Copyright © 2015 Korean Society for Schizophrenia Research 21 서 론 조현병은 자기장애(self-disorder) 라고 할 만큼 자기(self) 인 식에 변화가 온다는 사실이 오래 전부터 받아들여져 왔으며, 이 점에 대해 Bleuler는 자기 분열이 조현병 환자 자아의 핵심 이라고 언급하였다 . 1) 더 나아가 Jaspers는 조현병의 증상을 여 러 차원에 걸친 자기의식(self-consciousness) 이상으로 해석 하기도 하였다 . 2) 조현병의 증상을 양성증상과 음성증상으로 나 누어 이해를 하고 있는 현대에 와서도 두 증상군 모두 자기장 애로 설명하는 경향은 지속되고 있다 . 예를 들어, Sass와 Par- nas의 경우, Schneider 1 급 증상 3) 을 포함한 양성증상은 행동 , 생각 , 감정, 지각 등에서의 자아감 감소(diminished self-affec- tion) 라고 하였고, 음성증상은 자연적 자명성(natural self-evi- Received: February 13, 2015 / Revised: March 17, 2015 Accepted: March 27, 2015 Address for correspondence: Jae-Jin Kim, Department of Psychiatry, Yonsei University Gangnam Severance Hospital, 211 Eonju-ro, Gangnam- gu, Seoul 135-720, Korea Tel: 02-2019-3341, Fax: 02-3462-4304 E-mail: jaejkim@yonsei.ac.kr 본 논문은 한국연구재단 중견연구자지원사업(No. NRF-2013R1A2A2A03068342) 의 지원에 의하여 이루어졌음. 합성 얼굴사진을 이용한 조현병 환자의 자기-타인 경계 인식의 특성 연세대학교 강남세브란스병원 정신건강의학과, 1 연세대학교 의과대학 의학행동과학연구소, 2 성남사랑의병원 정신건강의학과 3 오승택 1 ·홍연주 2 ·신유빈 2 ·윤형준 2 ·선자연 3 ·김대현 3 ·김재민 3 ·김재진 1,2 Characteristics of Self-Other Boundary Recognition Using Morphed Face Pictures in Patients with Schizophrenia Seung-Taek Oh, MD 1 , Yeon-Ju Hong, MA 2 , Yu-Bin Shin, MA 2 , Hyung-Jun Yoon, MD 2 , Ja Yeun Sun, MD 3 , Dae Hyun Kim, MD 3 , Jae Min Kim, MD 3 and Jae-Jin Kim, MD, PhD 1,2 1 Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, 2 Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, 3 Department of Psychiatry, Seongam Love Hospital, Seongnam, Korea Objectives : Disturbance in self-experience has been considered to be a core feature of schizophrenia. Evidence from mirror face- recognition tasks supports the connection between self-face recognition and self-awareness which is a part of self-experience. The aim of this study was to investigate the self-other boundary recognition using morphed face pictures in patients with schizophrenia. Methods : Twenty-one patients with schizophrenia and twenty-three healthy controls completed the self-face recognition task that consisted of various morphed pictures. Participant’s own picture was morphed with each of three different, unknown, gender-matched facial identities in steps of 10% ; each pair producing 11 images with graded blending of facial features. Thirty-three images in to- tal were randomly presented as stimuli in a run, which was repeated three times. Participants were instructed to choose whether the stimulus was self-face or not. Results : Self-face proportion was significantly lower in the schizophrenia group at both recognition start point I and II (33.33% vs. 53.04%, p＜0.001 ; 61.43% vs. 70.87%, p=0.01, respectively). Using the mean value of each recognition start point in the con- trol group, we calculated the difference in self-face proportion for each individual with schizophrenia. There was a significant cor- relation between the degree of this difference and total Scale for the Assessment of Negative Symptoms (SANS) score at recogni- tion start point I (r=0.507, p=0.019). Conclusion : The difference in self-other boundary recognition in this study may account for self-disturbance of schizophrenia. Its correlation with SANS total score may reflect the shared nature of persistent disturbance between the disturbance in self-experi- ence and the negative symptom. (Korean J Schizophr Res 2015;18:21-27) Key Words : Schizophrenia · Self-experience · Self-other boundary · Negative symptom. Korean J Schizophr Res Vol. 18. 1, 2015 http://dx.doi.org/10.16946/kjsr.2015.18.1.21 ISSN 2287-6995