Spanish validation of the Detachment and Compartmentalization Inventory (DCI) in a community and clinical sample. A new instrument for measuring dissociation.

INTRODUCTION: Dissociative symptoms are a type of phenomenon which is present in a wide variety of psychopathological disorders. It is therefore necessary to develop scales that measure this type of experience for therapy and research. Starting out from the bipartite model of dissociation, this study intended to adapt and validate the Detachment and Compartmentalization Inventory (DCI) in Spanish. MATERIAL AND METHODS: For this, 308 participants (268 from the community population and 40 with psychiatric pathology) completed the DCI, the Dissociative Experiences Scale (DES-II), the Somatoform Dissociation Questionnaire (SDQ20) and the Mindfulness Attention Awareness Scale (MAAS). RESULTS: The results showed that the Spanish version has a two-factor structure similar to the original version and was invariant across participants. The reliability of DCI scores was adequate and acquired evidence of validity related to other instruments. CONCLUSIONS: It is concluded that the DCI is a valid scale for detecting detachment and compartmentalization dissociative experiences, both in the clinic and research.

Childhood and adolescent trauma and dissociation: The mediating role of rumination, intrusive thoughts and negative affect.

Dissociation is a complex phenomenon which is present in a wide variety of psychiatric disorders and also in the general population. The objective of this study was to examine the relationship between childhood and adolescent traumas and development of dissociative phenomena in a nonclinical population, emphasizing the potentially mediating role of rumination, intrusive thoughts and negative affect in a population with no psychiatric pathology in adulthood. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.10 years (SD: 14.08). They completed the Juvenile Victimization Questionnaire (JVQ), the Ruminative Response Scale (RRS), the White Bear Suppression Scale (WBSI), the Dissociative Experience Scale, 2d ver. Rev. (DES-II) and the Depression, Anxiety and Stress Scale (DASS-21). The results supported the starting hypotheses showing a positive correlation between childhood and adolescent trauma and dissociation, and between childhood and adolescent trauma and rumination, intrusive thoughts and negative affect, and mediation of these variables between childhood and adolescent trauma and dissociative states. The relationship between trauma in early ages and dissociation in adulthood is complex. Although the design used in this study was cross-sectional, the results are compatible with the starting hypothesis that rumination, intrusive thoughts and negative affect mediate this relationship.

Dissociation as a Mediator of Traumatic Childhood Experiences and Ideas of Reference.

Ideas of reference (IR) - self-attributions about what happens in the social environment are a frequent phenomenon present in a wide variety of people with mental health disorders as well as in the nonclinical population. The purpose of this study was to find out the relationship between traumatic childhood experiences, IR and dissociative states in the nonclinical population, emphasizing the potential mediating role of dissociation between traumatic experiences and IR. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.20 years (SD = 14.08). They filled in the Juvenile Victimization Questionnaire (JVQ), the Dissociative Experiences Scale-II (DES-II) and the Referential thinking Scale (REF). The results supported the original hypotheses and showed that the participants with higher frequency of IR reported more childhood traumatic (χ2 (2) = 64.33, p < .001, f = .39, 1- ß = .99) and dissociative experiences (χ2 (2) = 50,414, p < .001, f = .38, 1- ß = .99), and that dissociative states (ß = .12, p < .05; 95%CI [.07, .19]; c´ = .26, p < .001), specifically absorption (ß = .09, p < .05; 95% CI [.03, .15]; c´ = .26, p < .001), mediated between traumatic childhood experiences and referential thinking. It was concluded that the relationship between traumatic experiences and IR is complex and may be mediated by variables such as dissociation.

[Evidence-Based Psychological Treatments for Adults: A Selective Review]

Evidence-Based Psychological Treatments for Adults: A Selective Review. BACKGROUND: Psychological treatments have shown their efficacy, effectiveness, and efficiency in dealing with mental disorders. However, considering the scientific knowledge generated in recent years, in the Spanish context, there are no updating studies about empirically supported psychological treatments. The main goal was to carry out a selective review of the main empirically supported psychological treatments for mental disorders in adults. METHOD: Levels of evidence and degrees of recommendation were collected based on the criteria proposed by the Spanish National Health System (Clinical Practice Guidelines) for different psychological disorders. RESULTS: The results indicate that psychological treatments have empirical support for the approach to a wide range of psychological disorders. These levels of empirical evidence gathered range from low to high depending on the psychological disorder analysed. The review indicates the existence of certain fields of intervention that need further investigation. CONCLUSIONS: Based on this selective review, psychology professionals will be able to have rigorous, up-to-date information that allows them to make informed decisions when implementing empirically based psychotherapeutic procedures based on the characteristics of the people who require help.

The dark side of Instagram: Predictor model of dysmorphic concerns.

Dysmorphic concern are excessive preoccupation about one or several physical characteristics perceived as defects, usually unnoticeable by others. This study was intended to explore the relationship between Instagram use and dysmorphic concerns through appearance-related comparisons, ideas of reference and problems with emotion regulation, and find out whether this relationship is moderated by gender. METHOD: The sample was comprised of 796 participants (Mage  = 22.49; SD = 3.56; 54% women). RESULTS: The results showed a non-significant direct effect between Instagram use and dysmorphic concerns. However, the relationship between these variables was statistically significant through appearance-related comparisons, ideas of reference about "laughing, commenting" and difficulties in emotion regulation. Gender did not moderate any relationship. CONCLUSIONS: Men and women who made the most use of Instagram were equally vulnerable to dysmorphic concerns when they tended to compare their appearance with other users, had problems regulating their emotions, and showed interpretative biases related to the belief that others could make comments about them or laugh at them because of their imperfections. The implications of the study are discussed.

Las preocupaciones dismórficas hacen referencia a una preocupación excesiva por una o varias características físicas percibidas como defectos que normalmente no son observables por otras personas. El presente trabajo pretende explorar la relación entre el uso de Instagram y las preocupaciones dismórficas a través de la comparación de la apariencia, las ideas de referencia y las dificultades en la regulación emocional, así como analizar si esta relación está moderada por el género. Método: Participaron 796 sujetos (Medad  = 22,49; DT = 3,56; 54% mujeres). Resultados: Los resultados mostraron un efecto directo no significativo entre el uso de Instagram y las preocupaciones dismórficas. La relación entre estas variables fue estadísticamente significativa a través de la comparación de la apariencia, ideas de referencia sobre "risas y comentarios" y las dificultades en la regulación emocional. El género no moderó ninguna relación. Conclusiones: Hombres y mujeres que hacen un mayor uso de Instagram son igualmente vulnerables a manifestar preocupaciones dismórficas, cuando tienden a comparar su apariencia con otros usuarios, tienen dificultades para regular sus emociones, y muestran sesgos interpretativos relacionados con la creencia de que otros podrían hacer comentarios o burlarse de uno mismo por sus imperfecciones. Se discuten las implicaciones de este trabajo.

Dysmorphic concern and behavioural impairment related to body image in adolescents.

This study examined a moderated mediation model testing whether dysmorphic concern is related to behaviour altered to change appearance. This relationship is potentially mediated by depressive symptomatology (dysphoria and self-esteem) and ideas of reference about "laughing, commenting" and "attention, appearance," and each mediated relationship moderated by sex. The sample was made up of 3377 adolescents from 12 to 18 years old (Mage  = 14.52; SD = 1.65, 56.5% girls). The results showed that dysphoria and ideas of reference about "laughing, commenting" and "attention, appearance" partially mediated the relationship between dysmorphic concern and behavioural impairment related to body image. The relationship with dysphoria was moderated by sex, such that the mediation effect was stronger in girls than in boys. This result implies that girls who are worried about some characteristic of their appearance and show dysphoria are at greater risk of altered behaviour involving avoidance or controlling their appearance than boys. In addition, a possible risk of body dysmorphic disorder (3.45% of the sample) was found, with very prominent hiding behaviour using clothing or control behaviours, such as frequent weighing and looking at oneself in the mirror too much. Implications of these findings are discussed.

The relationship with the voices as a dialogical experience: The role of self-focused attention and dissociation.

OBJECTIVE: The purpose of this article was to study the relationship of self-focused attention and dissociation with the dialogical relationship persons diagnosed with psychosis have with their voices. METHOD: The DAIMON Scale was applied to 62 persons diagnosed with psychosis to measure the dialogical relationship with their voices, and the Cambridge depersonalization scale, the Tellegen absorption scale, and the self-focused attention scale. RESULTS: The results showed that the dialogical relationship with the voices was associated with high levels of self-focused attention (private and public), depersonalization, and absorption. It was also found that absorption mediated significantly between public self-focused attention and the dialogical relationship with the voices. CONCLUSIONS: The role of dissociation and self-focused attention in forming the dialogical relationship a person with psychosis has with the voices is discussed and approaches to treatment are suggested.

Spanish validation of the self-evaluation of negative symptoms scale SNS in an adolescent population.

BACKGROUND: Negative symptoms (NS) may be observed in the general population in an attenuated form and in high-risk mental states. However, they have been less studied in the general population than positive symptoms, in spite of their importance at the insidious onset of schizophrenia and their appearance before positive symptoms. This study aimed to analyze the empirical structure of the Spanish version of the Self-Evaluation of Negative Symptoms (SNS) Scale and find its psychometric properties and invariance of measurement across sex and age in a sample of adolescents. METHODS: The sample consisted of 4521 adolescents (53.6% female) from 11 to 18 years of age. RESULTS: Confirmatory Factor Analysis of the SNS confirmed an internal structure of five first-order factors by the characteristic dimensions of NS: avolition, social withdrawal, diminished emotional range, anhedonia, alogia, and one second-order factor which includes the total NS score. Multi-group confirmatory factor analysis showed that the scale was invariant across sex and age. Total scale reliability was adequate. A strong relationship was found between the SNS with depressive symptomatology, moderate with ideas of reference and low with aberrant salience. CONCLUSION: The results back use of the Spanish version of the SNS scale for detection of NS in the general population of adolescents.

Examining the structure of ideas of reference in clinical and community samples.

AIMS: This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis. METHODS: A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84. RESULTS: Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders. CONCLUSIONS: The results provide satisfactory that the REF scale could be used to study psychosis.

Childhood memories of threatening experiences and submissiveness and its relationship to hallucination proneness and ideas of reference: The mediating role of dissociation.

Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES-II scale for measuring dissociation, the LSHS-R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness.

Unusual sleep experiences and dissociation as mediators between sleep quality and proneness to hallucinations in a nonclinical population sample: a preliminary study.

INTRODUCTION: The purpose of this study was to examine the relationship of sleep quality to proneness to hallucinations and the mediating role of dissociation and unusual sleep experiences in a nonclinical sample. METHODS: One hundred and seventy-seven participants completed a questionnaire on sleep quality, a dissociative experiences scale, an unusual sleep experiences scale and a hallucination proneness scale. RESULTS: The results showed a significant positive association between quality of sleep and hallucination proneness, dissociation and unusual sleep experiences, and that dissociation and unusual sleep experiences fully mediated between sleep quality and hallucination proneness. CONCLUSIONS: Our study highlights the importance of variables related to sleep quality and unusual sleep experiences and dissociation in understanding hallucinations, and the importance of taking these variables into consideration in designing intervention directed at reducing distress caused by hallucinations.

Validation of Spanish Language Evaluation Instruments for Body Dysmorphic Disorder and the Dysmorphic Concern Construct.

Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in physical appearance with social avoidance and behavior directed at controlling the defect in appearance. This study attempted to adapt the factor structure of two instruments that cover the DC construct, the Dysmorphic Concern Questionnaire (DCQ) and the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR), to Spanish and establish their psychometric properties. A total of 920 subjects (62.7% women, Mage = 32.44 years) participated. Exploratory and Confirmatory Factor Analysis of both scales found adequate goodness of fit indices. A one-dimensional structure was found for the DCQ and two first-order factors (dissatisfaction/preoccupation with body image (BI) and BI avoidance behavior) were identified for the BDDE-SR. The psychometric test-retest reliability and validity properties (content, convergent, and discriminant) were satisfactory. It is suggested that the DC construct includes both cognitive and behavioral aspects and may represent a continuum of severity with Body Dysmorphic Disorder at the end.

A Mediation Model for Ideas of Reference.

Ideas of reference are common in human beings, but they are frequent in certain psychopathological disorders, mainly those concerning the psychotic spectrum. The purpose of this study was to attempt to construct a model predicting the appearance of ideas of reference and to test the relationship of personality (based on the Gray model), emotional, and self-consciousness variables. Five-hundred and seventy-four participants (287 patients with several different psychopathological diagnoses) filled in the Referential Thinking Scale (REF), the GHQ-28, the Self-Consciousness Scale (SCS-R), and the SPSRQ Scale. The resulting model found full mediation of sensitivity to punishment, sensitivity to reward, depression, and public self-consciousness between anxiety and ideas of reference, regardless of the group they were in (patients vs. nonpatients). This result, based on the appearance of anxiety symptomatology, explains 43% of the variance in scores, showing the presence of ideas of reference and therefore enables prediction of a set of vulnerabilities (established with self-reports) which could lead to a psychological state of high general pathological risk and proneness to psychosis in particular.

Body image and adolescence: A behavioral impairment model.

Adolescence is a period marked by important physical and social changes that can lead to a negative body image. The purpose of this study was to find a model enabling the appearance of behavioral impairment related to body image (restrictions, avoidance, and checking) to be predicted by body image attitudes (concern or Appearance Orientation, and dissatisfaction or Appearance Evaluation), Gender, emotional symptomatology, self-consciousness, ideas of reference (IR) and age. A total of 661 participants (67.47% girls) with an average age of 17.14 years (SD=2.34) filled in the GHQ-28, SCS on self-consciousness, REF referential thinking scale, MBSRQ (AO and AE), and BIAQ. A partial mediation model was found for IR, age and depressive symptomatology between dissatisfaction and concern about body image and Gender, to behavioral impairment related to body image. The results found suggest that age, depressive symptomatology, and IR may be mediator variables in the relationship between dissatisfaction and concern about body image, on body image behavioral impairment. This relationship implies a severity to be considered in intervention and monitoring of body image behavioral impairments in adolescents.

Leiden Index of Depression Sensitivity-Revised (LEIDS-R): Spanish validation proposal.

To adapt and validate the Leiden Index of Depression Sensitivity-Revised for evaluating cognitive reactivity to depressive mood to Spanish and validate this Spanish version. To find the scale's factor structure and psychometric properties. The sample consisted of 600 participants (103 patients and 497 subjects from the general population). A four-factor structure was found, a general factor evaluating cognitive reactivity was proposed and ten items were eliminated. A brief version of the (LEIDS-R24) scale is proposed. The factors and the overall scale have adequate internal consistency, and the results of validation show that all the factors on the scale predict depressive symptomatology (BDI-II) adequately, and are highly correlated with the Dysfunctional Attitudes Scale and BDI-II scales. The complete scale adequately discriminated depressive symptomatology in general population subjects and patients with anxiety and depressive disorders. No significant differences were found in the LEIDS-R24 measurement between subjects with anxiety and depressive disorder. The LEIDS-R24 scale may be a useful brief measure for evaluating cognitive reactivity to depressive mood and analyzing the vulnerability which could be common to persons with anxiety and depressive disorders.

Adaptar y validar al español la escala Leiden de Sensibilidad para la Depresión Revisada para evaluar la reactividad cognitiva al humor depresivo. Conocer la estructura factorial de la escala y hallar las propiedades psicométricas. La muestra consistió en 600 participantes (103 pacientes y 497 sujetos de población general). Se obtuvo una estructura de cuatro factores, se propuso un factor general que evalúa la reactividad cognitiva y se eliminaron 10 ítems. Se propone una versión reducida de la escala (LEIDS-R24). Los factores y la escala global presentan una adecuada consistencia interna y los resultados de la validación muestran que todos los factores de la escala predicen adecuadamente la sintomatología depresiva (BDI-II) y muestran correlaciones elevadas con la Escala de Actitudes Disfuncionales y BDI-II. La escala completa discriminó adecuadamente en sintomatología depresiva entre sujetos de la población general y sujetos con trastornos de ansiedad y depresivos. No se hallaron diferencias significativas en la medida LEIDS-R24 entre sujetos con trastornos de ansiedad y depresivos. La escala LEIDS-R24 puede ser una medida útil y breve para evaluar la reactividad cognitiva al humor depresivo y analizar la vulnerabilidad común que puede darse entre personas con trastornos de ansiedad y depresivos.

Relationship between inner dialog and ideas of reference and the mediating role of dissociation.

Recent lines of research have begun to concentrate on internal dialogue and its relationship to a diversity of psychopathological phenomena present in psychotic disorders. This study was intended as a preliminary exploration of the relationship of internal dialogue, dissociation and ideas of reference. To do this, a sample of 318 students filled in an internal dialogue scale (the VISQ, McCarthy-Jones & Fernyhough), one for dissociation (DES-II, Carlson & Putnam) and another for ideas of reference (REF, Lenzenweger, Bennett & Lilenfeld). The results confirm the hypothesis posed in the sense that internal dialogue was positively associated with dissociation and with ideas of reference. A partial mediation effect of dissociation was also found between inner speech and ideas of reference. Lines of future research this study opens and its possible integration in a model on ideas of reference are discussed.

The mediating role of metacognitive variables in the relationship between Thought-Action Fusion and obsessive-compulsive symptomatology / El papel mediador de las variables metacognitivas en la relación entre la fusión pensamiento-acción y la sintomatología obsesivo-compulsiva

Diverse studies support the central role of Thought-Action Fusion (TAF) and other metacognitive variables in the understanding of obsessive-compulsive disorder (OCD) symptomatology. However,amore detailed study of the involvement of the sevariables is needed. This article seeks to assess the possible mediating role of the factors of the Metacognitions Questionnaire (MCQ) in the relationship between TAF and OCD symptoms both in clinical and non-clinical samples.A cross-sectional design was used in which120 participants, divided into three groups (two clinical and one non-clinical), completed the questionnaires assessing the constructsof interest. The mediational findings generally supported the proposed mediation model. Specifically, the mediational analyses focused on negative beliefs and the need to control (metacognitive factors of the MCQ) showed that MCQ Negative beliefs mediated the effects of TAF-Total and TAF factors (except for the TAF-Moral) on OCD symptomatology in the OCD group. The MCQ Need to control was non-significantasa mediator of the relationships between TAF and OCD. However, it was observed that this mediation approached significance, with considerable effect sizes. In the clinical-control group, the analyses showed that MCQ Negative beliefs mediated the effects of TAF-Like lihood-One self on OCD symptoms. In the remaining group, neither MCQ Negative beliefs nor MCQ Need to control were found to be significant mediators. It is generally concluded that certain beliefs, such as TAF, can evolve toward more complex metacognitive beliefs, which ultimate ly lead to the development of OCD symptoms.

Diversos estudios han señalado el papel de la fusión pensamiento-acción (TAF) y otras creencias metacognitivas en la comprensión de la sintomatología obsesivo-compulsiva. No obstante, es preciso un estudio más pormenorizado que esclarezca la contribución de estas variables. El objetivo del presente estudio es evaluar el posible papel mediador de los factores del Cuestionario de Metacogniciones (MCQ)en la relación entre la TAF y la sintomatología obsesivo-compulsiva, tanto en muestras clínicas como no clínicas. Con un diseño transversal, 120 participantes divididos entres grupos (dos clínicos y uno no clínico) respondieron a los cuestionarios que evaluaban los constructos de interés. Los resultados apoyaron de manera general el modelo mediacional propuesto. Concretamente, los análisis se centraron en la necesidad de control y las creencias negativas (factores metacognitivos del MCQ) y mostraron los siguientes resultados. En el grupo de sintomatología obsesivo-compulsiva, las creencias negativas mediaron los efectos deTAF-totaly los factores de TAF en la sintomatología obsesivo-compulsiva, a excepción de TAF-moral. El factor necesidad de control no llegó a ser un mediador significativo; no obstante, esta mediación estaba próxima a la significatividad y se contemplaron tamaños del efecto considerables. Respecto al grupo de control clínico, los análisis mostraron que las creencias negativas mediaban los efectos de TAF-probabilidad-uno mismo en la sintomatología obsesivo-compulsiva. En el grupo restante, ni las creencias negativas ni la necesidad de control resultaron ser mediadores significativos. Se concluye, de manera general, que creencias como la TAF pueden evolucionar hacia creencias metacognitivas más complejas que conllevan, en último término, el desarrollo de la sintomatología obsesivo-compulsiva.

[Multidimensionality of inner speech and its relationship with abnormal perceptions]. / Multidimensionalidad del Habla Interna y su relación con las percepciones anómalas.

BACKGROUND: Inner speech is a common human experience. Recently, there have been studies linking this experience with cognitive functions, such as problem solving, reading, writing, autobiographical memory, and some disorders, such as anxiety and depression. In addition, inner speech is recognised as the main source of auditory hallucinations. OBJECTIVES: The main purpose of this study is to establish the factor structure of Varieties of Inner Speech Questionnaire (VISQ) in a sample of the Colombian population. Furthermore, it aims at establishing a link between VISQ and abnormal perceptions. METHOD: This was a cross-sectional study in which 232 college students were assessed using the VISQ and the Cardiff Anomalous Perceptions Scale (CAPS). RESULTS: Through an exploratory factor analysis, a structure of three factors was found: Other Voices in the Internal Speech, Condensed Inner speech, and Dialogical/Evaluative Inner speech, all of them with acceptable levels of reliability. Gender differences were found in the second and third factor, with higher averages for women. Positive correlations were found among the three VISQ and the two CAPS factors: Multimodal Perceptual Alterations and Experiences Associated with the Temporal Lobe. CONCLUSIONS: The results are consistent with previous findings linking the factors of inner speech with the propensity to auditory hallucination, a phenomenon widely associated with temporal lobe abnormalities. The hallucinations associated with other perceptual systems, however, are still weakly explained.

Rethinking Schizophrenia in the Context of the Person and Their Circumstances: Seven Reasons.

We know a great deal about schizophrenia, but the current state of the art is one of uncertainty. Researchers are confused, and patients feel misunderstood. This situation has been identified as due largely to the fact that the dominant neurobiological perspective leaves out the person. The aim of the present article is to review and integrate a series of clinical, phenomenological, historical, cultural, epidemiological, developmental, epigenetic, and therapeutic phenomena in support of a suggestion that schizophrenia is above all a disorder of the person rather than of the brain. Specifically, we review seven phenomena, beginning with the conception of schizophrenia as a particular disorder of the self. We continue by looking at its recent origin, as a modern phenomenon, its juvenile onset, related to the formation of the self, the better prognosis in developing countries compared to developed countries, and the high incidence of the disorder among migrants. In the context of these phenomena of a marked socio-cultural nature, we consider the so-called "genetic myth," according to which schizophrenia would have a genetic origin. On reviewing the current genetic emphasis in the light of epigenetics, it emerges that the environment and behavior recover their prominent role in the vicissitudes of development. The seventh reason, which closes the circle of the argument, concerns the role of interpersonal "chemistry" in recovery of the sense of self.