Passive and active schizophrenia: toward a new descriptive micropsychopathology.
The "experiences" reported by individuals affected by schizophrenia are fundamental components of the descriptive approach adopted by current diagnostic systems for mental disorders and by clinical diagnostic interviews and rating scales for the assessment of the symptoms of schizophrenia. However, the technical literature does not rely on a specific definition of experiences in schizophrenia. This article introduces a specific, restrictive, operationalized definition of the "experiential substrate" of schizophrenia, defined by the "self-giving" "passive experiences" of the disorder that break into the consciousness of the affected individual, and are distinguished from the "active" acts of judgment formulation and conviction/belief attainment. The experiential substrate of schizophrenia may be considered similar to the experiential substrate of pain. The operationalization of the definition of passive experiences can enable the experiential substrate of schizophrenia to be acknowledged as an independent domain with a specific role in the assessment of the disorder, a role that is substantially omitted or ignored by current research and practice. The term "descriptive micropsychopathology" is proposed for this new method aimed to describe passive experiences and active judgments as independent domains to enhance the reformulation of criteria for symptom assessment and, consequently, reformulation of the criteria for the assessment of the efficacy and effectiveness of interventions aimed at prevention, care, and rehabilitation in schizophrenia. A new measure focusing on the evaluation of the passive experiences of schizophrenia and on the disturbance they cause to patients is also described.
International Center ofMentalHealth Policy and Economics, Via Daniele Crespi 7, 20123 Milano, Italy. moscarelli@icmpe.org
Massimo
M
Moscarelli
D001364:Awareness; D032882:Comprehension; D003469:Culture; D003702:Delusions / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D006212:Hallucinations / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D007406:Interview, Psychological; D007600:Judgment; D011569:Psychiatric Status Rating Scales; D011599:Psychopathology; D012559:Schizophrenia / Q000175:diagnosis* / Q000517:prevention & control / Q000534:rehabilitation; D012565:Schizophrenic Psychology; D012803:Sick Role; D013850:Thinking; D016896:Treatment Outcome