The Role of Personal Identity in Psychotic Symptoms: a Study With the Repertory Grid Technique

Overview

Personal identity is being recently recognized as a core element for mental health disorders, with relevant clinical implications. However, scarcity of data exists on its role in schizophrenia and related disorders. The repertory grid (RGT), a technique derived from personal construct theory, has been used in different clinical and non-clinical contexts for the study of the construction perception of self and others, to appreciate aspects of interpersonal construing such as polarization and differentiation (unidimensional thinking) or self-construction.and Our study aims to explore the potential influence of the structure of personal identity and of other relevant cognitive factors (social cognition, metacognition, neurocognition) in positive and negative symptoms in people suffering schizophrenia and related disorders.

Full Title of Study: “Personal Identity, Cognitive Factors and Psychotic Symptoms in Schizophrenia and Related Disorders: A Cross-sectional Study With the Repertory Grid Technique”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Cross-Sectional
  • Study Primary Completion Date: November 2018

Detailed Description

Over recent years, the importance of the sense of self and personal identity in psychopathology and its treatment has been highlighted. Several studies inspired in the Personal Construct Psychology framework have found a variety of identity characteristics in clinical conditions such as depression or eating disorders, but the evidence in schizophrenia and other psychotic related disorders is scarce. In addition, current psychological models of positive and negative symptoms highlight the influence of neurocognition, social cognition and self-concepts in the development and maintenance of psychotic experiences. Despite the recognized need of person-centered approaches to understand psychopathology processes in psychosis, psychological models for explaining psychotic symptoms have not explored sufficiently the role of this kind of person-centered measures. Aim 1. To examine the influence of the structure of personal identity and other relevant cognitive factors in positive and negative symptoms Hypotheses 1. Positive symptoms will be influenced by dichotomous thinking style and construction of self as measured with the RGT. 2. Negative symptoms will be affected by the richness of the construct system as measured with the RGT.

Clinical Trial Outcome Measures

Primary Measures

  • Self-ideal discrepancy, RGT
    • Time Frame: 2 hours
    • Self-esteem. Possible range: 0-0,60. Higher values represent a worse outcome
  • Self-others discrepancy, RGT
    • Time Frame: 2 hours
    • Perceived social isolation. Possible range: 0-0,60. Higher values represent a worse outcome
  • Interpersonal construct differentiation, RGT
    • Time Frame: 2 hours
    • Percentage of Variance Accounted for the First Factor. Possible range: 0-100. Higher values represent a worse outcome
  • Polarization, RGT
    • Time Frame: 2 hours
    • Dichotomous thinking style in the interpersonal context. Possible range: 0-100. Higher values represent a worse outcome
  • Number of elicited constructs, RGT
    • Time Frame: 2 hours
    • Quantity of constructs that the person is able to express to describe self and others. Possible range: 10-50. Higher values represent a better outcome
  • Psychotic symptoms (PANSS, Kay et al. 1987; Peralta & Cuesta, 1994).
    • Time Frame: 40 minutes
    • Positive and negative symptoms of psychosis. Range: 7-112. Higher values represent a worse outcome.
  • Metacognition: BCIS (Beck et al. 2004; Gutiérrez-Zotes et al. 2012); Garety et al, 1991; Dudley et al, 1997)
    • Time Frame: 15 minutes
    • Cognitive insight. Range: 0-45. Higher values represent a better outcome
  • Theory of mind: the Hinting Task (Corcoran et al., 1995; Gil-Sanz et al., 2012)
    • Time Frame: 5 minutes
    • Possible range: 0-12. Higher values represent a better outcome
  • General intellectual functioning (WAIS)
    • Time Frame: 20 minutes
    • vocabulary subscale. Range: 70-140. Higher values represent a better outcome
  • Executive functioning: WSCT (Bergs et al., 1948)
    • Time Frame: 15 minutes
    • Wisconsin Card Sorting Test. Categories completed and perseverative errors. Higher values represent a better outcome

Secondary Measures

  • Sociodemographical data
    • Time Frame: 10 minutes
    • Gender, chronicity, antipsychotic dosage, diagnosis, age, marital status, education level, employment situation
  • Depressive symptoms
    • Time Frame: 10 minutes
    • Beck Depression Inventory (Beck et al. 1996; Sanz, Perdigón & Vázquez, 2003). Range_ 0-63. High values represent a worse outcome.
  • General functioning
    • Time Frame: 5 minutes
    • Global Assessment of Functioning (Endicot et al., 1976). Range: 0-100. Higher values represent a better outcome.
  • Self-esteem
    • Time Frame: 5 minutes
    • Rosenberg self-esteem scale (Martín Albó et al., 2007). Range: 0-40. Higher values represent a better outcome
  • Social functioning
    • Time Frame: 20 minutes
    • Social Functioning Scale (Birchwood et al., 1990; Torres & Olivares, 2000). Range: Range: 45-195
  • Psychological distress
    • Time Frame: 10 minutes
    • CORE-OM (Evans et al., 2002; Trujillo et al., 2016). Range: 0-4. Higher values represent a worse outcome
  • Jumping to Conclusions
    • Time Frame: 15 minutes
    • The beads task (Garety et al., 1991; Dudley et al, 1997). Dichotomous: yes/no. A “yes” represents a worse outcome

Participating in This Clinical Trial

Inclusion Criteria

  • diagnosis of schizophrenia, psychotic disorder not otherwise specified, delusional disorder, schizoaffective disorder, brief psychotic disorder, or schizophreniform disorder – age between 18 and 60 years. – patients from outpatient mental health units Exclusion Criteria:

  • traumatic brain injury, dementia, or intellectual disability (pre-morbid IQ <70) – current substance dependence

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 60 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • University of Barcelona
  • Collaborator
    • Parc Sanitari Sant Joan de Déu
  • Provider of Information About this Clinical Study
    • Principal Investigator: Helena García Mieres, M.Sc., Ph.D. Cand. – University of Barcelona
  • Overall Official(s)
    • Helena García-Mieres, MsC, Principal Investigator, Universitat de Barcelona & Parc Sanitari Sant Joan de Déu
    • Susana Ochoa, PhD, Study Director, Parc Sanitari Sant Joan de Déu
    • Guillem Feixas, PhD, Study Director, University of Barcelona

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