Role of the self in schizophrenia: a multidimensional examination of short-term outcomes.
The manifestation, course, and prognosis of schizophrenia are extremely variable, raising an interest in the role of personality and self-concept in the illness' outcome. Building on voluminous research attesting to the fragility and instability of the self in schizophrenia, we examined the role of four self-concept aspects--self-esteem level, self-esteem instability, self-concept clarity, and the perception of the self as ill--in schizophrenia-spectrum disorders. Eighty-nine outpatients were assessed at baseline, and five days subsequently, regarding these self-concept aspects, symptoms, stress, and quality of life. Six weeks later, participants were again assessed using the baseline battery. Self-esteem instability predicted a decrease in quality of life over the study period. Self-concept clarity predicted an increase in quality of life and in positive symptoms, particularly under low stress. Depressive symptoms predicted a decrease in self-esteem levels and an increase in the perception of the self as ill. Thus, all four self-concept aspects were shown to be pertinent to the experience of schizophrenia, albeit in different ways. Special attention should be directed to self-concept clarity, which embeds both risk and resilience.
Department of Psychology, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel.
Dafna
D
Weinberg
Golan
G
Shahar
Gal
G
Noyman
Larry
L
Davidson
Thomas H
TH
McGlashan
Shmuel
S
Fennig
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010556:Personality Tests / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011788:Quality of Life; D012044:Regression Analysis; D012559:Schizophrenia; D012565:Schizophrenic Psychology; D012649:Self Concept; D013315:Stress, Psychological / Q000523:psychology; D055815:Young Adult