Historical Perspectives on Proneness to Psychotic-like Experiences and Behaviors: A Conceptual Analysis and Synthesis

Contemporary research increasingly supports continuous models of psychotic-like experiences and behaviors (PLEBs), yet these models are rarely integrated with rich historical traditions that repeatedly describe similar phenomena. We address this gap by mapping historical accounts onto Disintegration, a broad personality dimension capturing individual differences in biased reality testing across perceptual, cognitive, affective, motivational, and behavioral domains. Using a structured cross-epoch approach, we synthesized descriptions from major scholars in Antiquity (500 BCE – 500 CE), the Medieval era (500–1500 CE), and the Pre-Modern period (1500 – c. 1850 CE), and organized these descriptions along Disintegration facets (i.e., perceptual distortions, paranoia, magical thinking, cognitive/executive impairment, somatoform dysregulation, enhanced awareness, apathy/depression, mania and flattened affect). To overcome the scale and heterogeneity of historical corpora, we used large language models (LLMs) to support concept detection and clustering, with subsequent expert validation of sources and interpretations. Across more than two millennia, historical descriptions revealed substantial phenomenological continuity in PLEBs, while explanatory frameworks shifted from humoral and temperamental accounts, through theological-moral interpretations, to early clinical psychopathology. These findings suggest that contemporary dimensional models like Disintegration may represent a systematic framework for organizing experiential patterns that have been repeatedly described throughout historical records.