© 2000 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
Vulnerability to Schizophrenia and Lack of Common Sense
Psychiatrist, Florence Department of Mental Health Florence, Italy; Secretary, World Psychiatric Association Clinical Psychopathology Section and Italian Society for Psychopathology; and Professor of Social Psychopathology, Postgraduate School of Psychiatry, University of Florence Florence, Italy
Send reprint requests to Dr. G. Stanghellini, U.O. Sperimentale di Psichiatria, Dipartimento di Salute Mentale, Università di Firenze, Viale Michelangiolo 41, I-50125 Firenze, Italy; e-mail: stan{at}dada.it
Abstract
This article explores the hypothesis that the relational deficit in schizophrenia is not a consequence of acute symptoms and course but instead is a fundamental aspect of schizophrenic vulnerability. This basic relational deficit could be better understood as disconnectedness from common sense. Common sense is a tool for adaptation whose main scope is establishing cause-and-effect and motivational relationships in the physical and social realms. The common sense deficit appears to involve a lack of intuitive attunement (impaired capacity to accurately typify the mental states of other persons because of the incapacity to be involved in their mental lives) and a damaged social knowledge network (disorders of the background of knowledge useful for organizing everyday experiences). Three dimensions of schizophrenic vulnerability can be distinguished: the sensory, conceptualization, and attitudinal dimensions. Sensory disorders are aberrations of self, body, and world perceptions. Conceptualization disorders are disturbances in the attribution of meanings and intentions. Attitudinal disorders consist of eccentricities in the individual's structure of values and beliefs, characterized by distrust toward conventional knowledge and attunement. This article describes the present state and possible future directions of qualitative analyses and empirical investigations relevant to assessing the interplay between vulnerability dimensions and disorders of common sense.
Keywords: Common sense / attunement / relational deficit / schizophrenia / social knowledge / vulnerability
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