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Adjudication committee
- First opponent: Professor Matthew Broome, University of Birmingham, UK
- Second opponent: Specialist in Psychology Erling Inge Kvig, Nordland Hospital
- Third member and chair of the evaluation committee: Associated Professor Anne Margrethe Myhre, University of Oslo
Chair of the Defence
Professor Lars Mehlum, University of Oslo
Summary
Anomalous self-experiences, involving a disturbed sense of identity and “ownership” to experiences, may constitute predictors of outcomes in clinical high-risk of psychosis (CHR-P) individuals. The overall aim of this thesis was to investigate such phenomena in a CHR-P sample, and relationships with conventional symptoms, diagnoses, present and childhood functioning, and childhood trauma, at baseline and after one year.
The 38 participants (age: 15-29) were included according to criteria in the Structured Interview for Prodromal Syndromes (SIPS), and underwent clinical assessments, including the Examination of Anomalous Self-Experience (EASE) at both time points. In the one-year follow-up, 32 of the 38 participated. Three studies had cross-sectional descriptive-correlational and/or prospective designs. One study was a qualitative, phenomenologically oriented comparison of anomalous self-experiences and other clinical characteristics in two selected participants.
At baseline, higher total EASE levels were associated with more severe negative symptoms and cognitive disturbances. Baseline total EASE levels predicted severity of positive symptoms and dysfunctioning at the one-year follow-up, and correlated strongly with follow-up negative and disorganization symptoms. EASE levels were not significantly associated with background factors. Cross-sectional analyses revealed higher EASE levels in subjects with schizophrenia spectrum disorders at baseline or follow-up. High EASE levels at follow-up were associated with a more severe clinical profile, even in subjects not developing psychosis.
In conclusion, the studies demonstrated that anomalous self-experience may constitute markers in clinical high-risk of psychosis for adverse clinical and functional outcomes, also in subjects not developing psychosis. Exploring self-experiences is also important to strengthen clinical understanding and guide therapeutic interventions.
Additional information
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