[Psychosis sight from the complexity research--a model for the examination of the self organisation of a dysfunctional self].
Nowadays the multifactorial genesis of psychotic illnesses is undisputed. The question of the integration of the multilayered results is open from the biological, emotional and social area. Based on the results of the complexity research (chaos theory, theory of the self organisation) the hypothesis was formulated for the emergence of psychotic illnesses that these are understood themselves as an expression of a dysfunctional self. Such a dysfunctional self arises in a self organizing process.


METHODS
The definition of the self was newly formulated. This happened on the knowledge of the complexity research and a bio- psycho-social model of illness and health. Ten main categories were defined, which seem essential for the development of a healthy, this means a flexible and autonomous self. In further consequence, based on these categories, a semistructured interview guide was developed. With this interview guide the information about the quality of the self organising process of the development of the self was collected. This guide was tested in the context of a master thesis in a multidimensional interview with a schizophrenic patient and his family. This interview was taken on video tap. The information on video became transcribed. Than the information was examined qualitatively to two aspects. This happened with the help of a qualitative contents analysis. The first aspect concerned the decision of the assignment to one or several of the ten categories. In a 2nd step it was judged, whether the examined information has to be classified as beneficial for the development of a healthy self or as impeding.


RESULTS
The developed and used examination model is suitable to make the investigation of a self organizing self possible. At the individual case analysis of a patient with a schizophrenic psychosis the inhibiting influences for the development of a healthy self predominated at a large part of the 10 categories. This corresponded to the hypothesis.


CONCLUSIONS
The used examination model seems suitable, to examine qualitatively the development of the self in psychotic people. At a more comprehensive study it is necessary to shorten the duration of the interview and to carry out the evaluation directly of video or CD-ROM The result of the qualitative contents analysis showed obviously, in which categories the impeding effect on the development of a healthy self outweighed. This result supports the idea of an individualized multidimensional therapeutic concept, which supports the development of a healthy self. Out of this could surrender to consequences regarding an individual, multidimensional therapy which promotes the development of a healthy itself.
Toifl
Karl
K
Univ. Klinik für Neuropsychiatrie des Kindes- und Jugendalters, Medizinische Universität Wien. Karl.Toifl@meduniwien.ac.at
Kimmel
Barbara
B
Mayring
Philipp
P
Mörth
Hans Marlies
HM
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use; D003142:Communication; D003220:Conflict, Psychological; D004532:Ego; D004644:Emotions; D005201:Fantasy; D006801:Humans; D007207:Individuation; D007398:Interpersonal Relations; D007406:Interview, Psychological; D008297:Male; D017711:Nonlinear Dynamics; D009769:Object Attachment; D010287:Parent-Child Relations; D016487:Parenting / Q000523:psychology; D010553:Personality Development; D010865:Pilot Projects; D012106:Research; D012307:Risk Factors; D012559:Schizophrenia / Q000175:diagnosis* / Q000188:drug therapy; D012565:Schizophrenic Psychology; D012931:Social Environment; D012951:Socialization; D014741:Video Recording
D014150:Antipsychotic Agents