Individuals with schizophrenia-spectrum disorders face profound challenges as they attempt to maintain identity through the course of illness. Narrative identity—the study of internalized, evolving life stories—provides a rich theoretical and empirical perspective on these challenges. Based on evidence from a systematic review of narrative identity in the psychosis spectrum (30 studies, combined N = 3859), we argue that the narrative identities of individuals with schizophrenia-spectrum disorders are distinguished by three features: disjointed structure, a focus on suffering, and detached narration. Psychotic disorders typically begin to emerge during adolescence and emerging adulthood, which are formative developmental stages for narrative identity, so it is particularly informative to understand identity disturbances from a developmental perspective. We propose a developmental model in which a focus on suffering emerges in childhood; disjointed structure emerges in middle and late adolescence; and detached narration emerges before or around the time of a first psychotic episode. Further research with imminent risk and early course psychosis populations would be needed to test these predictions. The disrupted life stories of individuals on the psychosis spectrum provide multiple rich avenues for further research to understand narrative self-disturbances.

患有精神分裂症谱系障碍的人在试图通过疾病过程保持身份时面临着巨大的挑战。叙事身份——对内化的、不断发展的生活故事的研究——为这些挑战提供了丰富的理论和经验视角。基于对精神病谱中叙述身份的系统评价的证据（30 项研究，综合N = 3859），我们认为精神分裂症谱系障碍患者的叙事身份具有三个特征：脱节的结构、对痛苦的关注和分离的叙述。精神障碍通常在青春期和成年期开始出现，这是叙事身份的形成发展阶段，因此从发展的角度理解身份障碍特别有用。我们提出了一种发展模式，其中关注儿童时期的痛苦；脱节结构出现在青春期中后期；在第一次精神病发作之前或前后出现超然的叙述。需要对迫在眉睫的风险和早期精神病人群进行进一步的研究来检验这些预测。