Self-identification of patients with schizophrenia: quantitative and qualitative analysis

The aim of the current research is to reveal the features of self-identification of patients with schizophrenia. The self-identification structure that includes three functional blocks: the establishment of sign as a self-identification tool, sign-mediating selection and the association of segmental individual story phenomenology (self-identification constructs formation), and providing symbolically mediating unity in conscious personal self-identification constructs is defined. This structure is based on the original normative model that lies in the framework of cultural-historical psychology. The experimental method of self-identification investigation aimed to revealing the realization of the functional blocks is developed. The results of comparison of the experimental group (thirty individuals with the paranoid form of schizophrenia, F20.0 in accordance with ICD-10, that are under medical care in Republican Research and Practice Center for Mental Health, Minsk) and a control group (thirty individuals) show that both groups are identical in the level of the functional development of sign usage as the self-identification tool. Both groups are characterized by the highest level of this functional development. The difference in development of the function of self-identification construct formation is found. The control group is mostly characterized by the highest level of its development in contrast to the experimental group which is mostly characterized by its lowest level. Significant difference in the development of self-identification integration function is revealed. The majority of patients with schizophrenia have the lowest level of this function development while almost a half of the control group has the highest level. These results show that patients with schizophrenia have no integral identity. The results obtained can be considered as an experimental confirmation of the earlier obtained data of identity fragmentariness typical for patients with schizophrenia. A qualitative analysis of the data shows that patients with schizophrenia whether cannot explain a self-identification category choice or give explanations not connected with personal characteristics and their activity specific features. Patients with schizophrenia fail to future forecasting. Two types of narratives produced by patients with schizophrenia can be distinguished. The first type is typical for patients with the stable delirium. These patients produce narratives in correspondence with their delirium content. The second type is absolutely spontaneous and internally incoherent text. The lack of patients with schizophrenia integral identity is worsened by actualization of the "shifting a motive to aim" mechanism when performing the task aimed to this function examination.

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