrum or related disorder were recruited from 4 mental health centers in Barcelona to participate in the study. All participants completed a repertory grid, an observer-rated interview of psychotic symptomatology, and measures of cognitive insight, neurocognition, depressive symptoms, and theory of mind.

Based on structural equation models, interpersonal dichotomous thinking directly affected positive symptoms among patients with psychosis. Moreover, self-discrepancies affected positive symptoms by the mediation of depressive symptoms. Further, interpersonal cognitive richness and interpersonal cognitive differentiation mediated the effect of neurocognitive deficits and self-reflectivity in negative symptomatology.

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The investigators concluded that the findings from this study demonstrate that these interventions might help patients with psychosis enrich the structure of their personal identity. Such enrichment might be attained by developing the complexity of the representations of self and of others.

Reference

García-Mieres H, Anna Villaplana A, Raquel López-Carrilero R, et al. The role of personal identity on positive and negative symptoms in psychosis: a study using the Repertory Grid Technique [published online July 29, 2019]. Schizophr Bull. doi.org/10.1093/schbul/sbz082