Impaired self-agency inferences in schizophrenia: The role of cognitive capacity and causal reasoning style

The cognitive neuroscience of self-awareness: Current framework, clinical implications, and future research directions

Self-awareness, the ability to take oneself as the object of awareness, has been an enigma for our species, with different answers to this question being provided by religion, philosophy, and, more recently, science. The current review aims to discuss the neurocognitive mechanisms underlying self-awareness. The multidimensional nature of self-awareness will be explored, suggesting how it can be thought of as an emergent property observed in different cognitive complexity levels, within a predictive coding approach. A presentation of alterations of self-awareness in neuropsychiatric conditions will ground a discussion on alternative frameworks to understand this phenomenon, in health and psychopathology, with future research directions being indicated to fill current gaps in the literature. This article is categorized under: Philosophy > Consciousness Psychology > Brain Function and Dysfunction Neuroscience > Cognition.

Agency of Subjects and Eye Movements in Schizophrenia Spectrum Disorders

People with schizophrenia spectrum disorders (SSD) show anomalies in language processing with respect to "who is doing what" in an action. This linguistic behavior is suggestive of an atypical representation of the formal concepts of "Agent" in the lexical representation of a verb, i.e., its thematic grid. To test this hypothesis, we administered a silent-reading task with sentences including a semantic violation of the animacy trait of the grammatical subject to 30 people with SSD and 30 healthy control participants (HCs). When the anomalous grammatical subject was the Agent of the event, a significant increase of Gaze Duration was observed in HCs, but not in SSDs. Conversely, when the anomalous subject was a Theme, SSDs displayed an increased probability of go-back movements, unlike HCs. These results are suggestive of a higher tolerability for anomalous Agents in SSD compared to the normal population. The fact that SSD participants did not show a similar tolerability for anomalous Themes rules out the issue of an attention deficit. We suggest that general communication abilities in SSD might benefit from explicit training on deep linguistic structures.

Bodily Self-Disturbances in Schizophrenia: A Comparative Study of South Korea and the USA

BACKGROUND

Bodily self-disturbances are highly salient to the phenomenology of schizophrenia (SZ) but difficult to quantify owing to the subjective nature of these experiences that challenge verbal descriptions. The Benson et al. [PsyCh J. 2019 Mar;8(1):110-21] Body Disturbances Inventory (B-BODI) provides visual aids to help participants access the frequency, distressfulness, and vividness of subjective self-experiences with good reliability and validity in North American samples. However, the concept of the self and, accordingly, the conceptualization of self-disorders are influenced by culture. Therefore, we examined self-disturbances in individuals with SZ and control (CO) participants in 2 distinct cultures.

METHODS

B-BODI was administered to South Korean and North American participants, with and without SZ. Severity of symptoms in diagnosed individuals with SZ and schizotypy in CO was assessed. We also assessed perceived social isolation and mood in all participants.

RESULTS

Endorsement and frequency of bodily self-disturbances in SZ were similar in both cultures. In contrast, there were significant cultural differences in the degree of distress and vividness of self-disturbances. Bodily self-disturbances were experienced as more vivid and distressing to Americans than Koreans, regardless of diagnosis. For both cultures, B-BODI scores were associated with positive, but not negative, symptoms in SZ. For CO, elevated schizotypy was associated with B-BODI scores. Mood and loneliness were not associated with B-BODI scores.

CONCLUSION

SZ reported overall increased levels of bodily self-disturbances compared with CO, regardless of culture. However, there were cultural differences in one's emotional reaction to these experiences. Americans were more distressed by self-disturbances and experienced them more vividly than Koreans. These findings suggest that Americans may be less accepting of anomalous bodily self-experiences relative to Koreans. Last, B-BODI appears to be a useful tool for future cross-cultural studies of SZ phenomenology.