Published online Sep 22, 2016. doi: 10.5498/wjp.v6.i3.381
Peer-review started: April 15, 2016
First decision: May 19, 2016
Revised: May 28, 2016
Accepted: August 11, 2016
Article in press: August 13, 2016
Published online: September 22, 2016
In this paper we illustrate the potential of the repertory grid technique as an instrument for case formulation and understanding of the personal perception and meanings of people with a diagnosis of psychotic disorders. For this purpose, the case of James is presented: A young man diagnosed with schizophrenia and personality disorder, with severe persecutory delusions and other positive symptoms that have not responded to antipsychotic medication, as well with depressive symptomatology. His case was selected because of the way his symptoms are reflected in his personal perception of self and others, including his main persecutory figure, in the different measures that result from the analysis of his repertory grid. Some key clinical hypotheses and possible targets for therapy are discussed.
Core tip: The repertory grid measures indicated that the patient’s meaning system was strongly articulated around a very negative view of self, and by symptomatic constructs related to fear, anxiety, sense of loneliness, and perceived aggressiveness in others. Furthermore, constructs related to hostility dominated his perception of his persecutory figure and also of his parental figures. Based on this appraisal, the case formulation was suggested as a focus for psychotherapy to enhance his self-esteem and deal with family conflicts.