Ontological Adaptation in Transition to Adulthood A Theoretical Framework for Integrating Phenomenology and Neuroscience in Psychosis Research

In this theoretical review, the neurodevelopmental model of psychotic disorders is considered within the framework of ontological development, referring to the individual-level construction of a sense of reality regarding identity and worldview. Following Erikson's theory of development, the challenge of forging a personal and social identity is a developmental process typical of late adolescence and early adulthood. Accompanying this process is a developmentally normal increase in exploratory and risk-taking behavior, which sometimes includes challenging and defying cultural norms. Although many aspects of ontological adaptation are developmentally appropriate, we argue that psychopathology such as psychosis can be rooted in an abnormal deviation of this process, in which aberrant salience accelerates the typical drive to develop a meaningful sense of identity, leading to delusion formation. By placing psychosis onset within a broader context of normal development, this model offers a humanistic approach for understanding experiences of new onset of psychotic disorders.