Pavan Brar

The Experience Sampling Method (ESM) is a promising approach for research on self-disorders, as it may enable studying how momentary changes in anomalous world experiences (AWEs) impact delusion development and maintenance. Using ESM to study AWEs requires clarification on two key issues: 1) discerning to what extent self-reports for AWEs align with clinician-based assessments; and 2) demonstrating the dynamic variability of AWEs in order to justify the use of ESM. This paper reports an exploratory ESM study (n = 7; 286 total ESM observations) on these two issues. False-positive indices and agreement rates between self-reports and clinician-based assessments were calculated, and ESM data was used to observe dynamic variability in AWEs. Exploratory mixed-effects models were conducted, using the AWE Unknown/Unstatable Significance as a predictor, and paranoia as an outcome. Two models were compared on indices of fit: Model 1, using all obtained data for the predictor variable (n = 6), and Model 2 (n = 5), eliminating data suspected of containing false-positives of the predictor. Average ESM completion rate was 68%. False-positive indices and agreement rates ranged from 20–88% and 14–86%, respectively. Visual inspection of temporal profiles of AWEs showed dynamic variability. Although mixed-effects models should be interpreted with caution, we observed a threshold effect for the relationship between Unknown/Unstatable Significance and paranoia (Model 1; B = –3.90, p = 0.015; Model 2: B = –2.87, p = 0.50). Indices of fit improved in Model 2 (Model 1; AIC = 1525.76, BIC = 1559.15; Model 2; AIC = 1172.64, BIC = 1203.77). Larger-scale validation studies on AWE self-report items are warranted, as are further ESM studies that examine the role of AWEs in delusions.

The self-disorder model provides a phenomenological framework for understanding how the core symptoms of Schizophrenia Spectrum Disorders (SSDs) are rooted in an instability of minimal selfhood. This instability involves a range of “anomalous experiences”: transformations in an individual’s perceptual field and sense of being an agent of action. The explanatory value of this theoretical model can be summarized in two claims about the role of anomalous experiences in self-disorders: (1) anomalous experiences express a common trait-like disturbance that is characteristic of SSDs, and (2) anomalous experiences contribute to explanations regarding how self-disorders progress into SSDs. While hypotheses consistent with the first claim have been substantiated in several studies, hypotheses consistent with the second claim remain underexamined. We argue that attending to this gap in the literature requires considering which methodological strategies are best suited for investigating if and how anomalous experiences contribute to the development of self-disorders into SSDs and psychotic states. Network modeling is discussed as one such strategy suitable for examining the role of anomalies of lived-world in the maintenance of paranoid delusions in SSDs.