services, carers generally considered clinicians approachable andresponsive to their needs. They felt they were listened to and theirsituation taken seriously. (iv) Feeling undervalued as a carer. While,overall, clinicians were perceived as approachable and supportive, acompeting theme is that some carers felt their contributions wereundervalued and concernswere not listened to or taken seriously. Thisis reflected in two overlapping sub-themes: balancing confidentialitywith the need-to-know, and not being taken seriously.Discussion: Accessing FEP services results in both negative andpositive experiences and these competing situations are interrelated.Our findings highlight a number of key implications for primarycaregivers, family workers, clinicians, and FEP services. First, greaterawareness is needed of the contribution, experience and difficultiesfirst-time primary caregivers face accessing services. Second, FEPservices disadvantage carers who lack knowledge and assertiveness.Ideally, access should be determined more by clinical need than thelevel of carers' persistence. Indeed, there is a need to improveawareness, availability and access to FEP services, especially to thosewhoare new to suchprograms. Third, ongoing family interventions arerequired for first-time caregivers, such as practical day-to-day supportabout accessing and getting the most out of services, as well asinformation regarding legal and financial supports and the possibilityof respite. Fourth, clinical training should incorporate measures toincrease sensitivity to carers' needs, and familiarity with governmentpolicies andmental health legislation about inclusion of carers. Finally,further national and international research is needed into the keyfindings and experience of carers accessing other health systems, andto understand the experience of non-engaged caregivers and thosefrom culturally diverse Backgrounds who access FEP services.

doi:10.1016/j.schres.2010.02.510

Poster 16A DESCRIPTIVE PHENOMENOLOGICAL STUDY OF SYMPTOMS OFSCHIZOPHRENIA IN DEAF CLIENTS

LaNiña E. Mompremier1, Irene W. Leigh1, Virginia Gutman1, BarbaraGerner De Garcia1, Mary Hufnell1, Caroline Kendall21Gallaudet University Washington, DC, USA; 2Yale University WestHaven, CT, USA

Background: Our clinical knowledge and understanding of themanifestation of schizophrenia in deaf patients is limited. Previousstudies address specific symptomatolgy observed in deaf personswith schizophrenia. The purpose of this research was to conductextensive interviews of clinicians working with deaf patientsdiagnosed with schizophrenia in order to understand how clinicianscharacterized each patient's presentation and defined the sympto-matology observed.Methods: Supplemental interview data were gathered from clientcharts by clinicians. Eight clinicians with advanced sign languageskills and extensive experience serving deaf clients with mentalillness were recruited to discuss a total of 13 client cases. Aqualitative investigation was employed to identify themes andpatterns present in each clinicians' concepts of symptoms mani-fested in deaf patients diagnosed with schizophrenia.Results: Symptomatology observed by clinicianswas consistentwithdiagnostic criteria established for hearing clients with schizophrenia.However, some symptom modality differences were noted inphenomena such as sign language and lip-reading hallucinationsand the language-related symptoms reported. The majority of"auditory hallucinations" in this sample were ambiguous in thatclients were unable to describe acoustic features and/or the messagecontent of the "voices." Delusional content mirrored hearingsamples. The most common language-related phenomena observed

were characterized as loose associations aswell as circumstantial andtangential communication. The theme of organization was encoun-tered multiple times throughout the interviews with clinicians.Schizophrenia was characterized by clinicians as a disease thatdisrupts major cognitive processes and erodes the brain's ability toorganize information, which impairs the individual's mental andsocial functioning. Such disorganization causedmisinterpretations ofstimuli or perceptual disturbance and impactedmotivation and driveas these relate to negative symptoms. Primary deficits reportedwereoften related to the clients' decline in social functioning declines.Discussion: A major limitation of this study is that data are basedsolely on the judgments, accuracy, and thoroughness of theobservations and interpretations of the mental health professionalsserving these clients. The nuances of the presentation of schizo-phrenia in deaf patients and the richness of this qualitative datamay benefit clinicians diagnosing schizophrenia in deaf patientsand subsequently developing appropriate treatment and interven-tion programs designed for deaf individuals with schizophrenia.

doi:10.1016/j.schres.2010.02.511

Poster 17ANOMALOUS SELF-EXPERIENCE IN THE PRODROMAL PHASE OFSCHIZOPHRENIA AND OTHER PSYCHOTIC DISORDERS

Barnaby Nelson, Alison YungOrygen Youth Health Research Centre Melbourne, Victoria, Australia

Background: Over the last fifteen years, there has been increasedinterest in the early phase of schizophrenia and other psychoticdisorders. The focus was initially on the first episode of psychosis butsoon reached further back to the pre-onset or prodromal phase. Severalstrategies have been introduced to identify individuals in the putativelyprodromal phase of psychotic disorder. The most widely used of theseapproaches is the "ultra-high risk" (UHR) approach, which combinesknown trait and state risk factors for psychotic disorder. Phenomen-ological research indicates that disturbance of the basic sense of selfmaybe a core phenotypic marker of psychotic vulnerability, particularly ofschizophrenia spectrum disorders. Disturbance of basic self-experienceinvolves a disruption of the sense of agency and ownership ofexperience, associated with a variety of dissociative symptoms andanomalous cognitive and bodily experiences. In this study, weinvestigated the presence of basic self-disturbance in a UHR group andwhether it predicted transition to psychotic disorder.Methods: 41 UHR subjects and 12 first episode psychosis subjectswere recruited from Orygen Youth Health, Melbourne. 52 non-clinical control subjects were recruited from the community.Subjects were assessed for basic self-disturbance using the EASEquestionnaire. A range of other clinical variables were alsomeasured.Subjects were assessed at baseline and at 12 months follow up.Results: Preliminary data will be presented. Levels of self-disturbance were significantly higher in the UHR sample and theFEP sample compared to the non-clinical control group (p<.001).Further follow-up is required to assess the predictive utility of self-disturbance in the UHR sample.Discussion: Identifying self-disturbance in the UHR population mayprovide a means of further "closing in" on individuals truly at highrisk of psychotic disorder, particularly of schizophrenia spectrumdisorders, thus supplementing the UHR identification approach.This would be of practical value by reducing inclusion of "falsepositive" cases in ultra-high risk samples, and of theoretical valueby shedding light on core features of psychotic pathology.

doi:10.1016/j.schres.2010.02.512

Abstracts306