Perception of self and other in psychosis: A method for analyzing the structure of the phenomenology
Received 18 December 2008; accepted 28 December 2008.
Abstract
Although the phenomenology accompanying psychoses is fascinating, hitherto empirical examinations have been qualitative and thus limited in their clinical conclusions regarding the actual underlying cognitive mechanisms responsible for the formation and maintenance of the delusion, which is often distressing to the patient. We investigated the internal cognitive structure (i.e., connections) of some delusions pertaining to self and others in a patient with psychosis who was very fluent and thus able to provide a lucid account of his phenomenological experiences. To this end we employed a clustering method (HICLAS disjunctive model) in conjunction with standard neuropsychological tests. A well-fitting, but parsimonious solution revealed the absence of unique feature sets associated with certain persons, findings that provide a compelling case underlying the confusion in certain instances between real and delusional people. We illustrate the methodology in one patient and suggest that it is sensitive enough to explore the structure of delusions, which in conjunction with standard neuropsychological and clinical assessments promises to be useful in uncovering the mechanisms underlying delusions in psychosis.
aClinical Brain Disorders Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, USA
bDepartment of Psychology, University of Leuven, Belgium
Corresponding author. Clinical Brain Disorders Branch, National Institute of Mental Health, National Institutes of Health, Building 10, Room 4 S235, MSC 1379, Bethesda, MD, USA. Tel.: +1 301 451 2123.