Alexandra Bachelor

Altered State and Phenomenology of Consciousness in Schizophrenia

The present study sought: 1) to determine whether schizophrenia represents an altered state of consciousness; and 2) to identify the unique phenomenology of the psychotic state using a multidimensional, quantitative assessment system. Fourteen schizophrenic patients, 19 psychiatric non-psychotic patients, and 29 undergraduate students completed the Phenomenology of Consciousness Inventory, that assesses 10 major and 14 associated minor dimensions of consciousness. As hypothesized, compared to the ordinary state of consciousness the psychotic experience was found to represent an altered state associated, however, only with the differential organization of the putative minor components of consciousness. In addition, the psychiatric non-psychotic state was also found to represent an altered state, compared to ordinary consciousness, that was specifically associated with the major components of consciousness. The phenomenology of the psychotic experience was characterized by expected differences relative to the ordinary state, involving more altered awareness and experience (perceptual changes and unusual meanings), greater negative affect (anger, sadness, fear), and diminished volitional control and rationality, as well as greater arousal and decreased attention. The phenomenology of the psychiatric non-psychotic state proved highly similar to that of psychosis. Results highlight the importance of multidimensional mapping in studying the functioning of consciousness in schizophrenia and of controlling for other pathologies.

COGNITIVE AND PSYCHODYNAMIC CORRELATES OF DEPRESSIVE SYMPTOMATOLOGY

31 depressed, 26 nondepressed participants completed measures reflecting putative cognitive and psychodynamic characteristics of self-reported depression. Of the 16 variables 9 discriminated the groups in the expected direction. Ten characteristics correlated significantly with scores on the Beck Depression Inventory, 4 reflecting negative automatic drinking, two of which (Negative Self-concepts and Expectations, Low Self-esteem) were important predictors of severity of depression.

Specificity and Persistence of Cognitive-Dynamic Characteristics in Elderly Depression

Given the lack of research in clinically depressed elders, and drawing on an integrative perspective, this study examined predictions of three prominent psychological models of depression (cognitive, learned helplessness, and psychodynamic theory) in a sample of elderly depressed patients. The hypothesized specificity to depression and stability of representative psychological characteristics were evaluated by comparing levels of 25 clinically depressed elders, 20 nondepressed psychiatric controls and 28 nondepressed medical controls, at hospitalization (Tl), discharge (T2) and five months later (T3). Also, the relative contribution of theory-based variables to depression severity at discharge and at follow-up was explored. While elderly depressed patients showed, overall, significantly higher levels of maladaptive cognitions, biased attributions, and selected depressogenic personality traits than medical controls, these variables did not discriminate among depressives and psychiatric controls, with the exception of negative automatic thinking, and pessimistic attributions in females. Positive attributional style and hedonism did not discriminate among subject groups. Support was found for the stability, in the depressed group, of purportedly traitlike characteristics through hospitalization to follow-up. Multiple regression analyses indicated that initial symptomatology level was the strongest predictor of both discharge and follow-up depression severity, whereas selected variables from each theoretical model contributed marginally, depending on the time of assessment.