Self-disturbances as a possible premorbid indicator of schizophrenia risk: a neurodevelopmental perspective. 2014

Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Massachusetts Mental Health Center Division of Public Psychiatry, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: bbrent@bidmc.harvard.edu.

Self-disturbances (SDs) are increasingly identified in schizophrenia and are theorized to confer vulnerability to psychosis. Neuroimaging research has shed some light on the neural correlates of SDs in schizophrenia. But, the onset and trajectory of the neural alterations underlying SDs in schizophrenia remain incompletely understood. We hypothesize that the aberrant structure and function of brain areas (e.g., prefrontal, lateral temporal, and parietal cortical structures) comprising the "neural circuitry of self" may represent an early, premorbid (i.e., pre-prodromal) indicator of schizophrenia risk. Consistent with neurodevelopmental models, we argue that "early" (i.e., perinatal) dysmaturational processes (e.g., abnormal cortical neural cell migration and mini-columnar formation) affecting key prefrontal (e.g., medial prefrontal cortex), lateral temporal cortical (e.g., superior temporal sulcus), and parietal (e.g., inferior parietal lobule) structures involved in self-processing may lead to subtle disruptions of "self" during childhood in persons at risk for schizophrenia. During adolescence, progressive neurodevelopmental alterations (e.g., aberrant synaptic pruning) affecting the neural circuitry of self may contribute to worsening of SDs. This could result in the emergence of prodromal symptoms and, eventually, full-blown psychosis. To highlight why adolescence may be a period of heightened risk for SDs, we first summarize the literature regarding the neural correlates of self in typically developing children. Next, we present evidence from neuroimaging studies in genetic high-risk youth suggesting that fronto-temporal-parietal structures mediating self-reflection may be abnormal in the premorbid period. Our goal is that the ideas presented here might provide future directions for research into the neurobiology of SDs during the pre-psychosis development of youth at risk for schizophrenia.

UI MeSH Term Description Entries
D011618 Psychotic Disorders Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994) Psychoses,Psychosis, Brief Reactive,Schizoaffective Disorder,Schizophreniform Disorders,Psychosis,Brief Reactive Psychoses,Brief Reactive Psychosis,Disorder, Psychotic,Disorder, Schizoaffective,Disorder, Schizophreniform,Disorders, Psychotic,Disorders, Schizoaffective,Disorders, Schizophreniform,Psychoses, Brief Reactive,Psychotic Disorder,Reactive Psychoses, Brief,Reactive Psychosis, Brief,Schizoaffective Disorders,Schizophreniform Disorder
D001921 Brain The part of CENTRAL NERVOUS SYSTEM that is contained within the skull (CRANIUM). Arising from the NEURAL TUBE, the embryonic brain is comprised of three major parts including PROSENCEPHALON (the forebrain); MESENCEPHALON (the midbrain); and RHOMBENCEPHALON (the hindbrain). The developed brain consists of CEREBRUM; CEREBELLUM; and other structures in the BRAIN STEM. Encephalon
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D012559 Schizophrenia A severe emotional disorder of psychotic depth characteristically marked by a retreat from reality with delusion formation, HALLUCINATIONS, emotional disharmony, and regressive behavior. Dementia Praecox,Schizophrenic Disorders,Disorder, Schizophrenic,Disorders, Schizophrenic,Schizophrenias,Schizophrenic Disorder
D012565 Schizophrenic Psychology Study of mental processes and behavior of schizophrenics. Psychology, Schizophrenic
D012649 Self Concept Persons' view of themselves. Self Esteem,Self Perception,Self Confidence,Self-Perception,Concept, Self,Confidence, Self,Esteem, Self,Perception, Self,Perceptions, Self,Self Esteems,Self Perceptions,Self-Perceptions

Related Publications

Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
August 1993, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
January 1977, Archives of general psychiatry,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
January 2003, Schizophrenia bulletin,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
December 2005, Archives of general psychiatry,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
December 2007, Schizophrenia research,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
September 2008, Brain : a journal of neurology,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
August 2012, Schizophrenia research,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
October 2015, Psychological medicine,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
January 2001, Neuropsychobiology,
Benjamin K Brent, and Larry J Seidman, and Heidi W Thermenos, and Daphne J Holt, and Matcheri S Keshavan
February 2016, Early intervention in psychiatry,
Copied contents to your clipboard!