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标题：Exploring a lay Gestalt of schizophrenia? A Danish background population’s explanations on why and how first-episode schizophrenia patients’ narratives were intuitively sensed as contextually inappropriate
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作者：Charlotte Petersen
期刊名称：Scandinavian Journal of Child and Adolescent Psychiatry and Psychology
印刷版ISSN：2245-8875
出版年度：2017
卷号：5
期号：2
页码：64-76
DOI：10.21307/sjcapp-2017-008
语种：English
出版社：Scandinavian Journal of Child and Adolescent Psychiatry and Psychology
摘要：AbstractBackground:Recent continental-phenomenological psychiatry emphasizes pragmatics orsocial and contextual inappropriatenessas a core disorder of schizophrenia, which is potentially relevant to early identification and treatment.Objective:However, there are hardly any studies that examine thebackground population’ssensitivity to inappropriateness in schizophrenia, even if “common” people, from a pragmatic perspective, are likely to be highly sensitive to cultural-conventional norms, including (in)appropriateness.Method:One empirical evaluation of contextual (in)appropriateness in 10 narratives from first-episode schizophrenia patients and healthy controls, respectively, found that when a phenomenologically informed Danish population (n=157 high-school students; mean age, 18.5) was “blinded” to the control–patient status – that is, “anonymous” narratives of the wordless picture storyFrog, Where Are You?– they consequently evaluatedpatientnarratives as moreinappropriatethan appropriate andcontrolnarratives as moreappropriatethan inappropriate (significant with 0.007). Aiming to explore a potential pattern recognition, distinguishing patient from control narratives, the present study systematizes and discusses salient explanations fromlay “experts”who almost consequently (80% to 100%) evaluated patient narratives as inappropriate and control narratives as appropriate (n=63 of 157).Results:Explanations of inappropriateness concernedaffectiveaspects (about how the patientfeltor how the evaluatorsfeltreading the narrative),formalaspects (about pauses, fluency, and brevity), and aspects aboutsense making(from lack of understanding to nonsense and strangeness).The background population may be sensitive to affective and formal inappropriateness, but only lay experts emphasize the lack of sense in the patients’ narratives.Conclusion:Further studies might benefit from investigating whether early referrals from family, friends, or schoolteachers of their own accord thematize such inappropriateness aspects, and whether questionnaires targeting inappropriateness could be developed and used in the early identification of young people at risk.
关键词：Keywords:first-episode schizophreniainappropriatenessnarrativesphenomenologypragmatics