Abstract
The self-disorder model offers a unifying way of conceptualizing schizophrenia's highly diverse symptoms (positive, negative, disorganized), of capturing their distinctive bizarreness, and of conceiving their longitudinal development. These symptoms are viewed as differing manifestations of an underlying disorder of ipseity or core-self: hyper-reflexivity/diminished-self-presence with accompanying disturbances of "grip" or "hold" on reality. Recent revision to this phenomenological theory, in particular distinguishing primary-vs-secondary factors, offers a bio-pheno-social model that is consistent with recent empirical findings and offers several advantages: (1) It helps account for the temporal variations of the symptoms or syndrome, including longitudinal progression, but also the shorter-term, situationally reactive, and sometimes defensive or quasi-intentional variability of symptom-expression that can occur in schizophrenia (consistent with understanding some aspects of ipseity-disturbance as dynamic and mutable, involving shifting attitudes or experiential orientations). (2) It accommodates the overlapping of some key schizophrenic symptoms with certain nonschizophrenic conditions involving dissociation (depersonalization, derealization), including depersonalization disorder and panic disorder, thereby acknowledging both shared and distinguishing symptoms. (3) It integrates recent neurocognitive and neurobiological as well as psychosocial (eg, influence of trauma and culture) findings into a coherent but multi-factorial neuropsychological account. An adequate model of schizophrenia will postulate shared disturbances of core-self experiences that nevertheless can follow several distinct pathways and occur in various forms. Such a model is preferable to uni-dimensional alternatives-whether of schizophrenia or ipseity-disturbance-given its ability to account for distinctive yet varying experiential and neurocognitive abnormalities found in research on schizophrenia, and to integrate these with recent psychosocial and neurobiological findings.
Highlights
The human dopamine (DA) transporter mediates clearance of DA
This state is defined by a “halfopen and inward facing” state (HOIF) of the intracellular gate that leads to DA dysfunction
We demonstrated these dysfunctions in brains of Drosophila melanogaster expressing human dopamine (DA) transporter (hDAT) ∆N336
Summary
Basic disorders of the embodied self (BDES) encompass a cloud of related clinical constructs (e.g. cenesthesias, distortions of somatopsychic unity, anomalous bodily experiences in a broad sense) that are immanently related to a profound transformation of subjectivity and with the developmental modulation of bodily awareness. They have been historically ascribed a potential role in the emergence of schizophrenia spectrum disorders. Discussion: Within the superordinate construct of Self-disorders, BDES are a potentially relevant dimensional phenotype for the characterization of broad Schizophrenia Spectrum vulnerability Their contextualization within a developmental and neurophysiological perspective could further amplify their value for etio-pathogenetic research
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