Capturing the dynamics of anomalous world experiences in schizophrenia-spectrum disorders: An exploratory experience-sampling study

Abstract The Experience Sampling Method (ESM) is a promising approach for research on self-disorders, as it may enable studying how momentary changes in anomalous world experiences (AWEs) impact delusion development and maintenance. Using ESM to study AWEs requires clarification on two key issues: 1) discerning to what extent self-reports for AWEs align with clinician-based assessments; and 2) demonstrating the dynamic variability of AWEs in order to justify the use of ESM. This paper reports an exploratory ESM study (n = 7; 286 total ESM observations) on these two issues. False-positive indices and agreement rates between self-reports and clinician-based assessments were calculated, and ESM data was used to observe dynamic variability in AWEs. Exploratory mixed-effects models were conducted, using the AWE Unknown/Unstatable Significance as a predictor, and paranoia as an outcome. Two models were compared on indices of fit: Model 1, using all obtained data for the predictor variable (n = 6), and Model 2 (n = 5), eliminating data suspected of containing false-positives of the predictor. Average ESM completion rate was 68%. False-positive indices and agreement rates ranged from 20–88% and 14–86%, respectively. Visual inspection of temporal profiles of AWEs showed dynamic variability. Although mixed-effects models should be interpreted with caution, we observed a threshold effect for the relationship between Unknown/Unstatable Significance and paranoia (Model 1; B = –3.90, p = 0.015 ; Model 2: B = –2.87, p = 0.50 ). Indices of fit improved in Model 2 (Model 1; AIC = 1525.76 , BIC = 1559.15; Model 2; AIC = 1172.64, BIC = 1203.77). Larger-scale validation studies on AWE self-report items are warranted, as are further ESM studies that examine the role of AWEs in delusions.