The interpersonal self in adolescent-onset psychosis: A grounded theory analysis: Part of a symposium titled Developmental and Interpersonal Factors in the Prodrome, Individual Adaptation, and Recovery from Psychosis

The prodromal phase has been conceptualised as a discrete phase in the disease process relevant for its ‘warning’ status. Recent psychological and medical research has suggested that intervention during this period may be beneficial. However, the phase is not well understood and definitions of it are both vague, referring to non-specific changes in interpersonal and intrapersonal functioning, and symptom led. The aim of this study was to explore how young people construct this period and how this may contribute to our understanding.

Using a social constructivist approach and grounded theory methodology, eight people aged between 18 and 23 who had experienced a first episode of psychosis were interviewed sequentially.

Analysis suggested that in this sample the self was described in interpersonal terms. The experience of developing psychosis was not considered by the sample as a series of discrete phases but as a process of survival over adversity. Two strategies emerged for this survival process, defined by the relationship between psychosis and self. Self-concept appeared to be a mediating factor and individuals vacillated between these two strategies. Survival and recovery was defined as re-establishment of interpersonal relationships, mainly with peers.

The research suggests that psychosis may best be understood as a struggle for self. The interpersonal nature of self may be a feature of developmental stage and/or predisposition to psychosis.

A post-analysis literature review explores the potential impact of psychosis on the development of self-concept in adolescence as both a psychopathological process and as a stress event. This review informs both clinical practice and future research in psychosis and adolescence.