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Introduction: Abnormal self-experiences are a common feature of major depression despite their absence from current diagnostic manuals. Current diagnostic criteria leave us with an impoverished conception of depressive disorders, and they fail to exploit the diverse experiential alterations that might be useful for understanding and diagnosing patients, and last but not least for explaining the aetiology of these disorders. Although some phenomenological descriptions of abnormal self-experiences in major depression are available, further research is needed to validate these through detailed clinical interviews. Methods: To characterize these phenomena in more detail and to verify and consolidate previous accounts, we conducted a qualitative study using the Consensual Qualitative Research method. Results: Our findings identified three categories of abnormal self-experiences: (1) impossibility to project oneself forward, (2) not recognizing one’s self, and (3) losing control on one’s self. Conclusion: Before delving into these results, we briefly described how the self is conceptualized in phenomenological psychopathology and explored in the literature on the self-experience in major depression. After discussing our results in the light of recent and contemporary phenomenological literature, we suggest that the inability to recognize otherness as part of oneself – which is the core of depressive experiences – ends in specific symptoms of depersonalization that differ from schizophrenic ones. We conclude that the self-experience, and in particular narrative identity, is central to the development and maintenance of depression. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to provide a qualitative analysis of anomalous bodily experiences (ABEs) of persons affected by feeding and eating disorders (FEDs). In particular, this study aimed to refine the description of bodily experiences in persons with FEDs so as to improve their treatment. Sampling and Methods: This is a naturalistic explorative study on a group of 29 patients affected by FED in psychotherapeutic treatment and 12 healthy controls. We asked the participants to write a letter on the way they experience their body. Later, we analysed their letters by means of consensual qualitative research. Results: All patients (29) reported at least 1 ABE. The main categories identified are (1) body-obstacle (the body interposes between the person and the world); (2) body-tyrant (the body imposes itself on the will of the person); (3) body-hyper-visible (the body is experienced as an exposed object); (4) body-geometric (the body is experienced or associated with a geometric form); and (5) body-numerical (the body is defined by numbers). All these categories are present in the clinical group, and they are absent in the control group. Conclusion: To grasp the experiential nuances of ABEs is relevant to understand the disorder of embodied self-hood and personal identity in these patients and thus to refine clinical treatment. [ABSTRACT FROM AUTHOR]

In a previous paper, we discussed a model that considers abnormal eating behaviour epiphenomena of a more profound disorder of lived corporeality and identity (Stanghellini and Mancini, this issue). The core idea is that persons with FEDs experience their own body first and foremost as an object being looked at by another, rather than coenaesthetically or from a first-person perspective. In this paper, alienation from one's own emotions, disgust and shame for one's body of persons with FED, will be discussed in the light of the embodiment and identity model of FED. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to define and describe the main phenomenological dimensions of the life-world of persons prone to Feeding and Eating Disorders (FEDs), within the framework of a model that considers abnormal eating behaviour an epiphenomenon of a more profound disorder of lived corporeality and identity. The core idea is that persons with FEDs experience their own body first and foremost as an object being looked at by another, rather than coenaesthetically or from a firstperson perspective. Alienation from one's own body and the need to feel oneself only through the gaze of the others can be illuminated by looking at it in the light of the Sartrean concept of feeling a lived-body-for-others. [ABSTRACT FROM AUTHOR]

In a recent book Cristopher Bollas, one of the greatest contemporary psychoanalysts, tells about how he began to bring together phenomenology and psychoanalysis in the clinical setting at the beginning of his career. Working with psychotic patients, he realized that it was first necessary to "absorb" their view of reality before being able to reflect on the mad scenarios of psychosis. In what world did they live? How did they perceive it? Only by "mirroring" this back to the patients was it possible to offer them the experience of being in front of someone trying to understand their world view. Today, phenomenology has been spreading over psychoanalysis more than one can think it did in the past. The aim of this paper is to review and discuss the most relevant theoretical-clinical areas characterizing contemporary psychoanalysis in which phenomenology can claim a legitimate (or still illegitimate for someone) position. The main areas that will be discussed are: (a) the larger relational system or field in which human experience is continually shaped, i.e., the intersubjective matrix in which we are embedded; (b) the capacity to think about the "what" of the patients' experience, rather than the "why" (especially with the most severely disturbed ones); and (c) the crisis of the primacy of interpretation in the analytical technique. Obviously, this review does not have the ambition to be exhaustive. Rather, it just wants to (re)open the discussion on a still controversial but very current topic. [ABSTRACT FROM AUTHOR]

In this paper, we discuss the philosophical and psychopathological background of Domain 3, Other persons, of the Examination of Anomalous World Experiences (EAWE). The EAWE interview aims to describe the manifold phenomena of the schizophrenic lifeworld in all of their concrete and distinctive features, thus complementing a more abstract, symptom-focused approach. Domain 3, Other persons, focuses specifically on subjectively experienced interpersonal disturbances that may be especially common in schizophrenia. The aim of this domain, as with the rest of the EAWE, is to provide clinicians and researchers with a systematic orientation toward, or knowledge of, patients' experiences, so that the experiential universe of schizophrenia can be clarified in terms of the particular feel, meaning, and value it has for the patient. To help provide a context for EAWE Domain 3, Other persons, we propose a definition of "intersubjectivity" (IS) and "dissociality." The former is the ability to understand other persons, that is, the basis of our capacity to experience people and social situations as meaningful. IS relies both on perceptive-intuitive as well as cognitive-computational resources. Dissociality addresses the core psychopathological nucleus characterizing the quality of abnormal IS in persons with schizophrenia and covers several dimensions, including disturbances of both perceptive-intuitive and cognitive-computational capacities. The most typical perceptive-intuitive abnormality is hypoattunement, that is, the lack of interpersonal resonance and difficulties in grasping or immediately understanding others' mental states. The most characteristic cognitive-computational anomaly is social hyperreflexivity, especially an algorithmic conception of sociality (an observational/ ethological attitude aimed to develop an explicit, often rule- based personal method for participating in social transactions). Other anomalous interpersonal experiences, such as emotional and behavioral responses to others, are also discussed in relation to this core of dissociality. [ABSTRACT FROM AUTHOR]

Background: Depressive disorders, despite being classified as mood or affective disorders, are known to include disturbances in the experience of body, space, time, and intersubjectivity. However, current diagnostic manuals largely ignore these aspects of depressive experience. In this article, we use phenomenological accounts of embodiment as a theoretical foundation for a qualitative study of abnormal body phenomena (ABP) in depressive disorders. Methods: 550 patients affected by schizophrenic and affective disorders were interviewed in a clinical setting. Interviews sought to uncover the qualitative features of experiences through self-descriptions. Clinical files were subsequently digitized and re-examined using consensual qualitative research. Results: Ninety-nine out of 100 patients with MDD reported at least one ABP. From cross-analysis of the MDD sample, we obtained 4 general categories of ABP, 3 of which had additional subcategories. The 4 categories include slowed embodied temporality (N = 90), anomalous vital rhythms (N = 82), worries about one's body (N = 22), and body deformation (N = 47). Conclusions: The results provide empirical evidence in support of theoretical discussions of embodiment in MDD found in the work of classical and contemporary phenomenologists. The findings also provide nuanced insight into the experience of persons living with MDD. Some categories of ABP, like slowed embodied temporality, can help to finely characterize psychomotor retardation or the so-called "medically unexplained symptoms" (MUS). This fine-tuned characterization can help to connect MUS to neuropsychological and neurobiological (e.g., alterations of interoceptive processes linked to anomalies of the brain resting-state hypothesis) and inflammatory (e.g., studies linking environmental stressors, inflammation mediators, and neurovegetative and affective symptoms) models of MDD. Our results can also support a pathogenic model of MDD, which posits, on the phenomenal level, ABP as the point of departure for the development of secondary symptoms including cognitive elaborations of these, namely, delusions about the body. Moreover, some of the categories, when contrasted with phenomenological qualitative studies of other disorders, provide conceptual resources of differential diagnosis and of identifying a "depressive core syndrome." For example, findings within category 4, deformation of the body, provide resources for using ABP to distinguish between MDD and schizophrenia. [ABSTRACT FROM AUTHOR]

Schizophrenia patients frequently display an array of abnormal bodily phenomena (ABPs). There is literature to suggest that the presence of ABPs may be representative of a fundamental disruption of the embodied and prereflexive state of selfhood and hence be relevant for the development of schizophrenia spectrum disorders. ABPs have been considered as trait features of vulnerability to psychosis and may have value as potential markers for early detection, target symptoms for prevention and predictors of clinical outcomes. This longitudinal cohort study aimed to explore: (1) the prevalence of ABPs in first episode psychosis, (2) their longitudinal stability, (3) how ABPs compare with data from patients with enduring psychosis, and (4) how aspects of disorders of self-experience (DSEs) and ABPs and the corresponding instruments relate to each other. Sixteen patients were recruited from an early intervention in psychosis service. They were assessed with a series of structured and semi-structured interviews at point of entry, after 6 months and 12 months of follow-up. A variety of ABPs and DSEs were displayed in all study subjects, associated with high levels of core psychotic symptoms and reduced with treatment over time. Compared with findings of both acute and chronic schizophrenia patients, the prevalence of ABPs seems to be representative of severity and acuteness of the illness. Two factors were identified with stable trait characteristics and might be of predictive value for the course of the illness. Further studies with bigger samples are needed to further test the value of ABPs as early markers of detection and predictors of clinical course. The association between DSEs and ABPs warrants further investigation. [ABSTRACT FROM AUTHOR]

Cet article présente la version francophone du questionnaire d'inspiration phénoménologique Identity and Eating Disorders (IDEA) (Stanghellini et al., 2012). La littérature d'inspiration phénoménologique met en évidence que les personnes souffrant d'anorexie mentale présentent des perturbations au niveau de l'incarnation et de l'intersubjectivité. Cette recherche évalue les expériences corporelles subjectives de participantes anorexiques grâce au concept du corps-pour-autrui proposé par J.-P. Sartre (1943). Les patientes anorexiques se définissent davantage à travers le regard des autres et tendent à moins ressentir leur corps de manière sensorielle. Soixante-sept patientes anorexiques et 246 participantes contrôles ont répondu à la version francophone, traduite par nos soins, du questionnaire IDentity and EAting disorders. Des tests non paramétriques de Mann-Whitney pour échantillons indépendants ont été effectués. Les résultats statistiques confirment l'hypothèse de recherche : les patientes anorexiques obtiennent des scores au questionnaire significativement supérieurs à ceux des participantes contrôles. Ces résultats confirment des difficultés au niveau de l'incarnation et de l'intersubjectivité chez les sujets anorexiques et annoncent des perspectives de recherche importantes. This research set out to test the French version of the IDentity and EAting disorders questionnaire (IDEA) (Stanghellini et al., 2012). From a phenomenological perspective, anorexic patients seem to experience difficulties regarding the subjective feeling of their own body (embodiment) and their personal identity, which leads to an impairment of inter-subjectivity in social interactions. Following these findings, this study investigated the " body-for-others " concept (Sartre, 1943) in a sample of anorexic female patients. These patients tended to define themselves mostly through the eyes of others instead of from their own perspective: their Leib (i.e. the real body) was hypothesized to be more vulnerable than their Körper (i.e. the body object). The main hypothesis was that anorexic patients would define themselves mostly through the eyes of others and would tend to experience fewer bodily sensations than control participants. Significantly higher scores for these dimensions in the clinical group compared to the control group were expected. This study included 67 anorexic female patients diagnosed on the Diagnostic and Statistical Manual IV criteria, and 246 female controls. All the participants were French speakers from Belgium, France and Switzerland. Participants were asked to complete two self-report questionnaires: The Eating Disorder Inventory 2 (EDI-2) (French version) evaluating eating disorders and the IDEA (French version translated and adapted by the authors) to explore the " body-for-others " concept. Mann-Whitney non-parametric tests were used to compare the results for the clinical and the control groups. The outcomes confirmed our hypothesis: the anorexic female patients had significantly higher scores compared to the control group on both of the questionnaires: the EDI-2 and the IDEA. The anorexic patients seemed to have difficulties in the way they experienced their own body, their personal identity and their perceptions of the gaze of others. The IDEA is a tool that has been elaborated for the assessment of these issues. It enriches knowledge relating to the body-self relationship and the first-person perspective, which is essential for a phenomenological approach. However, it still requires further research to be validated and used in clinical practice. [ABSTRACT FROM AUTHOR]

Highlights • Metacognitive deficits were found in a sample of Chilean patients with schizophrenia. • Metacognitive deficits were greater in schizophrenia than in bipolar disorder. • Metacognitive deficits were correlated with negative symptoms in schizophrenia. • The presence of metacognitive deficits and their associations with outcomes may occur cross culturally. Abstract Metacognition refers to the activities which allow for the availability of a sense of oneself and others in the moment. Research mostly in North America with English-speaking samples has suggested that metacognitive deficits are present in schizophrenia and are closely tied to negative symptoms. Thus, replication is needed in other cultures and groups. The present study accordingly sought to replicate these findings in a Spanish speaking sample from Chile. Metacognition and symptoms were assessed among 26 patients with schizophrenia, 26 with bipolar disorder and 36 community members without serious mental illness. ANCOVA controlling for age and education revealed that the schizophrenia group had greater levels of metacognitive deficits than the bipolar disorder and community control groups. Differences in metacognition between the clinical groups persisted after controlling for symptom levels. Spearman correlations revealed a unique pattern of associations of metacognition with negative and cognitive symptoms. Results largely support previous findings and provide added evidence of the metacognitive deficits present in schizophrenia and the link to outcome cross culturally. Implications for developing metacognitively oriented interventions are discussed. [ABSTRACT FROM AUTHOR]

Objective The overvaluation of body shape and weight of persons with eating disorders (EDs) is putatively explained by a disturbance in the way they experience their own body (embodiment). Moreover, attachment disorders seem to promote the use of body as source for self-definition. Therefore, we assessed the role of embodiment in the connection between attachment styles and ED psychopathology. Method One-hundred and thirteen ED patients and 117 healthy subjects completed the Identity and Eating Disorders (IDEA) Questionnaire, the Eating Disorder Inventory-2 (EDI-2) and the Experiences in Close Relationships Scale. Results Eating disorder patients displayed IDEA, EDI-2 and Experiences in Close Relationships scores significantly higher than controls. IDEA total and subtotal scores mediated entirely the influence of avoidant attachment on EDI-2 interoceptive awareness and impulsivity. Discussion These findings demonstrate a relationship between insecure attachment and disorders of identity and embodiment and point to embodiment as a possible mediator between avoidant attachment and specific ED psychopathological traits. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Background: Phenomenological psychopathology, through theoretical and idiographic studies, conceptualizes major depressive disorder (MDD) as a disorder of time experience. Investigations on abnormal time experience (ATE) in MDD adopting methodologies requested by the standards of empirical sciences are still lacking. Our study aimed to provide a qualitative analysis, on an empirical ground and on a large scale, of narratives of temporal experiences of persons affected by MDD. Methods: We interviewed 550 consecutive patients affected by affective and schizophrenic disorders. Clinical files were analysed by means of consensual qualitative research. Results: Out of 100 MDD patients, 96 reported at least 1 ATE. The principal categories of ATE are vital retardation- the experience of a stagnation of endogenous vital processes (37 patients), the experience of present and future dominated by the past (29 patients) and the experience of the slackening of the flow of time (25 patients). A comparison with ATE in schizophrenia patients showed that in MDD, unlike in schizophrenia, there is no disarticulation of time experience (disorder of temporal synthesis ) but rather a disorder of conation or inhibition of becoming. Limitations: The interview style was not meant to make a quantitative assessment ("false negatives" cannot be excluded). Conclusions: Our findings confirm the relevance of distinctive features of ATE in MDD, support the hypothesis of an intrinsic disordered temporal structure in depressive symptoms and may have direct implications in clinical practice, especially in relation to differential diagnosis, setting the boundaries between "true" and milder forms of depression and neurobiological research. [ABSTRACT FROM AUTHOR]

Eating Disorders (EDs) show a multifactorial etiopathogenesis including environmental, psychological and biological factors. In the present study, we propose a model of interactions between genetic vulnerability—represented by Fat Mass and Obesity-Associated (FTO) gene—and stable psychopathological traits, such as bodily disorders and emotion dysregulation for EDs patients. The distribution of a polymorphism of the FTO (rs9939609 T>A) was evaluated in a series of 250 EDs patients and in a group of 119 healthy control subjects. Clinical data were collected through a face-to-face interview and several self-reported questionnaires were applied, including the Emotional Eating Scale and the IDentity and EAting disorders (IDEA) questionnaire for bodily disorders and self-identity. The A-allele was associated with an increased vulnerability to EDs (AA+AT genotypes frequency 72.8% in EDs vs. 52.9% in controls). The presence of the A-allele was associated with binge eating behavior, higher emotional eating and higher IDEA scores. Finally, the FTO rs9939609 SNP was found to influence the relationship between these variables, as an association between disorder of corporeality and emotional eating was found only in A-allele carriers. A-allele seems to represent a potential additive risk factor for EDs persons, with bodily disorders to develop emotional eating and binge eating behaviors. [ABSTRACT FROM AUTHOR]