Experiences of Attenuated Psychosis Syndrome: A Phenomenological Study
Attenuated Psychosis Syndrome (APS) is listed in the DSM-5 Appendix as a diagnosis recommended for further study. Early intervention research has focused on APS as a collection of risk factors that can signal transition into psychosis. An increasing number of studies are re-focusing on the distress and lower functioning observed in this population. Understanding the experience of APS apart from its risk for psychosis is important to evaluating and improving professional care for this population. To understand APS’s psychological structure, this study used phenomenological analysis of interviews with ten female participants diagnosable with APS, ages 19–29. The resulting temporal structure begins with distal childhood experiences whose meanings would later be retained and echoed in the anomalous experiences. This is followed by temporally proximal challenges during the person’s developmental process of becoming independent, when the person finds her habitual way of being in the world faltering in effectiveness. Anomalous APS events are quasi-perceptions, intrusive thoughts, as well as a global sense of strangeness. They are presented as real and vivid but not belonging to the world of practical engagement, aggressively dominating, indeterminate in origin, and lacking in spatial-temporal stability. The anomalous events are distressing as they carry meanings of a total loss of control, self-alienation, a sense of self-defect, disjunction from the social world including stigma, and the fearful anticipation of future demise. Four typical pathways—“Nothing’s wrong,” “No more intrusions,” “Let it be,” and “Turning weakness into strength”—are described that aim to restore a world in which the person regains control, reclaims a sense of goodness, reestablishes social connections, and secures a more viable future. This study contributes to the current literature by articulating a psychological structure of APS that integrates disparate symptoms and situates them within the developmental context of emerging adulthood. Pathways through anomalous experiences provide new understanding of meaning making that aim with varying success as means of overcoming distress and dysfunction. The findings highlight the importance of interpersonal relationships and sociocultural context in the person’s attempts to come to terms with their anomalous experiences. The clinical and policy implications of the findings are discussed.
Hu, Bojun, "Experiences of Attenuated Psychosis Syndrome: A Phenomenological Study" (2016). ETD Collection for Fordham University. AAI10192407.