Self-control in psychotic disorders.

Our follow-up study of 20 psychiatric patients and a review of the relevant literature support the idea that some persons may be able to exert control over their own psychiatric symptoms. This self-regulation process consists of three phases: In the first phase, persons become aware of the existence of psychotic or prepsychotic behavior by self-monitoring. In the second phase, self-evaluation, the person recognizes the implications of these behaviors as a signal of disorder. In these phases, detecting early affective signals that may herald the onset of psychotic symptoms and noting the sequences of events often followed by symptoms are particularly important. Once these symptoms or their precursors are detected, phase 3 occurs in which mechanisms of self-control are employed. Three such mechanisms are particularly common: self-instruction, reduced involvement in activity, and increased involvement in activity.