Anomalies of Self in First-Episode Psychosis

Psychotic disorders are devastating illnesses that impact countless people worldwide, and a mounting body of empirical evidence promotes the importance of early intervention in psychosis for improving outcomes for young people living with these disorders. In particular, studies aimed at understanding the interactions between symptoms, functioning, and recovery amongst those early in the course of illness (i.e., first-episode psychosis) have become more prevalent. Despite these efforts, there is still much we don’t understand about the underpinnings of psychotic disorders. Though traditional approaches to the study of psychiatric disorders have focused primarily on symptoms and behavioral indicators of functioning (e.g., vocational status, social activities), an increasing number of researchers are adopting phenomenological approaches in order to understand how experiential aspects of psychosis may improve our understanding of these disorders. An accumulating literature suggests that anomalies in the sense of self that accompany psychosis provide a particularly important source of clinical information. Despite this insight, research on anomalies of self in psychotic disorders - and particularly first-episode psychosis - remains relatively limited, likely due in part to the inherent difficulties of assessing subjective constructs in empirical designs. In this review, theoretical models of self relevant to the understanding of anomalies of self in psychosis are discussed and the available literature is reviewed within this framework. Implications for the treatment of psychotic disorders as well as suggestions for future research are also discussed.