Transcript Introduction

The Self-Schema Stability in Schizophrenia
Marie Boulanger1*, Marie Dethier1, Nathalie Jacob2, Francis Gendre3 & Sylvie Blairy1
1University
of Liege, Belgium,
2
E.D.S. of Paifve, Belgium, 3 University of Lausanne, Suisse
INTRODUCTION
Autonoetic awareness is the kind of awareness experienced by individuals who consciously recollect personal events by reliving them mentally (Danion et al., 2005). The recollection
of the specific details of the encoding context characterizes autonoetic awareness lead to the recall of a specific autobiographical event located in time and space (Blairy et al., 2008).
This kind of consciousness is closely related to the “self” and one’s uniqueness. Autonoetic awareness enables individuals to think about their thoughts, feelings, actions, and social
relationships (Blairy et al., 2008). It makes memories unique and allows individuals to place themselves in the context of their personal life history. Consequently, autonoetic
awareness is also crucial to the construction of personal identity. According to Conway & Pleydell-Pearce (2000) and Danion et al. (2001) the individuals record memories, success
as well as failures in achieving goals, plans and desires of the self. The awareness of these past events enables individuals to built their identity with a view to adapt their future.
Actually it is well established that schizophrenia patients present autonoetic awareness deficits which are linked autobiographical memory impairments (Huron et al., 1995; Huron &
Danion, 2002; Danion et al., 2005).
Nienznanski (2003) showed that self-schema in patients with schizophrenia “experienced their personality as changing over time much more than healthy subjects do. Moreover,
their self-representation seems to be less differentiated from others-representation and less clearly defined than in normal subjects”.
Besides this Nienznanski’s research, few studies have investigated the “self-schema” in schizophrenia patients.
The purpose of this study was to investigate the self stability in schizophrenia.
METHOD
RESULTS
Table 1. Groups comparisons -means(standard deviations)-
Participants
•
•
42 patients (30♂) fulfilled the DSM-IV criteria for
schizophrenia
32 healthy subjects (22♂)
Education Level
Age
Self Stability
 Exclusion criteria for all subjects included (1) alcoholism
or other drug abuse, (2) organic cerebral diseases, (3)
neurological diagnosis.
 Benzodiazepines treatment was controlled.
Depression Symptoms
State Anxiety
Trait Anxiety
Healthy
Subjects
t
11,72 (2,63)
40,72 (11,65)
0,65 (0,30)
14,82 (8,53)
39,48 (11,96)
47,00 (8,58)
11,81 (2,63)
39,88 (12,61)
0,82 (0,17)
6,19 (6,75)
29,04 (6,80)
39,63 (9,75)
0,15
0,29
2,91**
4,60***
3,73***
3,39**
5,20 (1,03)
3,66 (1,20)
5,75 (1,05)
4,97 (1,58)
2,27*
4,00***
86,70 (35,69)
56,13 (19,79)
159,07 (62,60
27,00 (11,02)
62,40 (15,14)
45,26 (7,85)
99,51 (29,42)
35,31 (9,11)
3,60***
2,93**
4,97***
3,44***
Digit Span
Dependant measures
Forwards
1) “Version fonctionnelle unipolaire ultra courte”
(unpublished)
- It is an originally scale from L.A.B.E.L (Gendre et al., 2000)
where the participants can describe themselves;
- 2 parallel versions of the questionnaire that contained 50
adjectives (personality traits) each of them being employed;
- A comparison between the 2 versions allowed to investigate
the stability of the self-schema.
Backwards
Stroop-Color Word Test
Denomination time
Reading time
Interference time
Verbal Fluency Task
Groups comparisons
1. The analyses did not reveal any significant difference
between both groups for age and education levels.
2. “Self Stability”: a significant difference between both
groups emerged (η²=.11) which indicates that the
patients with schizophrenia have a knowledge of
themselves less stable than healthy subjects.
3. The “neuropsychological measures : significant
differences between both groups for all measures
emerged; schizophrenia group deficits on executive
functions compared to control group.
4. Mood measures : significant difference between both
groups emerged ; the patients with schizophrenia
reported more depressive symptoms and anxiety than
healthy subjects.
*p<.05 ; **p<.01 ;*** p<.001
Correlations
2) Executive functions measures
- Digit Span Forwards (Wechsler, 1997);
- Digit Span Backwards (Wechsler, 1997);
- Stroop-Color Word Test (Stroop, 1935);
- Verbal Fluency Task (Benton & Hamsher,
Schizophrenia
Patients
- For all participants: a significant correlation between “self stability” and the Stroop-Color Word Test, interference time (r(72) = -.25, p=.038)
as well as between BDI-II and State Anxiety inventory (r(73) = -.45; p<.001; r(74) = -.26; p=.023, respectively) emerged.
- In the schizophrenia group, a significant correlation between depressive symptoms and stability (r(42) = -.47; p=.002) emerged. This means
that more the patients have reported depressive symptoms less the self is stable. These correlations were missing in control group.
1976).
3) Depression and Anxiety
- Beck Depression Inventory II (Beck, 1996);
- State and Trait Anxiety Inventory (Spielberger,
1983)
 After Parallelism checkout, an ANCOVA analyses was conducted on the score of stability with :
- the score of interference time on Stroop-Color Test.The analyses didn’t reveal any differences between both groups on self stability
variable (F(1,71) = 3,73 ; p=.57); but that difference remained marginally significant.
- the score of State Anxiety Inventory. The difference between both groups on stability variable remained (F(1, 71) = 5.03 ; p=.027).
DISCUSSION
1.
As predicted the results showed that the patients with schizophrenia have impairments on self-schema stability. The stability of schizophrenia group was «average» while the
stability of control group was « high ». These results are in line with Nienznanski (2003) that underlined the poor stability of patients suffering schizophrenia.
2.
The self stability seems to relate with depressive symptoms and anxiety. However the results showed that the difference between groups in terms of self stability remained
despite the control of depressive and anxiety symptoms.
3.
The self stability seems closely associated with executive functions. That result isn’t surprising. Indeed, according to Raes et al. (2006), the autobiographical memory (AM) is
related to executive functioning. In view of the links between AM and self, we can suppose that the identity or identity construction are also supported by the executive functions.
Consequently, the representation of self-schema in schizophrenia seems to be deficient. We can expect that the consolidation of the material that constitutes the self
could help to prevent the development of the schizophrenia disorder or to reduce the handicap. The development of “self remediation therapy” could be a useful
additional intervention for schizophrenia patients.
*Correspondence to adress to Marie Boulanger,
Departement of Cognitive Science, University of Liège,
Boulevard du Rectorat 3 (B33), 4000 Liège, Belgium.
E-mail: [email protected]
Blairy, Neumann, Nutthals, Pierret, Collet and Philippot (2008). Improvements in Autobiographical Memory in Schizophrenia Patients after a Cognitive Intervention. Psychopathology, 41, 388-396. Danion, Cuervo, Piolino, Huron, Riutort, Peretti & Eustache (2005).
Conscious recollection in autobiographical memory: an investigation in schizophrenia. Consciousness and Cognition, 14, 535-547. Danion, Huron & Robert (2001). Treatment of cognitive dysfunction in schizophrenia. European Neuropsychopharmacology, S133-34.
D’Argembeau, Raffard, & Van der Linden (2008). Remembering the past and imagining the future in schizophrenia. Journal of Abnormal Psychology, 117(1), 247-25. Conway & Pleydell-Pearce (2000). The construction of autobiographical memories in the self-memory
system. Psychological Review, 107(2), 261-288. Gendre, F., Capel, R., & Monod, D. (2002). L.A.B.E.L. (liste d’adjectifs Bipolaire et en Echelles de Likert) Un modèle d’évaluation de la personnalité à visée universelle. Psychologie et Psychométrie, 23 (1/2). Huron,
Danion, Giacomoni, Grangé, Robert & Rizzo (1995). Impairment of recognition memory with, but not without conscious recollection in schizophrenia. American Journal of Psychiatry, 152, 1737-1742. Huron & Danion (2002). Impairment of constructive memory in
schizophrenia. International Clinical Psychopharmacology, 17, 127-133. Nieznanski (2003). The self and the schizophrenia: A cognitive approach, Swiss Journal of Psychology, 62, 45-51. Raes & al. (2006). Is overgeneral autobiographical memory an isolated memory
phenomenon in major depression? Memory, 14, 584-594. Williams, Ellis, Tyers, Healy, Rose and MacLeod (1996). The specificity of autobiographical memory and imageability of the future. Memory and cognition, 24, 116-125.