The Association between Self-Reported Self-Disturbance Phenomena and Personal Recovery in Patients with a Schizophrenia Spectrum Disorder, Siblings and Controls.

Introduction: Self-disturbance phenomena are increasingly recognized as fundamental and debilitating features for patients with a schizophrenia spectrum disorder (SSD). The concept of personal recovery describes the process of building a meaningful and satisfying life despite persistent symptoms or challenges related to mental illness. No previous study has investigated the association between self-disturbance phenomena and personal recovery in patients with SSD. Understanding the impact of self-disturbance could strengthen the therapeutic alliance with patients and contribute to the development of treatment strategies supporting their recovery.

Aim: To investigate whether severity of self-reported self-disturbance phenomena is associated with the level of self-reported personal recovery in patients with SSD, their unaffected siblings and healthy controls.

Methods: In a cross-sectional design with 522 patients with SSD, 608 unaffected siblings and 369 healthy controls, the frequency and distress of self-disturbance phenomena was measured with the Self-Experience Lifetime Frequency Scale (SELF). Personal recovery was assessed with the Recovery Assessment Scale (RAS-24). Spearman's rank correlation coefficients between both scales were examined. Subsequent multiple hierarchical regression analyses were conducted to assess additional explained variance in personal recovery by severity of self-disturbance phenomena, adjusting for positive, negative and general symptomatology.

Results: Significant correlations were reported between higher SELF and lower RAS-24 scores for patients (ρ = -0.20, p < 0.001), siblings (ρ = -0.24, p < 0.001) and controls (ρ = -0.16, p < 0.005). The severity of self-disturbance phenomena significantly albeit modestly predicted total personal recovery score after adjusting for positive, negative and general symptoms for patients (R2 Change = 0.035, β = -0.19, p < 0.001).

Conclusion: Current findings suggest that self-reported self-disturbance phenomena are relevant for the personal recovery of patients with SSD. Healthcare practitioners are urged for attention to patients' first-person perspectives, including experiences of self-disturbance.