Abstract
Background: Through its history, the search for the cause of psychotic disorders has varied in its disposition toward the utility of reported experience of psychotic symptoms. Presently, the pendulum seems to have swung toward interest in the utility of this information. There are multiple reasons for renewed interest in psychotic symptom phenomenology but one in particular seems to have arisen among some neuroscience-oriented researchers. These researchers postulate that complex psychotic symptoms can be broken down and mapped onto a systems neuroscience framework of understanding. Such a perspective guides hypothesis generation for both the symptom etiology and the pathophysiology of the ongoing state of psychosis (e.g., of active experiences of hallucinations or delusional thought). Methods: Relevant dimensions of reported experience that have informed this neuroscience-based approach include direct or indirect association with different types of traumatic life events, social withdrawal and isolation, and, in the case of hallucinations, properties such as physical sensory characteristics (loudness, location, and duration), emotional content, emotional response, sensory modalities engaged, and more. Results: This approach may be useful for more closely linking the various neural abnormalities that have been identified in psychotic disorders for decades with symptom severity or reported experience. It also offers a way forward for making sense of the heterogeneity of psychotic illness symptom presentations. Conclusion: Dr Ralph Hoffman was among the earliest scholars in this modern movement toward looking to phenomenology to inform ideas about the neurobiology of psychotic symptoms. He incorportated a cross-diagnostic perspective in this approach and developed a research program including interventions based on phenomenologically informed neurobiological hypotheses of psychotic illness.