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

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

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.

Study Overview

• Status: Completed
• Conditions: Psychotic Disorders; Schizophrenia; Self

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.

• Study Type: Observational
• Enrollment (Actual): 85

Contacts and Locations

Study Locations

• Spain
  • Barcelona
    • Sant Boi De Llobregat, Barcelona, Spain
      • Parc Sanitary Sant Joan de Déu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 60 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients recruited from the community, suffering schizophrenia and related disorder

Description

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

Study Plan

How is the study designed?

What is the study measuring?

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

Collaborators and Investigators

• Sponsor: University of Barcelona
• Collaborators: Parc Sanitari Sant Joan de Déu; Agència de Gestió d'Ajuts Universitaris i de Recerca, Catalunya, Spain; Ministerio de Educación y Formación Profesional, Spain
• Investigators: Principal Investigator: Helena García-Mieres, MsC, Universitat de Barcelona & Parc Sanitari Sant Joan de Déu; Study Director: Susana Ochoa, PhD, Parc Sanitari Sant Joan de Déu; Study Director: Guillem Feixas, PhD, University of Barcelona

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2016
• Primary Completion (Actual): November 1, 2018
• Study Completion (Actual): November 1, 2018

Study Registration Dates

• First Submitted: January 22, 2019
• First Submitted That Met QC Criteria: January 25, 2019
• First Posted (Actual): January 29, 2019

Study Record Updates

• Last Update Posted (Actual): January 29, 2019
• Last Update Submitted That Met QC Criteria: January 25, 2019
• Last Verified: January 1, 2019

More Information

Terms related to this study

• Keywords: personal identity; personal constructs
• Additional Relevant MeSH Terms: Schizophrenia Spectrum and Other Psychotic Disorders; Schizophrenia; Psychotic Disorders; Mental Disorders
• Other Study ID Numbers: FPU15/01721

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No