Chronic persecutory delusion and autobiographical memories in patients with schizophrenia: a diary study.

BACKGROUND: While chronic persecutory delusions are typically anchored into patients' everyday life situations, no investigation has ever looked at how situations associated with a feeling of persecution are recorded and later retrieved. METHOD: a diary methodology combined with a recognition task involving ten patients with schizophrenia who presented chronic persecutory delusions and ten control participants. Diaries of everyday persecutory events (Pe) and non-persecutory events (nPe) were kept. RESULTS: in both groups, 1) Pe were associated with higher anxiety scores than nPe, 2) Pe were experienced as less distinctive and more stereotyped than nPe, 3) the frequency of incorrect recognition of altered descriptions of Pe was higher than that of nPe. LIMITATIONS: because high levels of motivation are required of the diarists, our sample size was small. CONCLUSION: Memories of persecutory events were highly emotional and semanticized. they were frequently incorrectly recognized, suggesting the existence of bias resulting from interactions between their processing and persecutory delusions.

Impaired ability to give a meaning to personally significant events in patients with schizophrenia.

Schizophrenia is a severe mental illness affecting sense of identity. Autobiographical memory deficits observed in schizophrenia could contribute to this altered sense of identity. The ability to give a meaning to personally significant events (meaning making) is also critical for identity construction and self-coherence. Twenty-four patients with schizophrenia and 24 control participants were asked to recall five self-defining memories. We assessed meaning making in participants' narratives (spontaneous meaning making) and afterwards asked them explicitly to give a meaning to their memories (cued meaning making). We found that both spontaneous and cued meaning making were impaired in patients with schizophrenia. This impairment was correlated with executive dysfunctions and level of negative symptoms. Our results suggest that patients' difficulties in drawing lessons about past experiences could contribute to explain the lack of coherence observed in their life trajectories and their impaired social adjustment abilities. Implications for psychotherapy are also discussed.

Self-defining memories related to illness and their integration into the self in patients with schizophrenia.

Although schizophrenia alters the sense of personal identity, little is known about the impact of illness-related autobiographical events on patients' self-representation. We investigated self-defining memories (SDM) in 24 patients with schizophrenia and 24 controls to explore how illness-related SDM were integrated into the self at both the cognitive (how participants are able to give a meaning to past events: meaning making) and affective levels (how participants can re-experience past negative events as less negative: redemption and benefaction effects). We found that 26% of freely recalled SDM referred to their illness in patients. Further, while meaning making was impaired in patients for both illness-related and other SDM, illness-related SDM were characterized by a higher redemption and benefaction effects than other SDM. Our results highlight that despite a reduced ability to give a meaning to illness-related episodes, emotional processing seems to allow these events to become positively integrated into patients' life stories. This study provides new findings about the construction of the self in relation to psychotic episodes in patients with schizophrenia. We discuss clinical implications of our results that are helpful to guide cognitive interventions.