<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_sjcapp-2017-008_s_001"><h3>Background</h3><p>Recent continental-phenomenological psychiatry emphasizes pragmatics or <italic>social and contextual inappropriateness</italic> as a core disorder of schizophrenia, which is potentially relevant to early identification and treatment.</p></sec><sec id="j_sjcapp-2017-008_s_002"><h3>Objective</h3><p>However, there are hardly any studies that examine the <italic>background population’s</italic> sensitivity to inappropriateness in schizophrenia, even if “common” people, from a pragmatic perspective, are likely to be highly sensitive to cultural-conventional norms, including (in)appropriateness.</p></sec><sec id="j_sjcapp-2017-008_s_003"><h3>Method</h3><p>One empirical evaluation of contextual (in)appropriateness in 10 narratives from first-episode schizophrenia patients and healthy controls, respectively, found that when a phenomenologically informed Danish population (n=157 high-school students; mean age, 18.5) was “blinded” to the control–patient status – that is, “anonymous” narratives of the wordless picture story <italic>Frog, Where Are You?</italic> – they consequently evaluated <italic>patient</italic> narratives as more <italic>inappropriate</italic> than appropriate and <italic>control</italic> narratives as more <italic>appropriate</italic> than inappropriate (significant with 0.007). Aiming to explore a potential pattern recognition, distinguishing patient from control narratives, the present study systematizes and discusses salient explanations from <italic>lay “experts”</italic> who almost consequently (80% to 100%) evaluated patient narratives as inappropriate and control narratives as appropriate (n=63 of 157).</p></sec><sec id="j_sjcapp-2017-008_s_004"><h3>Results</h3><p>Explanations of inappropriateness concerned <italic>affective</italic> aspects (about how the patient <italic>felt</italic> or how the evaluators <italic>felt</italic> reading the narrative), <italic>formal</italic> aspects (about pauses, fluency, and brevity), and aspects about <italic>sense making</italic> (from lack of understanding to nonsense and strangeness).The background population may be sensitive to affective and formal inappropriateness, but only lay experts emphasize the lack of sense in the patients’ narratives.</p></sec><sec id="j_sjcapp-2017-008_s_005"><h3>Conclusion</h3><p>Further studies might benefit from investigating whether early referrals from family, friends, or schoolteachers of their own accord thematize such inappropriateness aspects, and whether questionnaires targeting inappropriateness could be developed and used in the early identification of young people at risk.</p></sec></abstract>

BackgroundRecent continental-phenomenological psychiatry emphasizes pragmatics or social and contextual inappropriateness as a core disorder of schizophrenia, which is potentially relevant to early identification and treatment.ObjectiveHowever, there are hardly any studies that examine the background population’s sensitivity to inappropriateness in schizophrenia, even if “common” people, from a pragmatic perspective, are likely to be highly sensitive to cultural-conventional norms, including (in)appropriateness.MethodOne empirical evaluation of contextual (in)appropriateness in 10 narratives from first-episode schizophrenia patients and healthy controls, respectively, found that when a phenomenologically informed Danish population (n=157 high-school students; mean age, 18.5) was “blinded” to the control–patient status – that is, “anonymous” narratives of the wordless picture story Frog, Where Are You? – they consequently evaluated patient narratives as more inappropriate than appropriate and control narratives as more appropriate than inappropriate (significant with 0.007). Aiming to explore a potential pattern recognition, distinguishing patient from control narratives, the present study systematizes and discusses salient explanations from lay “experts” who almost consequently (80% to 100%) evaluated patient narratives as inappropriate and control narratives as appropriate (n=63 of 157).ResultsExplanations of inappropriateness concerned affective aspects (about how the patient felt or how the evaluators felt reading the narrative), formal aspects (about pauses, fluency, and brevity), and aspects about sense making (from lack of understanding to nonsense and strangeness).The background population may be sensitive to affective and formal inappropriateness, but only lay experts emphasize the lack of sense in the patients’ narratives.ConclusionFurther studies might benefit from investigating whether early referrals from family, friends, or schoolteachers of their own accord thematize such inappropriateness aspects, and whether questionnaires targeting inappropriateness could be developed and used in the early identification of young people at risk.

Exploring a lay Gestalt of schizophrenia? A Danish background population’s explanations on why and how first-episode schizophrenia patients’ narratives were intuitively sensed as contextually inappropriate

Scandinavian Journal of Child and Adolescent Psychiatry and Psychology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

BackgroundRecent continental-phenomenological psychiatry emphasizes pragmatics or social and contextual inappropriateness as a core disorder of schizophrenia,...

Narrative F (Picture 1)	Narrative I (Picture 1)	Narrative J (Picture 1)	Narrative C (Picture 24)
I just have to figure out how to get started (You just take your time, and you can use these arrows when you need to). Yes. Does one (Danish: man) have to give the story a title? (You don’t need to … you don’t need to, you can if you want, but just (Danish altså) … just try to make a story based on the pictures)	I will give it a try…okay…once upon a time, there was a boy. He had caught a frog…but when he went to bed, then, then the frog saw his chance to run away.	Should I describe the pictures or tell a story? (It is your choice). Okay. Uhm…they, it is a boy and a dog, who has found a frog…uhm…that they are looking at…	and then…and then they take the frog home again…even if it had a family…and a lot of siblings and a mother and farther. And I think, that was where it preferred to be. So it did not end quite happily. That was it, I think”
Are you (Danish: man) allowed to give the boy a name?…………. (…THE QUESTIONS CONTINUE…)

FORMAL ASPECTS
Length	Fluency	Unfilled pauses	Filled pauses
“short” (n=31)	“not fluent” (n=15)	“many/	“uhm” (n=18)
“not detailed” (n=13)	“not going as a story ought to” (n=1)	“long pauses” (n=22)
“enumeration” (n=5)		“notches” (n=4)
“only one sentence at a time” (n=1)		“stops” (n=4)
“keyword form” (n=1)		“dots” (n=1)
“minimalistic” (n=1)

Exploring a lay Gestalt of schizophrenia? A Danish background population’s explanations on why and how first-episode schizophrenia patients’ narratives were intuitively sensed as contextually inappropriate

Article Category: research-article

Pubblicato online: 20 nov 2017

Pagine: 64 - 76

DOI: https://doi.org/10.21307/sjcapp-2017-008

Parole chiave
first-episode schizophrenia, inappropriateness, narratives, phenomenology, pragmatics

© 2017 Charlotte Petersen et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Narration to Picture 1 and 24

Lay experts’ explanative trends; formal, affective and meaning aspects

Exploring a lay Gestalt of schizophrenia? A Danish background population’s explanations on why and how first-episode schizophrenia patients’ narratives were intuitively sensed as contextually inappropriate

Article Category: research-article

Pubblicato online: 20 nov 2017

Pagine: 64 - 76

DOI: https://doi.org/10.21307/sjcapp-2017-008

Parole chiavefirst-episode schizophrenia, inappropriateness, narratives, phenomenology, pragmatics

© 2017 Charlotte Petersen et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Narration to Picture 1 and 24

Lay experts’ explanative trends; formal, affective and meaning aspects

Parole chiave
first-episode schizophrenia, inappropriateness, narratives, phenomenology, pragmatics