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Are Self-disorders in Schizophrenia Expressive of a Unifying Disturbance of Subjectivity: A Factor Analytic Approach

Abstract


Background and Hypothesis

The
idea that a disorder of the basic self is a central feature in
schizophrenia has recently been corroborated in a meta-analysis and a
systematic review. Manifestations of the self-disorder can be
systematically explored with the Examination of Anomalous
Self-Experience (EASE). In this study, we examined the factorial
structure of EASE, and diagnostic efficacy of EASE. We hypothesized that
EASE will have a monofactorial structure as an instability of the basic
self will result in multiple deformations of self-experience which
would be meaningfully interrelated as aspects of a unifying Gestalt.

Design

EASE
data for 226 patients suffering from various mental disorders were
analyzed under a confirmatory factor analysis framework (CFA). Area
under the receiver operating characteristic curve (AUC) was calculated
for the total EASE sums, and sensitivity and specificity values for
prediction of schizophrenia spectrum disorders based on different
cut-offs were obtained.

Results

Fit
indices for the CFA model: RMSEA = 0.036, SRMR = 0.100, CFI = 0.983,
TLI = 0.981. The AUC value was 0.946 (95% confidence interval:
0.919–0.974). Sensitivity as well as specificity for schizophrenia
spectrum disorders were high.

Conclusion

Our
results lend support for EASE exhibiting a monofactorial structure and
the notion of self-disorders as a central phenotypic feature of
schizophrenia spectrum disorders.

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