Psychosis: adolescent development and self-construction

The thesis starts with a review of the various branches of schizophrenia research, concluding that there is no evidence that biological differences should take precedence over psychological differences in people with schizophrenia, and that the opposite argument is as compelling. The purpose of the opening section is to critically evaluate and make explicit these key paradigm assumptions, and in doing so lay the framework for the rest of the thesis. The literature on normal adolescent development is then reviewed and a theory about late-adolescent onset schizophrenia put forward. The first empirical study demonstrates that levels of mild psychotic-like `symptoms' in normal teenagers were intimately linked to levels of psychological development. The second study shows that people with a diagnosis of schizophrenia showed on average a level of psychological development much more akin to young teenagers than normal adult controls. From the two studies it is speculated that psychosis sufferers become stuck at that point in development where normal psychotic-like symptoms are most prevalent. Unlike `normal' adolescents, psychosis-sufferers fail to resolve this phase. The second part of the thesis focuses on the psychological mechanisms whereby this may come about and elaborates a theory of selfconstruction, threat and defence, within the context of the established literature on the Self. An empirical study reconstructs key episodes from schizophrenia sufferer's lives. It was found that clients experience a dilemma between self-actualisation goals and affiliative goals, and that the pressure of this dichotomy could explain the development over time of many of the symptoms of schizophrenia. Finally, hypotheses derived from the empirical self-construction chapter are tested in another empirical study, and the thesis as a whole is discussed