German Title: Schizophrenie und Bewegung - wenn "Disembodiment" messbar wird

Preview

PDF, English (Mantelpapier Dissertation Lily Martin) - main document Download (15MB) | Lizenz: Rights reserved - Free Access

Abstract

Schizophrenia presents with a complicated clinical picture and causes immense suffering in the affected individuals and caregivers. In reaction to the lack of satisfying options for treatment and the ongoing academic dissent on the condition’s origin, the interdisciplinary embodiment approach emphasizes bodily mediated, pre-reflective experiences in schizophrenia etiology and treatment and focuses on the role of the (moving) body within psychiatric research on schizophrenia psychopathology. Schizophrenia is understood to be caused by a so-called disembodiment, which implies that it is not the psychotic symptoms which are essential for the understanding of schizophrenia, but rather the early and continuous disturbance of the pre-reflective, implicit functioning of the body in everyday life. Disembodiment is understood to manifest in symptoms on various experiential levels, such as basic self-disorders, motor abnormalities or a disturbed interbodily resonance, most of which are discussed phenotypic markers of schizophrenia vulnerability already, but are rarely studied in relation to each other. Scarcity of respective research or self-disorder and motor abnormality assessment in daily diagnostics might be due to the inconsistency of concepts and the lack of objective and sensitive assessment means for full-body movement and embodied interaction.

Filling this gap, the dissertation project aimed at operationalizing disembodiment. Measurable aspects of disembodiment were defined, the examination of anomalous self- experience (EASE) translated, a study protocol for objective movement assessment and analysis developed and a tool for an assessment of disembodied interaction proposed. Within three mixed-methods studies, the abovementioned methodology was applied. In the first study, I quantified data-driven and theory-independent movement markers (MM), comparing simple gait of patients with schizophrenia and controls. In the second study, we analyzed balance characteristics of participants with schizophrenia. In the third study the MM were systematically related to changes in self- and body experience of respective patients.

Results show that MM extracted and quantified from basic walking can differentiate between people with schizophrenia and controls. Many MM are related to the integration and adjustment of body sides, limbs or the direction of movement. Furthermore, patients with schizophrenia show significant disturbances in static and dynamic balance which also are related to the integrative movement of body parts for an adaptive balance strategy. The MM are related to quantitative and qualitative measurements of changes in self- and body experience, or to SDs. Integration- and coordination-related MM significantly correlate with somatic depersonalization and loss of ipseity. Descriptions of specific anomalous self- experiences, such as hyperreflexivity, systematically increase with greater MM manifestation.

The findings emphasize that manifestations of disembodiment can be measured. They further imply that motor impairment and self-disorders, instead of individually being understood as endophenotypes of schizophrenia vulnerability, can be considered two manifestations of and their interrelation preliminary evidence for one underlying disturbance of schizophrenia, namely a disturbed pre-reflective and embodied consciousness.