The Association between Self-Reported Self-Disturbance Phenomena and Personal Recovery in Patients with a Schizophrenia Spectrum Disorder, Siblings and Controls

Introduction: Self-disturbance phenomena are increasingly recognized as fundamental and debilitating features for patients with a schizophrenia spectrum disorder (SSD). The concept of personal recovery describes the process of building a meaningful and satisfying life despite persistent symptoms or challenges related to mental illness. No previous study has investigated the association between self-disturbance phenomena and personal recovery in patients with SSD. Understanding the impact of self-disturbance could strengthen the therapeutic alliance with patients and contribute to the development of treatment strategies supporting their recovery. Aim: The aim of this study was to investigate whether severity of selfreported self-disturbance phenomena is associated with the level of self-reported personal recovery in patients with SSD, their unaffected siblings, and healthy controls. Methods: In a cross-sectional design with 522 patients with SSD, 608 unaffected siblings, and 369 healthy controls, the frequency and distress of self-disturbance phenomena was measured with the Self-Experience Lifetime Frequency Scale (SELF). Personal recovery was assessed with the Recovery Assessment Scale (RAS-24). Spearman's rank correlation coefficients between both scales were examined. Subsequent multiple hierarchical regression analyses were conducted to assess additional explained variance in personal recovery by severity of selfdisturbance phenomena, adjusting for positive, negative, and general symptomatology. Results: Significant correlations were reported between higher SELF and lower RAS-24 scores for patients (ρ = -0.20, p < 0.001), siblings (ρ = -0.24, p < 0.001), and controls (ρ = -0.16, p < 0.005). The severity of self-disturbance phenomena significantly albeit modestly predicted total personal recovery score after adjusting forpositive, negative, and general symptoms for patients (R² change = 0.035, β = -0.19, p < 0.001). Conclusion: Current findings suggest that self-reported self-disturbance phenomena are relevant for the personal recovery of patients with SSD. Healthcare practitioners are urged for attention to patients' first-person perspectives, including experiences of self-disturbance.