Examination Of Anomalous World Experience Research Articles

Anomalous Experience of Self and World: Administration of the EASE and EAWE Scales to Four Subjects with Schizophrenia

The aim of this paper was to study anomalies of self- and world experience in schizophrenia from a phenomenological perspective through the use of the Examination of Anomalous Self-Experience (EASE) and Examination of Anomalous World Experience (EAWE) interviews. Four patients with diagnoses of schizophrenia were interviewed with both the EASE and the EAWE. A qualitative analysis of these interviews was carried out on all the data; quantitative scores were also assigned, based on the frequency and intensity of the items endorsed by the subjects. In the EASE, the subjects endorsed an average frequency of 45% of all items. In the EAWE, the subjects endorsed an average frequency of 26% of all items. Furthermore, the EAWE data indicated more heterogeneous profiles of experience than the EASE data. This heterogeneity is not surprising, given that the EAWE was designed to be a more broad-based or less targeted exploration of various changes likely to be associated with the schizophrenia spectrum (but also with certain other conditions). Our data suggest that although disturbances of world experience may always be present in schizophrenia, they may take numerous and varied forms. Because the experience of the world occurs across many different modalities, disturbances of this experience would be fundamentally less unitary, whereas the experience of the self presents a more coherent and unitary gestalt. These results show a certain overlapping between the scales while also indicating the potential value of a combined use of the two instruments. Finally, we discuss the relationship between experiential description and behavioral observation, and their potentially complementary value in exploring the first-person perspective, particularly in the case of experiences that occur at a more prereflective level.

Self and world experience in non-affective first episode of psychosis

A disturbance of “minimal self,” — of the immediate sense of mine-ness inherent in experience—is hypothesized to be the core disturbance in schizophrenia. Research with the Examination of Anomalous Self Experience (EASE) has demonstrated the selective aggregation of anomalous self-experiences in the schizophrenia spectrum. Conceptual research suggests that anomalous world experiences, including changes in the experience of space, time, and other persons, occur alongside anomalous self-experiences and are an important aspect of subjectivity in schizophrenia. The Examination of Anomalous World Experience (EAWE) is a recently published interview format designed to explore changes in world experience in schizophrenia. In the current study, 24 hospital outpatients with non-affective first-episode psychosis and 24 healthy-control participants were assessed with the EAWE and the EASE. First episode psychosis patients had total EAWE and EASE scores that were both, on average, significantly higher than the healthy-control group. EAWE and EASE scores were highly correlated, even after removing overlapping items. The distribution of EAWE items and subtypes in the first-episode psychosis sample was heterogeneous. We conclude that anomalous world experiences represent a relevant aspect of first-episode psychosis, and that they may be related to the self-disturbances thought to underlie schizophrenia spectrum disorders.

The loss of nosological validity: why and how should we consider disturbances of subjective world experience?

Contemporary psychiatric nosology has evolved with a primary goal of reducing the presence and influence of subjectivity by valuing objective symptoms and explanations (e.g. neurobiological models of psychopathology). However, improvements in the reliability and validity of these endeavours have fallen short of expectations, and it has been argued that one reason for these failures is the very omission or neglect of subjectivity in understanding and explaining mental illness. This paper supports the need for a paradigm shift, from researching the “what” of mental symptoms to a focus on “how” patients experience themselves and the world when undergoing a mental disorder. We review past contributions to disturbances of subjectivity, particularly in schizophrenia, which have contributed to the creation of a new bio-pheno-social model. We also discuss available tools for the systematic assessment of subjective anomalies. We pay special attention to the Examination of Anomalous World Experience (EAWE), which considers disturbances in world engagement, including the experience of atmosphere, space and objects, lived time and temporality, interpersonal relations, language, and existential concerns. Ultimately, we stress that the exploration of subjective experiences is essential, promising, and achievable in research on mental disorders.

Preface to the EAWE Portuguese version: A case for a new era of phenomenological psychopathology in psychiatry and clinical psychology

This special issue presents a Portuguese translation of the EAWE: Examination of Anomalous World Experience (Sass et al., this issue; original publication Sass et al., 2017). The EAWE is a semi-structured, phenomenologically-oriented interview designed to elicit descriptions of changes in the lived world, particularly those that may be more commonly found in schizophrenia spectrum disorders (though it may also be used to study disorders outside the schizophrenia spectrum). The EAWE represents an important trend in psychiatric research and practice: a growing appreciation for the role of subjectivity in understanding, explaining (Sass, 2010), classifying and treating psychiatric disorders, especially complex and heterogeneous disorders such as schizophrenia. The EAWE’s translation into Portuguese reflects several equally important developments. The ability to collect detailed information about the experience of schizophrenia and other psychiatric conditions among Portuguese-speaking participants will make it possible to study the phenomenological characteristics of schizophrenia outside of Anglophone cultures, providing important data about the intersections of individual, interpersonal, and cultural experiences in the development of the disorder. In addition, it occurs at a time of renewed energy and collaboration in phenomenological psychopathology, particularly in Brazil.

Schizophrenia, language, and the phenomenological interview

This paper reviews various perspectives regarding the relationship between language and experience, including the challenges of using verbal descriptions to access subjective experience in psychiatric interviews (in both clinical and research settings). Schizophrenia is a specific case in which the experience of language may be altered, posing unique challenges in the context of the interview. The phenomenology of language in schizophrenia is briefly presented, with discussion of related alterations in interpersonal orientation, attention and context, underlying experience, and attitudes toward language. It is suggested that some of the challenges posed by language, particularly in schizophrenia, may be addressed through the use of semi-structured, phenomenologically-informed interviews like the EASE: Examination of Anomalous Self-Experience and the EAWE: Examination of Anomalous World Experience. Guidelines for the administration of these interviews are presented to assist with eliciting descriptions of subjective experience with a higher degree of detail and accuracy.

The Phenomenology of Anomalous World Experience in Schizophrenia: A Qualitative Study

AbstractThis current study is a pilot project designed to clarify changes in the lived world among people with diagnoses within the schizophrenia spectrum. The Examination of Anomalous World Experience (eawe) was used to interview ten participants with schizophrenia spectrum disorders (sz) and a comparison group of three participants with major depressive disorder (dep). Interviews were analyzed using the descriptive phenomenological method. This analysis revealed two complementary forms of experience unique toszparticipants: Destabilization, the experience that reality and the intersubjective world are less comprehensible, less stable, and generally less real; and Subjectivization, the dominance of one’s internal, subjective experiences in the perception or interpretation of the lived world. Persons with depressive disorders, by contrast, did not experience disruptions of the reality or independence of the world or any significant disruptions of appearance or meaning. These results are consistent with contemporary and classic phenomenological views on anomalous world experience in schizophrenia.

Other Worlds: Introduction to the Special Issue on the EAWE: Examination of Anomalous World Experience

Other Worlds: Introduction to the Special Issue on the EAWE: Examination of Anomalous World Experience

Examination of Anomalous World Experience: A Report on Reliability

Background: The EAWE (Examination of Anomalous World Experience) is a newly developed, semi-structured interview that aims to capture anomalies of subjectivity, common in schizophrenia spectrum disorders, that pertain to experiences of the lived world, including space, time, people, language, atmosphere, and certain existential attitudes. By contrast, previous empirical studies of subjective experience in schizophrenia have focused largely on disturbances in self-experience. Aim: To assess the reliability of the EAWE, including internal consistency and interrater reliability. Sampling and Methods: In the course of developing the EAWE, two distinct studies were conducted, one in the United States and the other in Slovenia. Thirteen patients diagnosed with schizophrenia spectrum or mood disorders were recruited for the US study. Fifteen such patients were recruited for the Slovenian study. Two live interviewers conducted the EAWE in the US. The Slovenian interviews were completed by one live interviewer with a second rater reviewing audiorecordings of the interview. Internal consistency and interrater reliability were calculated independently for each study, utilizing Cronbach's α, Spearman's ρ, and Cohen's κ. Results: Each study yielded high internal consistency (Cronbach's α >0.82) and high interrater reliability for total EAWE scores (ρ > 0.83; average κ values were at least 0.78 for each study, with EAWE domain-specific κ not lower than 0.73). Conclusion: The EAWE, containing world-oriented inquiries into anomalies in subjective experience, has adequate reliability for use in a clinical or research setting.