Psychopathology最新文献

{"title":"Who Are People with Psychosis Delusional about? A Study of Social Agents in the Phenomenology of Delusions.","authors":"Elisavet Pappa, Nichola Raihani, Vaughan Bell","doi":"10.1159/000548611","DOIUrl":"10.1159/000548611","url":null,"abstract":"<p><strong>Introduction: </strong>Delusions frequently involve strong beliefs about, or interactions with, illusory social agents. Although such agents have been systematically described in hallucinations, few studies have investigated their nature and identity in delusions.</p><p><strong>Methods: </strong>We identified 205 electronic mental health records describing the content of delusions from the Clinical Record Interactive Search platform at South London and Maudsley NHS Foundation Trust. Delusional content was classified as non-social, implicitly social, or explicitly social. Descriptions of illusory social agents from explicitly social delusions were extracted and categorized using an upward coding analysis. A hierarchical cluster analysis identified distinct groupings of illusory social agents.</p><p><strong>Results: </strong>Most delusions (83.4%) contained explicit references to illusory social agents. Across 238 instances, we identified 220 distinct agent identities, with a mean of 1.17 agents per record. The majority were humans (85.1%), most often identified as family members (31.0%), followed by acquaintances (17.2%), religious figures (13.2%), unnamed persons (12.8%), professionals (11.8%), and cultural figures (10.9%). Hierarchical clustering revealed two distinct groups: one including socially proximate agents and the other more socially distant agents. These findings indicate a social gradient in delusions.</p><p><strong>Conclusion: </strong>Social content predominates in delusions, with patients experiencing delusions about socially closer individuals more frequently. We discuss the extent to which social gradient may not be unique to delusional misidentification syndromes but may instead represent a general feature of delusions. Better characterization of social agents in delusions could inform mechanistic accounts of these symptoms and, in clinical practice, guide family support and risk assessment.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal Hallucinations in Muslim Patients with Severe Psychotic Disorders: The Entity Experience Revisited.","authors":"Anastasia Lim, Hans W Hoek, Jan Dirk Blom","doi":"10.1159/000548607","DOIUrl":"10.1159/000548607","url":null,"abstract":"<p><strong>Introduction: </strong>In biomedicine, entity experiences are conceptualised as compound hallucinations featuring living beings. The term \"experience\" suggests that these have an objective basis in reality, as those perceiving them may maintain. So-called jinn encounters, typically described by Muslims with and without a psychiatric diagnosis, involve the multimodal perception of a spirit that, as described in the Qur'an, was created by Allah.</p><p><strong>Methods: </strong>We conducted a phenomenological investigation among Muslim patients residing at Parnassia Psychiatric Institute, The Hague, mostly diagnosed with a schizophrenia spectrum disorder. To enquire specifically into multimodal hallucinations featuring jinn or related entities, we used the Hallucination Attribution List, a tailor-made, semi-structured questionnaire.</p><p><strong>Results: </strong>Of the 42 interviewees, 35 described multimodal hallucinations, of which 22 fulfilled the criteria of entity experiences involving 2 to 6 sensory modalities simultaneously. Twelve participants (54.5%) were fully convinced they were dealing with jinn; the others left some room for doubt. Although we did not quantitatively assess the levels of jinn-associated distress, all participants characterised their experiences as impressive and impactful.</p><p><strong>Conclusion: </strong>Multimodal hallucinations may involve full-blown entity experiences, which in Muslim patients typically take the form of jinn encounters. The way in which these entity experiences are mediated is as yet uncertain. However, since visual, auditory, and tactile hallucinations in our sample were described substantially more frequently than somatic, olfactory, and gustatory ones, we hypothesise that the processes underlying the hallucinations may be driven by a stochastic mechanism in that the first three sensory modalities need to have been engaged before the latter three can be recruited. We highlight several biological models of potential underlying mechanisms as well as two overarching models that may help place the mechanisms in the wider context of personal, social, cultural, religious, philosophical, and evolutionary factors that, conceivably, all play a role in their mediation.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"12-22"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12867496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Paradox of Loving without Expectation: Between Existential Assurance and the Missed Encounter with the Other.","authors":"Giovanni Stanghellini","doi":"10.1159/000548794","DOIUrl":"10.1159/000548794","url":null,"abstract":"<p><strong>Background: </strong>The phenomenon of love is an important task for the psychopathologist since love experience is the site in which the Self is formed and potentially dismantled. This paper explores \"one-way love\" - an autotelic form of love that persists independently of return. It may serve as a way for the person to sustain a sense of autonomy finding fulfilment in the act of loving itself - a paradoxical affirmation of identity, existence, and autonomy.</p><p><strong>Summary: </strong>The analysis unfolds three central functions of one-way love: (1) it frees the person from dependency on the Other's love; (2) it preserves the integrity of the lover's own desire protecting it from the confrontation with the Other's desire; (3) it offers the lover a heroic and noble self-image rooted in fidelity to feeling. One-way lovers may appear as dependent on a beloved who does not reciprocate, but they are firmly convinced that they are performing a radical act of freedom: loving not to be loved in return, but to assert their own existence as a person fully capable of loving.</p><p><strong>Key message: </strong>One-way love is a strategy in which desire and fear intersect, sustaining the beloved at a distance and affirming the lover's capacity to love without dependence. Yet, this autonomy carries a cost: it prevents genuine intimacy with the Other. By avoiding the vulnerability required to share private aspects of the Self, one-way lovers evade the very encounter with otherness that is essential to the ongoing development and transformation of the Self.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"67-78"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learn to Control Your Anger: Neural Effects of Mechanism-Based Anti-Aggression Psychotherapy in Borderline Personality Disorder.","authors":"Marc Wenigmann, Corinne Neukel, Karen Spieß, Katja Bertsch, Sabine C Herpertz","doi":"10.1159/000549876","DOIUrl":"10.1159/000549876","url":null,"abstract":"<p><strong>Introduction: </strong>Severe anger and overt aggression are common phenomena in borderline personality disorder (BPD) which have serious negative consequences for those affected and their environment. New developments in psychotherapy for personality disorders aim to target etiological mechanisms involved in psychopathology. Since affect dysregulation is a prominent biobehavioral mechanism underlying overt aggressive behavior in BPD, we aimed to clarify whether a psychotherapy that has been shown to decrease aggression in BPD does indeed modulate this mechanism.</p><p><strong>Methods: </strong>Accordingly, the neural effects of a novel mechanism-based anti-aggression psychotherapy (MAAP) were compared to those of a nonspecific supportive psychotherapy (NSSP). Twenty-seven highly overt aggressive patients with BPD and 29 healthy controls were included in this functional magnetic resonance imaging (fMRI) study.</p><p><strong>Results: </strong>The BPD patients treated with MAAP showed an increase in neural activation in clusters comprising the left anterior insula, the right dorsomedial prefrontal cortex (PFC) and the bilateral anterior caudate being related to a reduction in overt aggression. In contrast, the BPD group that had received NSSP exhibited a decrease in activity in the aforementioned clusters, each associated with a rise in overt aggressive behavior. Furthermore, MAAP showed an increase and NSSP a decrease in context-dependent functional connectivity between the caudate seed cluster mentioned above and the left dorsolateral PFC. Likewise, this interaction effect was negatively related to the change in overt aggression with an OAS-M reduction for the MAAP and a rise for the NSSP group.</p><p><strong>Conclusion: </strong>The data may suggest that the aggression-reducing effect of MAAP is mediated through increasing cognitive control over dysregulated feelings of anger.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145763682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Collaborative Care Model in Mental Health: Towards a \"Phenomenological Cowriting?\"","authors":"Matteo Chiarani","doi":"10.1159/000549671","DOIUrl":"10.1159/000549671","url":null,"abstract":"<p><strong>Background: </strong>The shift in mental health towards ecological and collaborative models, in alignment with the recovery paradigm, has sparked interest in dialogical and coproductive practices. These practices aimed to promote epistemic justice and strengthen the therapeutic alliance. Among these, collaborative writing (cowriting) is emerging as a promising tool. However, it currently lacks a robust theoretical and methodological foundation, particularly in its integration with phenomenology and its clinical applications. This article proposes the core elements of a \"phenomenological cowriting\" model that seeks to frame the practice within clinical phenomenology, distinguish it from purely narrativist approaches, and highlight its unique contributions.</p><p><strong>Summary: </strong>This study conducts a theoretical analysis with a focus on clinical applicability, integrating the principles of clinical phenomenology with collaborative and dialogical methods. The relevance of a phenomenological cowriting model is demonstrated through a comparative analysis with other collaborative writing approaches, such as those based on narrativist or ethnographic traditions, and is exemplified by a case vignette. From a clinical perspective, we propose a three-phase model: (1) therapeutic dialogue, (2) the use of transcription as a \"textual artefact,\" and (3) joint rewriting. This model provides significant value in terms of process and outcomes. As a process, it embodies a collaborative care framework that minimises epistemic asymmetry and promotes patient agency. As an outcome, it helps clarify the patient's lived experience, including its prereflective dimensions, thereby enriching shared psychopathological knowledge with a first-person perspective.</p><p><strong>Key message: </strong>Phenomenological cowriting should be understood not as a mere technique but as a comprehensive and integrated model of care. Grounded in clinical phenomenology and the coproduction of a text, it provides a structured method for constructing therapeutic pathways that foreground an active role for the patient, ultimately generating clinical knowledge rooted in the subjective experience of suffering.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Interoception in Felt Presence and Psychosis Risk.","authors":"Anne Felsenheimer, Tatiana Baxter, Michael Sangimino, Sohee Park","doi":"10.1159/000549423","DOIUrl":"10.1159/000549423","url":null,"abstract":"<p><strong>Background: </strong>Felt presence (FP) - the sensation of someone nearby without sensory evidence - is common in healthy adults and related to psychosis risk. FP may arise from a misattribution of internal signals to an external source and often occurs when people are alone. Interoception, the ability to perceive one's own bodily signals, may help distinguish oneself from others. FP could relate to interoception across several dimensions: through altered signal perception (interoceptive accuracy), insight into their perception (interoceptive insight), and/or self-reported beliefs (interoceptive beliefs). This is the first study that investigates this potential relationship.</p><p><strong>Method: </strong>A total of 55 healthy adults completed the heartbeat counting task to assess interoceptive accuracy and insight under three \"social\" conditions: self-view (observing oneself on a screen), other view (being observed by the experimenter on a screen), and baseline (no viewing). Participants completed the Prodromal Questionnaire-16 to screen for psychosis risk, the Inclusion of Other in the Self Scale as a measure of self-other overlap, the Multidimensional Assessment of Interoceptive Awareness (MAIA-2), and indicated whether they ever had a \"felt- or sensed-presence experience\" (Y/N).</p><p><strong>Results: </strong>Psychotic experiences were elevated in individuals with FP, and it was experienced more often in solitude. Overall, the other-view condition reduced both interoceptive accuracy and insight. Distinct interoceptive patterns emerged for FP and psychosis risk. High risk was related to lower interoceptive accuracy, particularly when perceived self-other overlap was low. In contrast, individuals with FP showed intact interoceptive insight when the self-other overlap was low. Both FP and psychosis risk were associated with lower trust in bodily signals and tendency to not distract oneself from bodily sensations. Only FP group reported attending to bodily sensations to calm oneself.</p><p><strong>Conclusion: </strong>Interoceptive accuracy was preserved in those with FP regardless of their psychosis risk, but their trust of and insight into their own bodily signals were reduced. This mismatch may lead to misattributing internal signals to external sources, contributing to FP. However, preserved interoceptive accuracy may support self-regulation, potentially offering a protective effect. These results highlight the potential of interoceptive training to enhance resilience in individuals at risk for psychosis.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12716850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145506582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent Non-Suicidal Self-Injury: An Integrative Review of Clinical, Psychopathological, and Sociocultural Dimensions.","authors":"Anneliese Dörr, Sandra Viani, Pablo Salinas, Rainer M Holm-Hadulla","doi":"10.1159/000549350","DOIUrl":"10.1159/000549350","url":null,"abstract":"<p><strong>Background: </strong>Self-injury has become increasingly prevalent among adolescents and young adults over the past decades, reflecting the intersection between individual vulnerability and sociocultural transformations. Understanding this phenomenon requires not only a clinical perspective but also a broader reflection on how current social dynamics - such as digital hyperconnectivity and weakened interpersonal bonds - shape subjectivity and emotional regulation.</p><p><strong>Summary: </strong>This article offers an integrative and interpretive study based on the authors' previous empirical research conducted in 2022, which included semi-structured clinical interviews with 20 young people (19 females and 1 male) aged between 13 and 28 years who engaged in skin-cutting. The analysis considered four dimensions: family dynamics, identity, symptom onset and context, and the function of the symptom. The findings revealed that self-injury is associated with difficulties in identity formation, emotional regulation, and family relationships, which were interpreted in light of contemporary sociocultural changes. To enrich this perspective, theoretical contributions from sociology and philosophy were incorporated to link individual experience with the broader cultural framework.</p><p><strong>Key messages: </strong>Self-injury reflects not only intrapsychic conflict but also the impact of sociocultural transformations characteristic of postmodernity. Understanding its meaning requires integrating clinical, familial, and sociocultural levels of analysis. The proposed therapeutic approach combines evidence-based strategies for emotion regulation with interventions that address the patient's identity and social context. This work aims to provide clinicians with conceptual and practical tools to better understand and treat self-injury as a phenomenon rooted in contemporary culture.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual and Auditory Verbal Hallucinations in Schizophrenia and Their Relation to Self-Disorders.","authors":"Bettina Magnolia Löfs, Andreas Rosén Rasmussen","doi":"10.1159/000548797","DOIUrl":"10.1159/000548797","url":null,"abstract":"<p><strong>Introduction: </strong>The current definition of hallucinations as perception-like experiences has been criticized for neglecting their experiential character and context. This study examined the phenomenology of auditory verbal hallucinations (AVHs) and visual hallucinations (VHs) in schizophrenia and their relation to other psychopathology, particularly basic self-disorders.</p><p><strong>Methods: </strong>Twenty patients with schizophrenia-spectrum psychosis and hallucinations participated in phenomenologically oriented, semi-structured interviews exploring the experiential characteristics and context of AVH and VH as well as a comprehensive psychopathological examination, including the Examination of Anomalous Self-Experience (EASE).</p><p><strong>Results: </strong>The far majority of participants considered their hallucinations distinct from perceptual experience and described alterations of the ordinary experiential structure of sensory experience. Generally, both AVH and persistent VH were experientially intertwined with self-disorders and other subjective pathological phenomena. Moreover, AVHs were characterized by alterations of spatiality and experienced as private, i.e., not being accessible to others. Compared to a control group, the participants with hallucinations had significantly higher levels of self-disorders, earlier onset of psychopathology, and lower IQ.</p><p><strong>Conclusion: </strong>The findings align with prior research proposing that most AVHs in schizophrenia reflect an underlying alteration of the structure of subjectivity (i.e., disorder of basic self). We report novel findings suggesting that a similar link between self-disorders and VH should be further investigated. Our study highlights the importance of assessing hallucinations within the broader context of the patient's psychopathology for adequate differential diagnostic evaluation and understanding of lived experience.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Importance of Existential Questions in Patients with a Depressive Disorder: A Pilot Study.","authors":"Paraskevi Mavrogiorgou, Valerie Pauline Paffrath, Georg Juckel","doi":"10.1159/000548702","DOIUrl":"10.1159/000548702","url":null,"abstract":"<p><strong>Background: </strong>Depressive disorders are among the most common mental illnesses. Many approaches to treatment using psychotherapy or psychotropic drugs exist, but the proportion of non-responders should not be ignored. The consideration of existential, so-called \"meaningful questions\" of life, although their significance is well known, has so far been used little or not at all in the diagnosis and treatment of mental illnesses like depressive disorders. The aim of this study was, therefore, to examine the significance of existential questions in the context of depressive disorders and to shed light on the attitudes of affected patients.</p><p><strong>Method: </strong>This exploratory cross-sectional study used semi-structured interviews and questionnaires to examine 30 inpatients with a diagnosed depression and 30 mentally healthy individuals as a comparison group. Clinical parameters were collected from all study participants. The psychometrics included the recording of depression (BDI-II), anxiety (STAI-I/II), loneliness (UCLA Loneliness Scale), and life meaning (LeBe/SoMe). The BOFRETTA scale was also used to assess the subjects' fear of death and attitudes toward death. The Bochum Questionnaire on the Importance of Existential Questions (BOFBEX), newly designed for this study, was used to assess attitudes to existential issues.</p><p><strong>Results: </strong>For the depressed patients, there were unfavourable and significantly different values compared to the mentally healthy subjects with regard to meaningfulness and crisis of meaning. Most depressives (66.7%) stated they suffered subjectively from experience of meaninglessness at most, whereas this did not occur in any of the healthy subjects. However, the level of depressiveness correlated significantly positively with loneliness in both groups and with the perception of a crisis in meaning.</p><p><strong>Conclusions: </strong>Depressed patients had a need and desire to be able to address existential questions, which mainly concerned their loneliness, the feeling of autonomy, and having meaning in life, more strongly and more frequently with reference therapists as part of psychiatric-psychotherapeutic treatment.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-13"},"PeriodicalIF":2.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Activity and Psychopathological Knowledge Are Related to Real-World Performance of Leading International Psychiatrists in Diagnosing Schizophrenia Spectrum Disorders.","authors":"Bar Urkin, Josef Parnas, Andrea Raballo, Danny Koren","doi":"10.1159/000549313","DOIUrl":"10.1159/000549313","url":null,"abstract":"<p><strong>Introduction: </strong>A recent empirical benchmark study designed to assess real-world diagnostic accuracy and reliability among 30 internationally renowned psychiatrists specializing in the schizophrenia spectrum found that only 33.3% of the psychiatrists correctly diagnosed two vignettes that included typical descriptions of disorders in the schizophrenia spectrum. The present study aimed to identify clinician-related factors that might account for this poor diagnostic performance, such as clinical versus research focus, years of clinical experience, and perceived usefulness of psychopathological concepts.</p><p><strong>Methods: </strong>The study employed secondary analyses of data collected in in-depth online interviews with a group of 30 top-tier international psychiatrists specializing in schizophrenia spectrum disorders (SSDs). Participants were asked to make their best clinical diagnostic estimate for two written clinical vignettes developed on the basis of real-world SSD cases.</p><p><strong>Results: </strong>We found that diagnostic accuracy was nearly significantly related to length of clinical experience, greater emphasis on practice versus research (estimated by low H-index), a proclivity to engage in psychotherapy, a nuanced view of psychosis as a spectrum concept, and acknowledgment of the relevance of self-disorders (i.e., subtle, enduring, nonpsychotic phenomenological anomalies of subjective experience) for SSD diagnosis.</p><p><strong>Conclusion: </strong>Taken together, these findings suggest that continuous clinical activity and nuanced knowledge of psychopathology that goes beyond the guidelines of DSM and ICD are crucial for accurate diagnostic performance in real-world diagnostic encounters.</p>","PeriodicalId":20723,"journal":{"name":"Psychopathology","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12707909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145409889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}