Self-defining memories predict engagement in structured activity in first episode psychosis, independent of neurocognition and metacognition
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Background: Self-defining memories (SDMs) are vivid personal memories, related to narrative identity. Individuals with schizophrenia report less specific, more negative, and extract less meaning from these memories compared to control groups. SDMs have been shown to be predicted by neurocognition, associated with metacognition, and linked to goal outcomes in healthy controls. As neurocognition and metacognition are known predictors of poor functioning in psychosis, SDMs may also be a predictor. No study has assessed the relationship to functioning or pattern of SDMs in first episode psychosis (FEP). Methods: This was a cross-sectional study involving 71 individuals with FEP and 57 healthy controls who completed an SDM questionnaire. FEP participants completed measures of neurocognition, metacognition (Metacognitive Assessment Interview), functional capacity (The University of California, San Diego [UCSD] Performance-Based Skills Assessment), and functional outcome (Time-Use Survey). Results: SDMs reported by individuals with FEP were less integrated compared to healthy controls. Within the FEP sample, holding less specific memories was associated with engagement in significantly fewer hours of structured activity per week and specificity of SDMs mediated the relationship between neurocognition and functional outcome, independent of metacognition. Conclusion: This is the first study to assess SDMs in FEP and to explore the important role of SDMs on clinical outcomes, compared to healthy controls. This study suggests that elaborating on specific SDMs is a valid therapeutic target and may be considered a tool to improve daily functioning in FEP.
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In schizophrenia, the most personally significant memories more often involve psychotic episodes, hospitalizations, and trauma, while normative adults' significant memories more often involve achievement and relationships.
“The most personally significant memories of individuals with schizophrenia are more likely to include psychotic episodes, hospitalizations, and traumatic events, whereas normative adults’ significant memories are more likely to include achievement and relationships (Berna et al., 2011a, 2011b; Raffard et al., 2009, 2010; Wright et al., 2019).”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
Table 2 reports more hospitalization/illness and life-threatening memories in the first-episode psychosis group, and more relationship memories in healthy controls. But achievement memories were more common in the psychosis group, not controls, and the paper does not identify psychotic episodes as a memory category. The Discussion also describes differences in negative memory content as nonsignificant. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn the first episode psychosis study, narratives were dichotomized as positive or negative, limiting statistical power, and a small to medium effect size in direction of more negative tone in SSD was reported (Cox logit d = .32).
“this study dichotomized narratives as positive or negative, which limited its statistical power, and reported a small to medium effect size in the direction of more negative tone in the SSD group (Cox logit d = .32)”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
Table 2 reports positive-versus-negative memory content and a nonsignificant difference in the direction of more negative memories in the first-episode psychosis group (48% versus 35% in controls; P = .15). The Limitations section says the small sample was a particular problem for binary-variable analyses. The paper does not report Cox logit d = .32 for this comparison, and its studied group is specifically first-episode psychosis, not SSD broadly. (LLM, conf=0.88)
Experimental — accuracy not yet measuredSince that review, a third study found no specificity differences for self-defining memories between first-episode psychosis and healthy controls.
“Since that review was published, a third study has reported no differences in specificity for self-defining memories between first episode psychosis and healthy controls (Wright et al., 2019).”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
In first episode psychosis, no significant difference from controls in valence of self-defining memories.
“finding no significant difference from controls (Wright et al., 2019)”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
In first episode psychosis, specificity mediated the relationship between impaired neurocognition (memory performance) and functional outcomes.
“specificity mediated the relationship between impaired neurocognition (memory performance) and functional outcomes”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
Impairments in meaning-making are not associated with neurocognition.
“impairments in meaning-making are not associated with neurocognition (Wright et al., 2019)”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
In first episode psychosis, meaning-making is lower than in controls.
“One study has also reported lower levels of meaning-making in a first episode psychosis sample (Wright et al., 2019)”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
By the time they experience a first psychotic episode, individuals are engaged in less meaning-making compared to healthy controls, and this trend becomes more pronounced in chronic schizophrenia-spectrum disorder.
“By the time they experience a first psychotic episode, individuals are engaged in less meaning-making compared to healthy controls (Wright et al., 2019), a trend which only becomes more pronounced in the chronic phase of SSD.”
From Narrative identity in the psychosis spectrum: A systematic review and developmental model (2021) · cites this paper as Wright et al., 2019
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James, A. V., Hasson‐Ohayon, I., Vohs, J. L., Minor, K. S., Leonhardt, B. L., Buck, K. D., George, S. E., & Lysaker, P. H. (2016) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2016.05.008 · Cited by 30 · see citing works
Donkers, F. C. L., & Belger, A. (2011) · Research Publications (Maastricht University) · Cited by 16 · see citing works
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Flagged first, then by citations
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- Lysaker PH, Lysaker JT. Narrative structure in psych- osis schizophrenia and the dialogical self. Theory Psychol. 2002;12(2):207-220.
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Narrative identity in the psychosis spectrum: A systematic review and developmental model
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Understanding Identity Changes in Psychosis: A Systematic Review and Narrative Synthesis
Conneely, M., McNamee, P., Gupta, V., Richardson, J., Priebe, S., Jones, J. M., & Giacco, D. (2021) · Schizophrenia Bulletin · doi:10.1093/schbul/sbaa124 · Cited by 60 · see citing works
Wright, A. C., Davies, G., Fowler, D. G., & Greenwood, K. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00182 · Cited by 22 · see citing works
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Self-citationCowman, M., Godfrey, E., Walsh, T., Frawley, E., Fowler, D. G., Álvarez‐Jiménez, M., O’Connor, K., Wykes, T., Birchwood, M. J., & Donohoe, G. J. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad062 · Cited by 14 · see citing works
Self-citationWright, A. C., Moody, E., Browne, J., & Cather, C. (2022) · Memory · doi:10.1080/09658211.2022.2042565 · Cited by 16 · see citing works
Self-citationSelf-concept and Narrative Identity in Youth at Clinical High Risk for Psychosis
Cowan, H. R., McAdams, D. P., Ouellet, L., Jones, C. M., & Mittal, V. A. (2023) · Schizophrenia Bulletin · doi:10.1093/schbul/sbad142 · Cited by 15 · see citing works
Wright, A. C., Fowler, D. G., & Greenwood, K. (2019) · Psychiatry Research · doi:10.1016/j.psychres.2019.112643 · Cited by 10 · see citing works
Self-citationMcGuire, N., Gumley, A. I., Hasson‐Ohayon, I., Allan, S., Aunjitsakul, W., Aydın, O., Bo, S., Bonfils, K. A., Bröcker, A., de Jong, S., et al. (2023) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12505 · Cited by 5 · see citing works
Self-report Assessment of Metacognition Among Schizophrenia Patients: A Systematic Review
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The Assessment of Metacognition in Psychosis: Systematic Review and Future Lines of Research
Díaz-Cutraro, L., Verdaguer-Rodríguez, M., Ferrer-Quintero, M., Montserrat, R., Moritz, S., Lysaker, P. H., Dimaggio, G., Palma‐Sevillano, C., Lamarca, M., Espinosa, V., et al. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70223 · Cited by 4 · see citing works
Lipskaya‐Velikovsky, L., Hershkovitz, A., Bukai, M., & Bar‐Shalita, T. (2024) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2024.1413635 · Cited by 3 · see citing works
Allé, M. C., Giersch, A., Potheegadoo, J., Meyer, N., Danion, J., & Berna, F. S. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00699 · Cited by 2 · see citing works
Self in recent onset schizophrenia: clinical and theoretical considerations
Lemée, T., Haj, M. E., & Robin, F. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33040-7.00031-2
Blagov, P. S., Conner, J., & Singer, J. A. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-33040-7.00008-7
- Authors
- Wright, A. C., Davies, G., Fowler, D., & Greenwood, K. E.
- Affiliations
- University of Sussex (GB)
- University of Surrey (GB)
- Corresponding author
- Wright, Abigail C
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-11-02
- Volume
- 45
- Issue
- 5
- Pages
- 1081-1091
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC6737466
- OpenAlex
- W2897189667
- Cited by
- 15
- References
- 93
- Citations by year
- 2026: 4 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 4
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Sussex Research Online (University of Sussex) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Sussex Partnership NHS Foundation Trust
- Economic Social Research Council (ES/J500173/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Developmental and Educational Psychology › Identity, Memory, and Therapy
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- self-defining memories, first-episode psychosis
- MeSH terms
- Metacognition, Adolescent, Adult, Cognition, Cross-Sectional Studies, Female, Humans, Intelligence Tests, Male, Memory, Neuropsychological Tests, Psychotic Disorders, Surveys and Questionnaires, Task Performance and Analysis, Time Factors, Linear Models, Logistic Models, Case-Control Studies, Young Adult, Executive Function, Memory, Episodic, Prodromal Symptoms
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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