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

Study Overview
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Brief Summary
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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.

Detailed Description
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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 Positive symptoms will be influenced by dichotomous thinking style and construction of self as measured with the RGT. Negative symptoms will be affected by the richness of the construct system as measured with the RGT.

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

Conditions
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Schizophrenia, Psychotic Disorders, Self

Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

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

Secondary Outcome Measures

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

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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personal identity, personal constructs