Page 61 - JCBP-2-1

Journal of Clinical and
Basic Psychosomatics Exteroceptive/interoceptive processing

1. Introduction in noisy environments and filtering deficits of the less
relevant stimuli . In summary, an increasing amount of
[15]
Perception serves as the backdrop of every experience we evidence suggests that individuals with psychosis exhibit
have of the world . Each second, we integrate a multitude perceptual and self-disturbances compared to the general
[1]
of sensory stimuli originating from both our internal population. The intensity of these alterations varies
body and the external environment, translating them into inversely with treatment responsiveness and directly
conscious perceptions. These processes are fundamental for with symptom severity . This insight has potentially
[16]
generating a stable sense of self, an inherent feeling of unity relevant clinical implications, as perceptual alterations
that allows us to perceive ourselves as unique individuals could provide a starting point for a deeper understanding
distinct from the surrounding world . In essence, through of psychotic-like experiences and even become a future
[2]
the cohesive integration of diverse stimuli, we establish therapeutic target.
clear boundaries between our self and non-self. This
awareness allows us to recognize ourselves as something Perceptual disorders can also be identified during
different from the objects we perceive. In this context, it high-risk states preceding the first psychotic episode [17] .
becomes impossible to disentangle the concept of self Therefore, it is crucial to ascertain whether perceptual
and perception, as these two psychological constructs are alterations remain consistent over time or are linked to
deeply intertwined. the phase of illness. This understanding is pivotal not
only for validating the theoretical underpinnings of
Understanding the relationship between perception
and the self becomes even more complex when perceptual and self-related disturbances in psychosis but
also from a clinical standpoint. In fact, understanding
considering mental disorders, specifically psychosis. specific perceptual dysfunctions and their dynamics
On the one hand, phenomenological psychopathology
has pointed out that schizophrenia and psychotic could help develop specific markers and allow the
early identification of vulnerability traits. Nevertheless,
disorders, in general, are characterized by an impaired the literature on this topic is very limited to date. This
sense of the basic self, which mediates the pre-reflective limitation is also due to the lack of specific means of
experience of reality . On the other hand, perceptual
[3]
abnormalities, such as hallucinations, are among the investigation that has garnered consensus within the
core symptoms of the psychosis spectrum [4,5] . However, scientific community and been validated in clinical
practice. Perceptual profiles are often evaluated with
the pathways through which alterations in perception self-administered questionnaires that find extensive
and self are intertwined in the pathogenesis of psychotic [18,19]
symptoms remain largely unknown [6,7] . In light of the use in the general population . More specifically,
growing interest in this field, preliminary evidence from the Multidimensional Assessment of Interoceptive
[20]
behavioral tasks suggests that individuals with psychosis Awareness (MAIA) is among the most utilized self-
questionnaires for assessing the perception of internal
exhibit impaired sensory profiles compared to the bodily states (i.e., interoception). Conversely, the
general population [8,9] . In psychosis, sensory channels [8]
undergo dissociation, eroding the connections between Adolescent/Adult Sensory Profile (AASP) is a validated
the internal and external worlds, thus giving rise to approach for evaluating external sensory processing
(i.e., exteroception). Although these questionnaires are
incoherent and paradoxical multisensory experiences . not typically integrated into routine clinical evaluations
[10]
This state is termed “perceptual incoherence,” and certain
authors propose that, to mitigate or resolve it, the brain conducted in psychiatric settings, they could prove highly
might produce incongruent mental contents or altered valuable for psychiatric patients, offering a meaningful
[21]
[11]
sensory experiences (i.e., delusions and hallucinations) . marker of their subjective experiences .
These observations are in line with the phenomenological Building upon the abovementioned premises, our study
description of Wahnstimmung experiences, which are aimed to use MAIA and AASP to measure perceptual
characterized by the overlapping of perceptual stimuli profiles in a group of 23 patients with psychosis (PSY
felt as significant. However, if everything is significant, patients) in the post-acute and remission phases of illness
then nothing is significant, ending up in the loss of (PSY-T1 and PSY-T2, respectively). Due to the high stability
significance of the world and the delusional restructuring of perceptual profile scores in the general population [18,22,23] ,
of experiences [12,13] . In line with these theories, it has we hypothesized that perceptual profiles would be more
been postulated that auditory hallucinations result from related to a vulnerability trait rather than linked to the
distorted sensory perceptions . Other authors identified active phase of illness. To enhance the reliability of our
[14]
the heightened or disorganized perception of stimuli findings, we also compared patients’ perceptual profiles in
as the process responsible for attentive dysregulations the two different phases of illness to those of 210 healthy

Volume 2 Issue 1 (2024) 2 https://doi.org/10.36922/jcbp.1764