Altered awareness of action in schizophrenia: a specific deficit in predicting action consequences

Disturbance at the self-other boundary in schizophrenia: Linking phenomenology to clinical neuroscience

In this selective review, we describe the current neuroscientific literature on disturbances of the self-other boundary in schizophrenia as they relate to structural and experiential aspects of the self. Within these two broad categories, the structural self includes body ownership and agency, and the experiential self includes self-reflection, source monitoring, and self-referential and autobiographical memory. Further, we consider how disturbances in these domains link to the phenomenology of schizophrenia. We identify faulty internal predictive coding as a potential mechanism of disturbance in body ownership and agency, which results in susceptibility to bias (over- or under-attributing outcomes to one's own actions or intentions). This is reflected in reduced activity in the temporoparietal junction (TPJ), a heteromodal association area implicated in several aspects of self-other processing, as well as reduced fronto-parietal functional connectivity. Deficits of the experiential self in schizophrenia may stem from a lack of salience of self-related information, whereby the mental representation of self is not as rich as in healthy controls and therefore does not result in the same level of privileged processing. As a result, memory for self-referential material and autobiographical memory processes is impaired, which hinders creation of a cohesive life narrative. Impairments of the experiential self implicate abnormal activation patterns along the cortical midline, including medial prefrontal cortex and posterior cingulate/precuneus, as well as TPJ. In fact, TPJ appears to be involved in all the reviewed aspects of the self-other disturbance. We conclude with suggestions for future work, including implications for interventions with critical timing considerations.

Hierarchical analysis of the sense of agency in schizophrenia: motor control, control detection, and self-attribution

The sense of agency refers to the feeling of initiating and controlling one's actions and their resulting effects on the external environment. Previous studies have uncovered behavioral evidence of excessive self-attribution and, conversely, a reduction in the sense of agency in patients with schizophrenia. We hypothesize that this apparent paradox is likely to result from impairment in lower-level processes underlying the sense of agency, combined with a higher-level compensational bias. The present study employed three behavioral tasks utilizing the same stimuli and experimental design to systematically evaluate multiple factors that influence the sense of agency, including motor control, sensorimotor processing, and self-attribution. Participants' real-time mouse movements were combined with prerecorded motions of others in ratios of 30/70, 55/45, or 80/20, with an additional angular bias of either 0° or 90°. Twenty-six patients with schizophrenia and 27 health control volunteers participated in the three tasks. Patients with schizophrenia performed significantly worse in the reaching and control detection tasks than healthy controls. However, their self-attribution in the control judgment task was comparable to that of the healthy controls. Patients with schizophrenia were impaired in motor control components and in the detection of control using sensorimotor information, but their evaluation of agency remained relatively less affected. This underscores the importance of distinguishing between different subcomponents when addressing the abnormal sense of agency in patients with schizophrenia. Subsequent cluster analysis revealed that the combined task performance accurately distinguished between the patients and healthy control participants.

Altered sense of agency in schizophrenia: the aberrant effect of cardiac interoceptive signals

Background

Schizophrenia (SZ) is characterized by abnormalities in self-representation, including a disturbed sense of agency (SoA). The continuous processing of sensory information concerning the internal state of the body (interoception) is argued to be fundamental to neural representations of the self. We, therefore, tested if aberrant interoception underpins disturbances in SoA in SZ, focusing on cardiac interoceptive signaling.

Methods

Forty-two SZ and 29 non-clinical participants (healthy controls; HC) performed an intentional binding task to measure SoA during concurrent heartbeat recording. The effect of cardiac interoceptive signals on SoA was measured by the difference in intentional binding effect during systole and diastole. This measure was standardized based on the overall intentional binding effect to control for non-cardiac factors, and then compared between SZ and HC.

Results

Our study revealed a significant difference between SZ and HC groups, with opposite effects of cardiac systole on SoA. Specifically, cardiac systole disrupted SoA in SZ, contrasting with the enhanced SoA in HC. Across the SZ group, the extent to which SoA was disrupted by cardiac systole correlated significantly with a clinical proxy for symptom instability, namely the number of hospital admissions for hallucinations and delusions. Furthermore, the disruption was particularly observed in patients with severe hallucinations.

Conclusions

This study revealed a disturbance in the impact of cardiac interoceptive signals on an implicit index of SoA in schizophrenia. This supports the notion that pathophysiological disruption of the central integration of interoceptive information increases vulnerability to disturbances in self-representation and the associated expression of schizophrenic symptoms.

Visuomotor prediction during action planning in the human frontoparietal cortex and cerebellum

The concept of forward models in the brain, classically applied to describing on-line motor control, can in principle be extended to action planning, i.e. assuming forward sensory predictions are issued during the mere preparation of movements. To test this idea, we combined a delayed movement task with a virtual reality based manipulation of visuomotor congruence during functional magnetic resonance imaging. Participants executed simple hand movements after a delay. During the delay, two aspects of the upcoming movement could be cued: the movement type and the visuomotor mapping (i.e. congruence of executed hand movements and visual movement feedback by a glove-controlled virtual hand). Frontoparietal areas showed increased delay period activity when preparing pre-specified movements (cued > uncued). The cerebellum showed increased activity during the preparation for incongruent > congruent visuomotor mappings. The left anterior intraparietal sulcus showed an interaction effect, responding most strongly when a pre-specified (cued) movement was prepared under expected visuomotor incongruence. These results suggest that motor planning entails a forward prediction of visual body movement feedback, which can be adjusted in anticipation of nonstandard visuomotor mappings, and which is likely computed by the cerebellum and integrated with state estimates for (planned) control in the anterior intraparietal sulcus.

Sense of agency in schizophrenia: A reconciliation of conflicting findings through a theory-driven literature review

The sense of agency is the experience of being the author of self-generated actions and their outcomes. Both clinical manifestations and experimental evidence suggest that the agency experience and the mechanisms underlying agency attribution may be dysfunctional in schizophrenia. Yet, studies investigating the sense of agency in these patients show seemingly conflicting results: some indicated under-attribution of self-agency (coherently with certain positive symptoms), while others suggested over-attribution of self-agency. In this review, we assess whether recent theoretical frameworks can reconcile these divergent results. We examine whether the identification of agency abnormalities in schizophrenia might depend on the measure of self-agency considered (depending on the specific task requirements) and the available agency-related cues. We conclude that all these aspects are relevant to predict and characterize the type of agency misattribution that schizophrenia patients might show. We argue that one particular model, based on the predictive coding theory, can reconcile the interpretation of the multifarious phenomenology of agency manifestations in schizophrenia, paving the way for testing agency disorders in novel ways.

Pons-to-Cerebellum Hypoconnectivity Along the Psychosis Spectrum and Associations With Sensory Prediction and Hallucinations in Schizophrenia

BACKGROUND

Sensory prediction allows the brain to anticipate and parse incoming self-generated sensory information from externally generated signals. Sensory prediction breakdowns may contribute to perceptual and agency abnormalities in psychosis (hallucinations, delusions). The pons, a central node in a cortico-ponto-cerebellar-thalamo-cortical circuit, is thought to support sensory prediction. Examination of pons connectivity in schizophrenia and its role in sensory prediction abnormalities is lacking.

METHODS

We examined these relationships using resting-state functional magnetic resonance imaging and the electroencephalography-based auditory N1 event-related potential in 143 participants with psychotic spectrum disorders (PSPs) (with schizophrenia, schizoaffective disorder, or bipolar disorder); 63 first-degree relatives of individuals with psychosis; 45 people at clinical high risk for psychosis; and 124 unaffected comparison participants. This unique sample allowed examination across the psychosis spectrum and illness trajectory. Seeding from the pons, we extracted average connectivity values from thalamic and cerebellar clusters showing differences between PSPs and unaffected comparison participants. We predicted N1 amplitude attenuation during a vocalization task from pons connectivity and group membership. We correlated participant-level connectivity in PSPs and people at clinical high risk for psychosis with hallucination and delusion severity.

RESULTS

Compared to unaffected comparison participants, PSPs showed pons hypoconnectivity to 2 cerebellar clusters, and first-degree relatives of individuals with psychosis showed hypoconnectivity to 1 of these clusters. Pons-to-cerebellum connectivity was positively correlated with N1 attenuation; only PSPs with heightened pons-to-postcentral gyrus connectivity showed this pattern, suggesting a possible compensatory mechanism. Pons-to-cerebellum hypoconnectivity was correlated with greater hallucination severity specifically among PSPs with schizophrenia.

CONCLUSIONS

Deficient pons-to-cerebellum connectivity linked sensory prediction network breakdowns with perceptual abnormalities in schizophrenia. Findings highlight shared features and clinical heterogeneity across the psychosis spectrum.

Arousal, interindividual differences and temporal binding a psychophysiological study

The sense of agency varies as a function of arousal in negative emotional contexts. As yet, it is unknown whether the same is true for positive affect, and how inter-individual characteristics might predict these effects. Temporal binding, an implicit measure of the sense of agency, was measured in 59 participants before and after watching either an emotionally neutral film clip or a positive film clip with high or low arousal. Analyses included participants' individual differences in subjective affective ratings, physiological arousal (pupillometry, skin conductance, heart rate), striatal dopamine levels via eye blink rates, and psychopathy. Linear mixed models showed that sexual arousal decreased temporal binding whereas calm pleasure had no facilitation effect on binding. Striatal dopamine levels were positively linked whereas subjective and physiological arousal may be negatively associated with binding towards actions. Psychopathic traits reduced the effect of high arousal on binding towards actions. These results provide evidence that individual differences influence the extent to which the temporal binding is affected by high arousing states with positive valence.

Predicting the bodily self in space and time

To understand how the human brain distinguishes itself from external stimulation, it was examined if motor predictions enable healthy adult volunteers to infer self-location and to distinguish their body from the environment (and other agents). By uniquely combining a VR-setup with full-body motion capture, a full-body illusion paradigm (FBI) was developed with different levels of motion control: (A) a standard, passive FBI in which they had no motion control; (B) an active FBI in which they made simple, voluntary movements; and (C) an immersive game in which they real-time controlled a human-sized avatar in third person. Systematic comparisons between measures revealed a causal relationship between (i) motion control (prospective agency), (ii) self-other identification, and (iii) the ability to locate oneself. Healthy adults could recognise their movements in a third-person avatar and psychologically align with it (action observation); but did not lose a sense of place (self-location), time (temporal binding), nor who they are (self/other). Instead, motor predictions enabled them to localise their body and to distinguish self from other. In the future, embodied games could target and strengthen the brain's control networks in psychosis and neurodegeneration; real-time motion simulations could help advance neurorehabilitation techniques by fine-tuning and personalising therapeutic settings.

Forgetting ourselves in flow: an active inference account of flow states and how we experience ourselves within them

Flow has been described as a state of optimal performance, experienced universally across a broad range of domains: from art to athletics, gaming to writing. However, its phenomenal characteristics can, at first glance, be puzzling. Firstly, individuals in flow supposedly report a loss of self-awareness, even though they perform in a manner which seems to evince their agency and skill. Secondly, flow states are felt to be effortless, despite the prerequisite complexity of the tasks that engender them. In this paper, we unpick these features of flow, as well as others, through the active inference framework, which posits that action and perception are forms of active Bayesian inference directed at sustained self-organisation; i.e., the minimisation of variational free energy. We propose that the phenomenology of flow is rooted in the deployment of high precision weight over (i) the expected sensory consequences of action and (ii) beliefs about how action will sequentially unfold. This computational mechanism thus draws the embodied cognitive system to minimise the ensuing (i.e., expected) free energy through the exploitation of the pragmatic affordances at hand. Furthermore, given the challenging dynamics the flow-inducing situation presents, attention must be wholly focussed on the unfolding task whilst counterfactual planning is restricted, leading to the attested loss of the sense of self-as-object. This involves the inhibition of both the sense of self as a temporally extended object and higher-order, meta-cognitive forms of self-conceptualisation. Nevertheless, we stress that self-awareness is not entirely lost in flow. Rather, it is pre-reflective and bodily. Our approach to bodily-action-centred phenomenology can be applied to similar facets of seemingly agentive experience beyond canonical flow states, providing insights into the mechanisms of so-called selfless experiences, embodied expertise and wellbeing.

Temporal binding and sense of agency in major depression

Background

Alterations in the experience of controlling oneself and one's environment are of high relevance to understanding the psychopathology of depression. This study investigated the relationship between Temporal Binding for action-event sequences, sense of agency, self-efficacy and symptom severity in Major Depressive Disorder.

Method

We employed the Sense of Agency Scale (SoAS) and the General Self-Efficacy Scale (GSE) to assess explicit Sense of Agency and self-efficacy in a group of 42 persons diagnosed with Major Depressive Disorder (MDD) [20 identifying as female, 19 as male; mean age 37.8 years (± 13.3)] and 40 control persons without a psychiatric diagnosis (CG) [22 identifying as female, 20 as male; mean age 38.0 years ( ± 13.3)]. Depressive symptom severity was measured using the BDI-II. We additionally performed a temporal binding paradigm as a potential correlate to Sense of Agency. Participants partook in a time estimation task judging three intervals (250ms, 450ms, 650ms) while either observing or causing stimulus presentations. The underestimation of intervals following intentional actions causing stimulus presentations (compared to merely observing the stimulus presentation) is interpreted as temporal binding.

Results

SoAS scores demonstrated an inverse correlation with depressive symptoms (CG: p=.032, R2=.113; MDD: p<.001, R2=.260) and a positive correlation with GSE scores (CG: p<.001, R2=.379; MDD: p<.001, R2=.254). We found distinct differences in temporal binding between healthy participants and the Major Depressive Disorder group without significant correlation between temporal binding and the SoAS or GSE scores. The data suggest group differences in time estimation particular pertaining to time intervals involving intentional action and increasingly complex multisensory stimuli.

Discussion

We investigated parameters of subjective control, namely Sense of Agency and Self Efficacy. Here, we were able to reveal their inverse relationship with depressive symptoms in patients with major depressive disorder, highlighting a profound experience of loss of control with increasing symptom load. Deficits in experiencing control, particularly involving intentional motor actions (and more complex multisensory stimuli), appear to be more pronounced in Major Depressive Disorder, involving not only negative self-efficacy expectations but also an altered Sense of Agency and temporal binding. Temporal binding and SoAS scores did not correlate, adding to the growing evidence that the two measures may not be directly related. We propose that future research be directed at this contiguous relationship between Sense of Agency and Self Efficacy in Major Depressive Disorder.

The sense of agency in near and far space

The sense of agency is the ability to recognize that we are the actors of our actions and their consequences. We explored whether and how spatial cues may modulate the agency experience by manipulating the ecological validity of the experimental setup (real-space or computer-based setup) and the distance of the action-outcome (near or far). We tested 58 healthy adults collecting explicit agency judgments and the perceived time interval between movements and outcomes (to quantify the intentional binding phenomenon, an implicit index of agency). Participants show greater implicit agency for voluntary actions when there is a temporal and spatial action-outcome contingency. Conversely, participants reported similar explicit agency for outcomes appearing in the near and far space. Notably, these effects were independent of the ecological validity of the setting. These results suggest that spatial proximity, realistic or illusory, is essential for feeling implicitly responsible for the consequences of our actions.

Evaluating the Bayesian causal inference model of intentional binding through computational modeling

Intentional binding refers to the subjective compression of the time interval between an action and its consequence. While intentional binding has been widely used as a proxy for the sense of agency, its underlying mechanism has been largely veiled. Bayesian causal inference (BCI) has gained attention as a potential explanation, but currently lacks sufficient empirical support. Thus, this study implemented various computational models to describe the possible mechanisms of intentional binding, fitted them to individual observed data, and quantitatively evaluated their performance. The BCI models successfully isolated the parameters that potentially contributed to intentional binding (i.e., causal belief and temporal prediction) and generally better explained an observer's time estimation than traditional models such as maximum likelihood estimation. The estimated parameter values suggested that the time compression resulted from an expectation that the actions would immediately cause sensory outcomes. Furthermore, I investigated the algorithm that realized this BCI and found probability-matching to be a plausible candidate; people might heuristically reconstruct event timing depending on causal uncertainty rather than optimally integrating causal and temporal posteriors. The evidence demonstrated the utility of computational modeling to investigate how humans infer the causal and temporal structures of events and individual differences in that process.

Flexibility Retained: Unimpaired Updating of Expectations in Schizophrenia

Flexibly and actively updating expectations based on feedback is crucial for navigating daily life. Previous research has shown that people with schizophrenia (PSZ) have difficulty adjusting their expectations. However, there are studies suggesting otherwise. To explore this further, we used a novel trial-based expectation updating paradigm called attribute amnesia. In the task, the participants needed to report the location of a target stimulus among distractors in pre-surprise trials. In the surprise trial, they were unexpectedly asked to report the identity of the target before reporting its location. Afterward, control trials were conducted whereby the participants were asked the same questions as in the surprise trial. Notably, the surprise trial and control trials were nearly identical, except that the participants expected to be asked about identity information in the control trials but not in the surprise trial. Thus, an improvement in identity reporting accuracy in the control trials in comparison with the surprise trial indicated active updating of expectations. In the current study, a total of 63 PSZ and 60 healthy control subjects (HCS) were enrolled. We found that both the PSZ and the HCS were unable to report information that they had fully attended to (i.e., identity) in the surprise trial. However, both groups showed a significant improvement in reporting identity information even in the first control trial. Critically, there was no significant difference in the magnitude of improvement between the two groups. The current findings indicate that PSZ have the ability to update their expectations as quickly and flexibly as HCS, at least in the context of the current task. The possible factors that might contribute to the discrepancy regarding expectation updating are discussed.

Sense of agency and its disturbances: A systematic review targeting the intentional binding effect in neuropsychiatric disorders

Sense of agency (SoA) indicates a person's ability to perceive her/his own motor acts as actually being her/his and, through them, to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual's functioning, as observed in several neuropsychiatric disorders. This is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients. Eligible were studies of IB involving patients with neurological and/or psychiatric disorders. We included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Abnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson's disease taking dopaminergic medications or reporting impulsive-compulsive behaviors. A decreased IB effect was observed in Tourette's disorder and functional movement disorders, whereas increased action-outcome binding was found in patients with the cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered.

Agency in schizophrenia and autism: a systematic review

Introduction

Previous research suggests that altered experiences of agency are an underlying vulnerability in both schizophrenia and autism. Here, we explore agency as a potential transdiagnostic factor by conducting a systematic review of existing literature investigating agency in autism and schizophrenia individually and together.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted three systematic searches on PsycINFO, Embase, Medline, PubMed and Web of Science to identify studies that investigated (1) agency in schizophrenia, (2) agency in autism, and (3) agency in both schizophrenia and autism.

Results

A total of 31 articles met eligibility criteria for inclusion and data extraction, with 24 measuring agency in schizophrenia, 7 investigating agency in autism, and no articles comparing the two. Results show that, compared to control populations, agency is significantly different in every identified schizophrenia study and generally not significantly different in autism.

Discussion

Importantly, we identified a lack of studies using common tasks and a disproportionate number of studies investigating different dimensions of agency across the two conditions, resulting in limited grounds for valid comparison.

Systematic review registration

Prospero, CRD42021273373.

Reduced neural connectivity in the caudate anterior head predicts hallucination severity in schizophrenia

BACKGROUND

Caudate functional abnormalities have been identified as one critical neural substrate underlying sensory gating impairments that lead to auditory phantom hallucinations in both patients with schizophrenia (SZ) and tinnitus, characterized by the perception of internally generated sounds in the absence of external environmental auditory stimuli. In this study, we tested the hypothesis as to whether functional connectivity abnormalities in distinct caudate subdivisions implicated in sensory gating and auditory phantom percepts in tinnitus, which are currently being localized for neuromodulation targeting using deep brain stimulation techniques, would be associated with auditory phantom hallucination severity in SZ.

METHODS

Twenty five SZ and twenty eight demographically-matched healthy control (HC) participants, completed this fMRI resting-state study and clinical assessments.

RESULTS

Between-group seed-to-voxel analyses revealed only one region, the caudate anterior head, which showed reduced functional connectivity with the thalamus that survived whole-brain multiple comparison corrections. Importantly, connectivity between the caudate anterior head with thalamus negatively correlated with hallucination severity.

CONCLUSIONS

In the present study, we deliver the first evidence of caudate subdivision specificity for the neural pathophysiology underlying hallucinations in schizophrenia within a sensory gating framework that has been developed for auditory phantoms in patients with tinnitus. Our findings provide transdiagnostic convergent evidence for the role of the caudate in the gating of auditory phantom hallucinations, observed across patients with SZ and tinnitus by specifying the anterior caudate division is key to mediation of hallucinations, and creating a path towards personalized treatment approaches to arrest auditory phantom hallucinations from reaching perceptual awareness.

Aberrant sense of agency induced by delayed prediction signals in schizophrenia: a computational modeling study

Aberrant sense of agency (SoA, a feeling of control over one's own actions and their subsequent events) has been considered key to understanding the pathology of schizophrenia. Behavioral studies have demonstrated that a bidirectional (i.e., excessive and diminished) SoA is observed in schizophrenia. Several neurophysiological and theoretical studies have suggested that aberrancy may be due to temporal delays (TDs) in sensory-motor prediction signals. Here, we examined this hypothesis via computational modeling using a recurrent neural network (RNN) expressing the sensory-motor prediction process. The proposed model successfully reproduced the behavioral features of SoA in healthy controls. In addition, simulation of delayed prediction signals reproduced the bidirectional schizophrenia-pattern SoA, whereas three control experiments (random noise addition, TDs in outputs, and TDs in inputs) demonstrated no schizophrenia-pattern SoA. These results support the TD hypothesis and provide a mechanistic understanding of the pathology underlying aberrant SoA in schizophrenia.

Correlation of motor-auditory cross-modal and auditory unimodal N1 and mismatch responses of schizophrenic patients and normal subjects: an MEG study

Introduction

It has been suggested that the positive symptoms of schizophrenic patients (hallucinations, delusions, and passivity experience) are caused by dysfunction of their internal and external sensory prediction errors. This is often discussed as related to dysfunction of the forward model that executes self-monitoring. Several reports have suggested that dysfunction of the forward model in schizophrenia causes misattributions of self-generated thoughts and actions to external sources. There is some evidence that the forward model can be measured using the electroencephalography (EEG) and magnetoencephalography (MEG) components such as N1 (m) and mismatch negativity (MMN) (m). The objective in this MEG study is to investigate differences in the N1m and MMNm-like activity generated in motor-auditory cross-modal tasks in normal control (NC) subjects and schizophrenic (SC) patients, and compared that activity with N1m and MMNm in the auditory unimodal task.

Methods

The N1m and MMNm/MMNm-like activity were recorded in 15 SC patients and 12 matched NC subjects. The N1m-attenuation effects and peak amplitude of MMNm/MMNm-like activity of the NC and SC groups were compared. Additionally, correlations between MEG measures (N1m suppression rate, MMNm, and MMNm-like activity) and clinical variables (Positive and Negative Syndrome Scale (PANSS) scores and antipsychotic drug (APD) dosages) in SC patients were investigated.

Results

It was found that (i) there was no significant difference in N1m-attenuation for the NC and SC groups, and that (ii) MMNm in the unimodal task in the SC group was significantly smaller than that in the NC group. Further, the MMNm-like activity in the cross-modal task was smaller than that of the MMNm in the unimodal task in the NC group, but there was no significant difference in the SC group. The PANSS positive symptoms and general psychopathology score were moderately negatively correlated with the amplitudes of the MMNm-like activity, and the APD dosage was moderately negatively correlated with the N1m suppression rate. However, none of these correlations reached statistical significance.

Discussion

The findings suggest that schizophrenic patients perform altered predictive processes differently from healthy subjects in latencies reflecting MMNm, depending on whether they are under forward model generation or not. This may support the hypothesis that schizophrenic patients tend to misattribute their inner experience to external agents, thus leading to the characteristic schizophrenia symptoms.

Increased temporal binding during voluntary motor task under local anesthesia

Temporal binding refers to a systemic bias in the perceived time interval between two related events, most frequently voluntary motor actions and a subsequent sensory effect. An inevitable component of most instrumental motor actions is tactile feedback. Yet, the role of tactile feedback within this phenomenon remains largely unexplored. Here, we used local anesthesia of the index finger to temporarily inhibit incoming sensory input from the finger itself, while participants performed an interval-estimation task in which they estimated the delay between a voluntary motor action (button press) and a second sensory event (click sound). Results were compared to a control condition with intact sensation. While clear binding was present in both conditions, the effect was significantly enhanced when tactile feedback was temporarily removed via local anesthesia. The results are discussed in light of current debates surrounding the underlying mechanisms and function of this temporal bias.

Preserved Metacognition for Undetected Visuomotor Deviations

Humans can successfully correct deviations of movements without conscious detection of such deviations, suggesting limited awareness of movement details. We ask whether such limited awareness impairs confidence (metacognition). We recorded functional magnetic resonance imaging data while 31 human female and male participants detected cursor deviations during a visuomotor reaching task and rated their confidence retrospectively. We show that participants monitor a summary statistic of the unfolding visual feedback (the peak cursor error) to detect visuomotor deviations and adjust their confidence ratings, even when they report being unaware of a deviation. Crucially, confidence ratings were as metacognitively efficient for aware and unaware deviations. At the neural level, activity in the ventral striatum tracks high confidence, whereas a broad network encodes cursor error but not confidence. These findings challenge the notion of limited conscious action monitoring and uncover how humans monitor their movements as they unfold, even when unaware of ongoing deviations.SIGNIFICANCE STATEMENT We are unaware of the small corrections we apply to our movements as long as our goals are achieved. Here, although we replicate the finding that participants deny perceiving small deviations they correct, we show that their confidence reliably reflects the presence or absence of a deviation. This observation shows they can metacognitively monitor the presence of a deviation, even when they deny perceiving it. We also describe the hemodynamic correlates of confidence ratings. Our study questions the extent to which humans are unaware of the details of their movements; describes a plausible mechanism for metacognition in a visuomotor task, along with its neural correlates; and has important implications for the construction of the sense of self.

"InMotion"-Mixed physical exercise program with creative movement as an intervention for adults with schizophrenia: study protocol for a randomized controlled trial

Background

Schizophrenia is among the world's top 10 causes of long-term disability with symptoms that lead to major problems in social and occupational functioning, and in self-care. Therefore, it is important to investigate the efficacy of complementary treatment options for conventionally used antipsychotic medication, such as physical training, and psychosocial interventions.

Objective

To combine aerobic and strength training with cognitive, emotional and social stimulation in one intervention for people with schizophrenia and test the feasibility and effects of this intervention.

Methods

The study is a mixed-method randomized controlled trial to evaluate the effects of a 12-week intervention for adults with schizophrenia. The treatment group (30 participants) will receive the intervention in addition to standard care and the control group (30 participants) only standard care. The intervention consists of 24 biweekly sessions with a duration of 60 min. The pre-test (weeks from 4 to 2 prior to the intervention) and post-test (week 12) include clinical measure (PANSS), quality of life, social performance, movement quantity, brain function and eye tracking measures. In addition, a treatment subgroup of 12-15 participants and their family member or other next of kin will complete a qualitative interview as a part of their post-test. Two follow-up tests, including clinical, quality of life, brain function and eye tracking will be made at 6 and 12 months from the completion of the intervention to both study groups. The primary outcome is change in negative symptoms. Secondary outcome measures include general and positive symptoms, quality of life, social performance, movement quantity, brain function and eye tracking. Explorative outcome includes patient and family member or other next of kin interview.

Results

Pilot data was collected by June 2023 and the main data collection will begin in September 2023. The final follow-up is anticipated to be completed by 2026.

Conclusion

The InMotion study will provide new knowledge on the feasibility, efficacy, and experiences of a novel intervention for adults with schizophrenia. The hypothesis is that regular participation in the intervention will reduce clinical symptoms, normalize physiological measures such as brain activation, and contribute to new active habits for the participants.

Trial registration

ClinicalTrials.gov, identifier NCT05673941.

Relating movement markers of schizophrenia to self-experience-a mixed-methods study

Introduction

Basic self-disorders on the one hand and motor symptoms on the other hand are discussed as endophenotypes of schizophrenia psychopathology. However, the systematic interaction between motor symptoms and the self-experience of patients is rarely studied.

Methods

In a previous study we defined motor markers of schizophrenia via a data-driven analysis of patients' gait patterns. In this study, we related the movement markers to measures of basic self-disorder obtained with EASE interviews. We substantiated the correlations with a qualitative content analysis of the interviews of a subset of four patients. We related qualitative and quantitative data on an intra- and interpersonal level.

Results

Our results suggest an association between the previously defined, theory-independent movement markers and basic self-disorders, specifically in the domain of cognition, self-experience and bodily experiences. While movement marker manifestation was not precisely reflected in the individuals' descriptions of anomalous self- and body experience, we found clear trends of more and more intense descriptions with increasing movement marker scores, when looking at specific experiences, such as hyper reflexivity.

Discussion

These results foster an integrated view of the patient and could stimulate therapeutic approaches aiming at an improvement of self- and body-experience of patients with schizophrenia.

Impaired perception of temporal contiguity between action and effect is associated with disorders of agency in schizophrenia

Delusions of control in schizophrenia are characterized by the striking feeling that one's actions are controlled by external forces. We here tested qualitative predictions inspired by Bayesian causal inference models, which suggest that such misattributions of agency should lead to decreased intentional binding. Intentional binding refers to the phenomenon that subjects perceive a compression of time between their intentional actions and consequent sensory events. We demonstrate that patients with delusions of control perceived less self-agency in our intentional binding task. This effect was accompanied by significant reductions of intentional binding as compared to healthy controls and patients without delusions. Furthermore, the strength of delusions of control tightly correlated with decreases in intentional binding. Our study validated a critical prediction of Bayesian accounts of intentional binding, namely that a pathological reduction of the prior likelihood of a causal relation between one's actions and consequent sensory events-here captured by delusions of control-should lead to lesser intentional binding. Moreover, our study highlights the import of an intact perception of temporal contiguity between actions and their effects for the sense of agency.

The human cerebellum in reward anticipation and reward outcome processing: An activation likelihood estimation meta-analysis

The cerebellum generates internal prediction models and actively compares anticipated and actual outcomes in order to reach a desired end state. In this process, reward can serve as a reinforcer that shapes internal prediction models, enabling context-appropriate behavior. While the involvement of the cerebellum in reward processing has been established in animals, there is no detailed account of which cerebellar regions are involved in reward anticipation and reward outcome processing in humans. To this end, an activation likelihood estimation meta-analysis of functional neuroimaging studies was performed to investigate cerebellar functional activity patterns associated with reward anticipation and reward outcome processing in healthy adults. Results showed that reward anticipation (k=31) was associated with regional activity in the bilateral anterior lobe, bilateral lobule VI, left Crus I and the posterior vermis, while reward outcome (k=16) was associated with regional activity in the declive and left lobule VI. The findings of this meta-analysis show distinct involvement of the cerebellum in reward anticipation and reward outcome processing as part of a predictive coding routine.

Obsessive-compulsive symptoms and dissociative experiences: Suggested underlying mechanisms and implications for science and practice

A strong and specific link between obsessive-compulsive disorder or symptoms (OCD/S) and a tendency for dissociative experiences (e.g., depersonalization-derealization, absorption and imaginative involvement) cannot be explained by trauma and is poorly understood. The present theoretical formulation proposes five different models conceptualizing the relationship. According to Model 1, dissociative experiences result from OCD/S through inward-focused attention and repetition. According to Model 2, dissociative absorption causally brings about both OCD/S and associated cognitive risk factors, such as thought-action fusion, partly through impoverished sense of agency. The remaining models highlight common underlying causal mechanisms: temporo-parietal abnormalities impairing embodiment and sensory integration (Model 3); sleep alterations causing sleepiness and dreamlike thought or mixed sleep-wake states (Model 4); and a hyperactive, intrusive imagery system with a tendency for pictorial thinking (Model 5). The latter model relates to Maladaptive Daydreaming, a suggested dissociative syndrome with strong ties to the obsessive-compulsive spectrum. These five models point to potential directions for future research, as these theoretical accounts may aid the two fields in interacting with each other, to the benefit of both. Finally, several dissociation-informed paths for further developing clinical intervention in OCD are identified.

Adaptability of the Sense of Agency in Healthy Young Adults in Sensorimotor Tasks for a Short Term

Sense of agency (SoA) refers to the subjective feeling of controlling one's own actions and sensory feedback. The SoA occurs when the predicted feedback matches the actual sensory feedback and is responsible for maintaining behavioral comfort. However, sensorimotor deficits because of illness cause incongruence between prediction and feedback, so the patient loses comfort during actions. Discomfort with actions associated with incongruence may continue robustly (i.e., "not" adaptable) throughout life because of the aftereffects of the disease. However, it is unclear how the SoA modulates when incongruency is experienced, even for a short term. The purpose of this study was to investigate the adaptability of the SoA in healthy participants in sensorimotor tasks for a short term. Participants were divided into congruent and incongruent exposure groups. The experimental task of manipulating the ratio of the self-control of a PC cursor was used to measure the SoA before and after exposure to congruent or incongruent stimuli. The results showed no significant differences between the groups before and after exposure for a short term. The finding that the SoA was not adaptable may assist in guiding the direction of future studies on how to correct incongruence.

The pursuit of the end: The effects of action-goal choices on temporal binding

The effect of action choice (whether one can choose their actions freely) on temporal binding (TB), the temporal contraction between a voluntary action and its effect, is controversial. The present study tried to distinguish action-goal choice (whether one could pursue the action-effect freely) from action choice. Experiments 1 and 2 focused on the effect of action-goal choice on TB while the congruency between actions and outcomes was manipulated (i.e., 50% in Experiment 1 and 80% in Experiment 2). Experiment 3 investigated the effect of action choice on TB when the outcome congruency was 80%. Results showed that free and instructed action-goals led to comparable magnitudes of TB while free actions led to a larger TB than instructed actions. Furthermore, the effect of outcome congruency on TB varied by action-goal choices (Experiment 2) but not action choices (Experiment 3). These results demonstrate the potential differences between action choice and action-goal choice.

Flexible control as surrogate reward or dynamic reward maximization

The utility of a given experience, like interacting with a particular friend or tasting a particular food, fluctuates continually according to homeostatic and hedonic principles. Consequently, to maximize reward, an individual must be able to escape or attain outcomes as preferences change, by switching between actions. Recent work on human and artificial intelligence has defined such flexible instrumental control in information theoretic terms and postulated that it may serve as a reward surrogate. Another possibility, however, is that the adaptability afforded by flexible control is tacitly implemented by planning for dynamic changes in outcome values. In the current study, an expected utility model that computes decision values over a range of possible monetary gains and losses associated with sensory outcomes provided the best fit to behavioral choice data and performed best in terms of earned rewards. Moreover, consistent with previous work on perceived control and personality, individual differences in dimensional schizotypy were correlated with behavioral choice preferences in conditions with the greatest and lowest levels of flexible control. These results contribute to a growing literature on the role of instrumental control in goal-directed choice.

Impaired sense of agency and associated confidence in psychosis

The Sense of Agency (SoA), our sensation of control over our actions, is a fundamental mechanism for delineating the Self from the environment and others. SoA arises from implicit processing of sensorimotor signals as well as explicit higher-level judgments. Psychosis patients suffer from difficulties in the sense of control over their actions and accurate demarcation of the Self. Moreover, it is unclear if they have metacognitive insight into their aberrant abilities. In this pre-registered study, we examined SoA and its associated confidence judgments using an embodied virtual reality paradigm in psychosis patients and controls. Our results show that psychosis patients not only have a severely reduced ability for discriminating their actions but they also do not show proper metacognitive insight into this deficit. Furthermore, an exploratory analysis revealed that the SoA capacities allow for high levels of accuracy in clinical classification of psychosis. These results indicate that SoA and its metacognition are core aspects of the psychotic state and provide possible venues for understanding the underlying mechanisms of psychosis, that may be leveraged for novel clinical purposes.

Consider the pons: bridging the gap on sensory prediction abnormalities in schizophrenia

A shared mechanism across species heralds the arrival of self-generated sensations, helping the brain to anticipate, and therefore distinguish, self-generated from externally generated sensations. In mammals, this sensory prediction mechanism is supported by communication within a cortico-ponto-cerebellar-thalamo-cortical loop. Schizophrenia is associated with impaired sensory prediction as well as abnormal structural and functional connections between nodes in this circuit. Despite the pons' principal role in relaying and processing sensory information passed from the cortex to cerebellum, few studies have examined pons connectivity in schizophrenia. Here, we first briefly describe how the pons contributes to sensory prediction. We then summarize schizophrenia-related abnormalities in the cortico-ponto-cerebellar-thalamo-cortical loop, emphasizing the dearth of research on the pons relative to thalamic and cerebellar connections. We conclude with recommendations for advancing our understanding of how the pons relates to sensory prediction failures in schizophrenia.

Depressive traits are associated with a reduced effect of choice on intentional binding

A sense of agency (SoA) over wilful actions is thought to be dependent on the level of choice and the nature of the outcome. In a preregistered study, we manipulated choice and valence of outcome to assess the relationship between SoA across the depression and psychosis continuum. Participants (N = 151) completed a Libet Clock task, in which they had either a free or forced choice to press one of two buttons and received either a rewarding or punishing outcome. Participants also completed questionnaires on depressive and psychosis-like traits. Rewarding outcomes increased intentional binding. The evidence favoured no effect of choice on average, but this was influenced by inter-individual differences. Individuals reporting more depressive traits had less of a difference in intentional binding between free and forced choice conditions. We show that implicit SoA is sensitive to outcome valence and the effect of choice differs across the depression continuum.

What is new with Artificial Intelligence? Human–agent interactions through the lens of social agency

In this article, we suggest that the study of social interactions and the development of a “sense of agency” in joint action can help determine the content of relevant explanations to be implemented in artificial systems to make them “explainable.” The introduction of automated systems, and more broadly of Artificial Intelligence (AI), into many domains has profoundly changed the nature of human activity, as well as the subjective experience that agents have of their own actions and their consequences – an experience that is commonly referred to as sense of agency. We propose to examine the empirical evidence supporting this impact of automation on individuals’ sense of agency, and hence on measures as diverse as operator performance, system explicability and acceptability. Because of some of its key characteristics, AI occupies a special status in the artificial systems landscape. We suggest that this status prompts us to reconsider human–AI interactions in the light of human–human relations. We approach the study of joint actions in human social interactions to deduce what key features are necessary for the development of a reliable sense of agency in a social context and suggest that such framework can help define what constitutes a good explanation. Finally, we propose possible directions to improve human–AI interactions and, in particular, to restore the sense of agency of human operators, improve their confidence in the decisions made by artificial agents, and increase the acceptability of such agents.

Unperceived motor actions of the balance system interfere with the causal attribution of self-motion

The instability of human bipedalism demands that the brain accurately senses balancing self-motion and determines whether movements originate from self-generated actions or external disturbances. Here, we challenge the longstanding notion that this process relies on a single representation of the body and world to accurately perceive postural orientation and organize motor responses to control balance self-motion. Instead, we find that the conscious sense of balance can be distorted by the corrective control of upright standing. Using psychophysics, we quantified thresholds to imposed perturbations and balance responses evoking cues of self-motion that are (in)distinguishable from corrective balance actions. When standing immobile, participants clearly perceived imposed perturbations. Conversely, when freely balancing, participants often misattributed their own corrective responses as imposed motion because their balance system had detected, integrated, and responded to the perturbation in the absence of conscious perception. Importantly, this only occurred for perturbations encoded ambiguously with balance-correcting responses and that remained below the natural variability of ongoing balancing oscillations. These findings reveal that our balance system operates on its own sensorimotor principles that can interfere with causal attribution of our actions, and that our conscious sense of balance depends critically on the source and statistics of induced and self-generated motion cues.

The sense of agency for brain disorders: A comprehensive review and proposed framework

Sense of Agency (SoA) refers to the feeling of control over voluntary actions and the outcomes of those actions. Several brain disorders are characterized by an abnormal SoA. To date, there is no robust treatment for aberrant agency across disorders; this is, in large part, due to gaps in our understanding of the cognitive mechanisms and neural correlates of the SoA. This apparent gap stems from a lack of synthesis in established findings. As such, the current review reconciles previously established findings into a novel neurocognitive framework for future investigations of the SoA in brain disorders, which we term the Agency in Brain Disorders Framework (ABDF). In doing so, we highlight key top-down and bottom-up cues that contribute to agency prospectively (i.e., prior to action execution) and retrospectively (i.e., after action execution). We then examine brain disorders, including schizophrenia, autism spectrum disorders (ASD), obsessive-compulsive disorders (OCD), and cortico-basal syndrome (CBS), within the ABDF, to demonstrate its potential utility in investigating neurocognitive mechanisms underlying phenotypically variable presentations of the SoA in brain disorders.

I Hear My Voice; Therefore I Spoke: The Sense of Agency Over Speech Is Enhanced by Hearing One's Own Voice

The subjective experience of causing an action is known as the sense of agency. Dysfunctional sense of agency over speech has been suggested as a cause of auditory hallucinations. However, agency over speech has not been extensively characterized in previous empirical studies. Here, we manipulated self-voice identity, an indicator of self, embedded in the acoustic quality of voice and examined implicit and explicit measures of the sense of agency. Experiment 1 (N = 29 adults) demonstrated more compression of a perceived interval between action and outcome when participants heard their undistorted voices than their pitch-distorted voices. Experiment 2 (N = 28 adults) revealed a strong top-down effect of self-voice identity: Specifically, the judgment of agency over speech was more resistant than the judgment of agency over hand/limb movement to low-level sensorimotor inconsistency. Our findings provide new insight into the sense of agency over speech and an informative perspective for understanding aberrant experience in auditory hallucinations.

Sense of agency during and following recovery from anorexia nervosa

The need to feel in control is central to anorexia nervosa (AN). The sense of control in AN has only been studied through self-report. This study investigated whether implicit sense of control (sense of agency; SoA) differs across AN patients, recovered AN (RAN) patients and healthy controls (HC). Furthermore, we assessed whether state anxiety is influenced by negative emotional states. SoA was measured with the intentional binding task (IB) and state-anxiety levels through a questionnaire. We did not find any evidence of differences in SoA between groups. Furthermore, state anxiety was not a significant predictor of SoA. Further research into SoA in AN should focus on other features of the SoA that are not targeted by the IB task.

I overthink-Therefore I am not: An active inference account of altered sense of self and agency in depersonalisation disorder

This paper considers the phenomenology of depersonalisation disorder, in relation to predictive processing and its associated pathophysiology. To do this, we first establish a few mechanistic tenets of predictive processing that are necessary to talk about phenomenal transparency, mental action, and self as subject. We briefly review the important role of 'predicting precision' and how this affords mental action and the loss of phenomenal transparency. We then turn to sensory attenuation and the phenomenal consequences of (pathophysiological) failures to attenuate or modulate sensory precision. We then consider this failure in the context of depersonalisation disorder. The key idea here is that depersonalisation disorder reflects the remarkable capacity to explain perceptual engagement with the world via the hypothesis that "I am an embodied perceiver, but I am not in control of my perception". We suggest that individuals with depersonalisation may believe that 'another agent' is controlling their thoughts, perceptions or actions, while maintaining full insight that the 'other agent' is 'me' (the self). Finally, we rehearse the predictions of this formal analysis, with a special focus on the psychophysical and physiological abnormalities that may underwrite the phenomenology of depersonalisation.

Neural correlates of disturbance in the sense of agency in schizophrenia: An fMRI study using the 'enfacement' paradigm

An altered sense of self-awareness and agency has been proposed to underlie symptoms of schizophrenia. In this study, we used the enfacement illusion paradigm - in which perception of another person's face leads to changes in perception of one's own peri-personal space - to examine the brain correlates of the sense of agency and its potential disruption in schizophrenia. Thirty-three schizophrenic patients and 27 healthy controls underwent fMRI scanning during performance of a task designed to elicit the enfacement illusion. Activations were examined using whole-brain analysis and also in an a priori identified region of interest (ROI) in the temporoparietal junction (TPJ), a region that has been described as involved in self/other differentiation and sense of agency. Both groups showed a pattern of cortical activation involving the pre and postcentral cortex, Rolandic operculum, insula, parietal, temporal and occipital cortex bilaterally as well as TPJ (but only right-side in patients). Examination of the TPJ ROI revealed significantly reduced activation on the left in the patients that was associated with poorer insight. The findings suggest brain functional abnormality in schizophrenia related to the formation or maintenance of processes related to self and/or agency. Decreased function in the TPJ may have a role in the impaired insight seen in patients with the disorder.

Agency Deficits in a Human Genetic Model of Schizophrenia: Insights From 22q11DS Patients

Schizophrenia is a chronic and disabling mental illness characterized by a disordered sense of self. Current theories suggest that deficiencies in the sense of control over one's actions (Sense of Agency, SoA) may underlie some of the symptoms of schizophrenia. However, it is not clear if agency deficits are a precursor or a result of psychosis. Here, we investigated full body agency using virtual reality in a cohort of 22q11 deletion syndrome participants with a genetic propensity for schizophrenia. In two experiments employing virtual reality, full body motion tracking, and online feedback, we investigated SoA in two separate domains. Our results show that participants with 22q11DS had a considerable deficit in monitoring their actions, compared to age-matched controls in both the temporal and spatial domain. This was coupled with a bias toward erroneous attribution of actions to the self. These results indicate that nonpsychotic 22q11DS participants have a domain general deficit in the conscious sensorimotor mechanisms underlying the bodily self. Our data reveal an abnormality in the SoA in a cohort with a genetic predisposition for schizophrenia, but without psychosis, providing evidence that deficits in delineation of the self may be a precursor rather than a result of the psychotic state.

Factors governing the assignment of visual consequence to the corresponding action

To achieve fast feedback control of voluntary movements, the visual consequences of our motor commands need to be quickly identified and analyzed by the motor control processes in the brain. These processes work remarkably well even in complex visual environments and in the face of discrepancies between physical actuator and visually perceived effect, e.g. when moving a computer mouse on a visually crowded screen. Here we use an ambiguous situation in which a single cursor could be controlled by either the left or the right hand to determine the visual and cognitive factors that determine the assignment of a visual stimulus to the corresponding motor command. Our results demonstrate that the visuomotor system is exquisitely sensitive to the spatio-temporal correlation between cursor and hands, learning the appropriate mapping implicitly within several minutes. In contrast, spatial proximity between end effector and visual consequence has an immediate but only transient effect on the assignment process. Finally, an explicit instruction about which hand controls the cursor only has a minor influence when the instruction is presented first. These findings provide insight into the relative importance of the factors that determine the binding of visual information to the corresponding motor structures to enable fast feedback control.

The over-estimation of distance for self-voice versus other-voice

Self-related stimuli are important cues for people to recognize themselves in the external world and hold a special status in our perceptual system. Self-voice plays an important role in daily social communication and is also a frequent input for self-identification. Although many studies have been conducted on the acoustic features of self-voice, no research has ever examined the spatial aspect, although the spatial perception of voice is important for humans. This study proposes a novel perspective for studying self-voice. We investigated people's distance perception of their own voice when the voice was heard from an external position. Participants heard their own voice from one of four speakers located either 90 or 180 cm from their sitting position, either immediately after uttering a short vowel (i.e., active session) or hearing the replay of their own pronunciation (i.e., replay session). They were then asked to indicate which speaker they heard the voice from. Their voices were either pitch-shifted by ± 4 semitones (i.e., other-voice condition) or unaltered (i.e., self-voice condition). The results of spatial judgment showed that self-voice from the closer speakers was misattributed to that from the speakers further away at a significantly higher proportion than other-voice. This phenomenon was also observed when the participants remained silent and heard prerecorded voices. Additional structural equation modeling using participants' schizotypal scores showed that the effect of self-voice on distance perception was significantly associated with the score of delusional thoughts (Peters Delusion Inventory) and distorted body image (Perceptual Aberration Scale) in the active speaking session but not in the replay session. The findings of this study provide important insights for understanding how people process self-related stimuli when there is a small distortion and how this may be linked to the risk of psychosis.

The Role of the Medial Prefontal Cortex in Self-Agency in Schizophrenia

Schizophrenia is a disorder of the self. In particular, patients show cardinal deficits in self-agency (i.e., the experience and awareness of being the agent of one’s own thoughts and actions) that directly contribute to positive psychotic symptoms of hallucinations and delusions and distort reality monitoring (defined as distinguishing self-generated information from externally-derived information). Predictive coding models suggest that the experience of self-agency results from a minimal prediction error between the predicted sensory consequence of a self-generated action and the actual outcome. In other words, the experience of self-agency is thought to be driven by making reliable predictions about the expected outcomes of one’s own actions. Most of the agency literature has focused on the motor system; here we present a novel viewpoint that examines agency from a different lens using distinct tasks of reality monitoring and speech monitoring. The self-prediction mechanism that leads to self-agency is necessary for reality monitoring in that self-predictions represent a critical precursor for the successful encoding and memory retrieval of one’s own thoughts and actions during reality monitoring to enable accurate self-agency judgments (i.e., accurate identification of self-generated information). This self-prediction mechanism is also critical for speech monitoring where we continually compare auditory feedback (i.e., what we hear ourselves say) with what we expect to hear. Prior research has shown that the medial prefrontal cortex (mPFC) may represent one potential neural substrate of this self-prediction mechanism. Unfortunately, patients with schizophrenia (SZ) show mPFC hypoactivity associated with self-agency impairments on reality and speech monitoring tasks, as well as aberrant mPFC functional connectivity during intrinsic measures of agency during resting states that predicted worsening psychotic symptoms. Causal neurostimulation and neurofeedback techniques can move the frontiers of schizophrenia research into a new era where we implement techniques to manipulate excitability in key neural regions, such as the mPFC, to modulate patients’ reliance on self-prediction mechanisms on distinct tasks of reality and speech monitoring. We hypothesize these findings will show that mPFC provides a unitary basis for self-agency, driven by reliance on self-prediction mechanisms, which will facilitate the development of new targeted treatments in patients with schizophrenia.

Sense of agency for mental actions: Insights from a belief-based action-effect paradigm

A substantial body of research has converged on the idea that the sense of agency arises from the integration of multiple sources of information. In this study, we investigated whether a measurable sense of agency can be detected for mental actions, without the contribution of motor components. We used a fake action-effect paradigm, where participants were led to think that a motor action or a particular thought could trigger a sound. Results showed that the sense of agency, when measured through explicit reports, was of comparable strength for motor and mental actions. The intentional binding effect, a phenomenon typically associated with the experience of agency, was also observed for both motor and mental actions. Taken together, our results provide novel insights into the specific role of intentional cues in instantiating a sense of agency, even in the absence of motor signals.

Two faces of temporal binding: Action- and effect-binding are not correlated

Research on the sense of agency has proliferated a range of explicit and implicit measures. However, the relation of different measures is poorly understood with especially mixed findings on the correlation between explicit judgments of agency and the implicit perceptual bias of temporal binding. Here, we add to the conundrum by showing that the two sub-components of temporal binding - action-binding and effect-binding, respectively - are not correlated across participants either, suggesting independent processes for both components. Research on inter-individual differences regarding the sense of agency is thus well-advised to rely on other implicit measures until the phenomenon of temporal binding is better understood.

Did i do that? Cognitive flexibility and self-agency in patients with obsessivecompulsive disorder

Self-agency can be understood as the ability to infer causal relationships between actions and sensory events. Obsessive-Compulsive Disorder (OCD) patients with checking compulsions often report lack of "action-completion" sensations, possibly due to an altered sense of agency in these patients. The present study aimed to investigate whether self-agency was related to cognitive flexibility in OCD checkers. In 18 adult OCD checkers and 18 age- and gender-matched healthy controls, cognitive flexibility was assessed with the Intra-Extra Dimensional Set Shift Task (IED). Self-agency attribution was evaluated in two tasks that targeted the novel construct of "gaze-agency", the capability of an observer to identify his or her own eye movements as the cause of a concurrent event (here, an auditory beep). This technique allows sensitive measurement of agency under subtly varying investigator-controlled conditions. OCD checkers manifested significantly inferior performance correctly ascribing the beeps to their own ocular saccades than controls, even when after a hint was provided. Although cognitive inflexibility (errors on the IED) did not differ significantly between the two groups, within the OCD sample there were positive correlations between errors in self-agency attribution and total and extra-dimensional shift errors. These findings show that cognitive inflexibility is related to self-agency in OCD.

Delusional thinking and action binding in healthy individuals

Action binding is the effect that the perceived time of an action is shifted towards the action related feedback. A much larger action binding effect in schizophrenia compared to normal controls has been shown, which might be due to positive symptoms like delusions. Here we investigated the relationship between delusional thinking and action binding in healthy individuals, predicting a positive correlation between them. The action binding effect was evaluated by comparing the perceived time of a keypress between an operant (keypress triggering a sound) and a baseline condition (keypress alone), with a novel testing method that massively improved the precision of the subjective timing measurement. A positive correlation was found between the tendency of delusional thinking (measured by the 21-item Peters et al. delusions inventory) and action binding across participants after controlling for the effect of testing order between operant and baseline conditions. The results indicate that delusional thinking in particular influences action time perception and support the notion of a continuous distribution of schizotypal traits with normal controls at one end and clinical patients at the other end.

Temporal Binding, Causation, and Agency: Developing a New Theoretical Framework

In temporal binding, the temporal interval between one event and another, occurring some time later, is subjectively compressed. We discuss two ways in which temporal binding has been conceptualized. In studies showing temporal binding between a voluntary action and its causal consequences, such binding is typically interpreted as providing a measure of an implicit or pre-reflective "sense of agency." However, temporal binding has also been observed in contexts not involving voluntary action, but only the passive observation of a cause-effect sequence. In those contexts, it has been interpreted as a top-down effect on perception reflecting a belief in causality. These two views need not be in conflict with one another, if one thinks of them as concerning two separate mechanisms through which temporal binding can occur. In this paper, we explore an alternative possibility: that there is a unitary way of explaining temporal binding both within and outside the context of voluntary action as a top-down effect on perception reflecting a belief in causality. Any such explanation needs to account for ways in which agency, and factors connected with agency, has been shown to affect the strength of temporal binding. We show that principles of causal inference and causal selection already familiar from the literature on causal learning have the potential to explain why the strength of people's causal beliefs can be affected by the extent to which they are themselves actively involved in bringing about events, thus in turn affecting binding.