Improving access to evidence‐based interventions for young adolescents: Early Adolescent Skills for Emotions (EASE)

105 tal stimuli (in other words, excessive attention to information that is irrelevant or highly familiar), leading to an unusual salience of stimuli. There is strong face validity that the phenomenological disturbances which might arise from (and in turn consolidate) these neurocognitive disturbances accord with many of the experiential alterations associated with basic self disturbance (e.g., diminished “ownership” of mental content, confusion of self-other boundaries, hyper-reflexivity). We tested this model empirically in 50 ultra-high risk for psychosis subjects, 39 first-episode psychosis patients and 34 healthy controls. Participants were assessed with a variety of clinical measures, including the Examination of Anomalous Self-Experience (EASE), and neurocognitive and neurophysiological measures of source monitoring deficits (Action Memory Task, Word Recognition Test, Temporal Binding Task, Auditory Button-Press Task) and aberrant salience (Salience Attribution Test, Babble Task, Auditory Oddball Paradigm). Linear regression indicated that source monitoring (composite score across neurocognitive and neurophysiological measures), with study group as an interaction term, explained 39.8% of the variance in EASE scores (R=.41, F(3,85)=14.78, p<0.001). Source monitoring significantly predicted EASE scores (β=.80, p<0.001), and there was a significant source monitoring by study group interaction effect (β=.29, p<0.05). In order to determine the specificity of the relationship between source monitoring deficits and EASE scores, a series of regressions with other clinical scales as dependent variables were performed. Although source monitoring was found to significantly predict variance in scores on each of these clinical measures, the variance explained was not as substantial as for the EASE scale: 25% for Brief Psychiatric Rating Scale (BPRS) scores (R=.25, F(3,85)=9.01, p<0.01); 19% for BPRS positive symptoms (R=.19, F(3,85)=6.69, p<0.01); 26% for Comprehensive Assessment of At Risk Mental States (CAARMS) positive symptoms (R=.26, F(3,85)=9.45, p<0.01); 14% for Scale for the Assessment of Negative Symptoms (SANS) scores (R=.14, F(3,85)=4.71, p<0.01). The same analysis was performed with the aberrant sa lience composite score. This score explained only 6% of the variance in EASE scores (R=.06, F(3,85)=1.44, p=0.93). However, ex ploratory analyses indicated moderate relationships between aberrant salience, particularly the Babble task, and general psychopathology (BPRS score in first-episode psychosis patients, r=.44, p<0.05), particularly with positive psychotic symptoms (BPRS positive symptoms in first-episode psychosis patients, r=.53, p<0.01; CAARMS positive symptoms in ultra-high risk subjects, r=.44, p<0.01). This is the first empirical test of a neurophenomenological model organized around the construct of basic self disturbance. Partial support for the model emerged: there was a significant relationship between basic self disturbance and source monitoring deficits, while no relationship was found with aberrant salience, which was moderately related to general psychopathology, particularly positive psychotic symptoms (and is therefore possibly more a state-based feature of the illness). The model may need to be expanded from source monitoring deficits to encompass other constructs that recent theoretical and empirical work suggests may be relevant, such as disturbed temporal processing, intermodal/multisensory integration, and hierarchical predictive processing. These are overlapping constructs and it is yet to be determined if one or several of these constructs have causal or explanatory primacy with regard to basic self disturbance. The current data and other related recent research show an emerging picture of neurocognitive and neurophysiological correlates of core phenomenological aspects of schizophrenia spectrum disorders beyond surface-level episodic psychotic symptoms. Pursuing this approach offers the possibility of integrating levels of research around central features of the schizophrenia spectrum and of “mutual enlightenment” between these different levels of enquiry.