mirror self-misidentification the mirror sign
Conditions
Interventions
The intervention will consist out of the irrigation of the external canal of
the contra lateral (left) ear with room temperature tap water, using a common
plastic Luer lock syringe (without needle a
the emotional alienation which the patients
experience occurs instantly upon looking in the mirror, and so, presumably,
would any change.
If the command of Dutch or English is not sufficient in the
Sponsors
De Gelderse Roos (Wolfheze)
Eligibility
Age
18 Years to 99 Years
Inclusion criteria
Inclusion criteria: Sampling The patients should be recruited from sufficiently stabilised inpatients from a psychiatric clinic for asylum seekers and refugees; in addition they should suffer from a psychogenic disorder in mirror self-recognition. The intervention should initially only be applied to patients with minor degrees of fear for mirrors and intact reality testing. If no adverse effects are observed, more severely affected patients could be included later.
Exclusion criteria
Exclusion criteria: Exclusion criteria Although the aim of the study is to contribute to the development of therapeutic reprocessing without confrontation with traumatic memory, confrontation with a mirror is still unavoidable for the purpose of this study. Confrontation with a mirror typically induces fear in the study objects; they should therefore be sufficiently stabilised, and preferably still admitted in order to monitor them sufficiently after the experiment. Patients with organic brain anomalies or injuries are excluded. Prior to the intervention every patient will be otoscopically assessed by a physician to check if the eardrums are intact (perforation of the eardrum is an exclusion criterium) and to clear away excess earwax if necessary. The physician will also establish the lateralisation of hand function in the patient (left- or righthandedness); left-handed patients are not excluded, but in their case the intervention is likely to be the control and vice versa.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| In the CVS experiments so far anosognosia and asomagnosia were assessed using 4 point rating scales. The proposal is to apply a similar scale for the assessment of the level of self alienation induced by confrontation with a mirror. 1. the patient recognises his/her reflection without discrepancy 2. the patient reports a discrepancy between the perceived reflection and his/her self-image but has no doubt it is correct 3. the patient reports doubt as to whether the perceived reflection really belongs to his/her self 4. the patient reports that someone else is gazing back from the mirror A similar scale can be applied if trauma related memories are induced. 1. the patient reports no reminiscences 2. the patient reports induction of trauma related memories, but does not locate them in the mirror 3. the patient reports induction of trauma related memories, locates them in the mirror but identifies them as mere imagery 4. the patient reports that persons inside the mirror intend to inflict harm like in the past The reaction of the patient is rated by the nurse who applies the intervention. As the aim of this pilot is to assess a so far unknown effect, a qualitative assessment of the experiences of the participants in general following the intervention will also be part of the protocol. After each confrontation the patient will also be asked about his/her experiences in general in an open interview for a more qualitative description of the effect. This part of the assessment will be done by the author, and will, if the patient consents, also be recorded on videotape. This will ensure the transparency of the procedure by making it available to assessment later by independent assessors, as the interviews themselves are for logistic reasons not done by an independent assessor. | — |
Secondary
| Measure | Time frame |
|---|---|
| The fact that the CVS effect is assessed following exposure to a mirror, makes assessment by several independent and blinded assessors, assessing the exact same material also possible. This would be helpful especially in a pilot in which the main purpose is to establish whether there is any effect at all, like this study. For this the one-way screen of the clinic, acting as a mirror could be used. The one-way screen will be partly shaded to appear like a common size bathroom mirror, to prevent undue fear possibly caused by a larger reflecting surface. The confrontation with the mirror could be videotaped from the other side of the one-way screen with a camera. The results can then be shown in random order to independent mental health professionals; the assessors will be simply asked to guess which of the confrontations was baseline, which one followed the control intervention and which the experimental intervention. Apart from this the author will ask the assessors in an open interview to describe their observations in a qualitative way as well. | — |
Countries
Netherlands
Outcome results
None listed