1
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Rodgers E, Marwaha S, Humpston C. Co-occurring psychotic and eating disorders in England: findings from the 2014 Adult Psychiatric Morbidity Survey. J Eat Disord 2022; 10:150. [PMID: 36258254 PMCID: PMC9578255 DOI: 10.1186/s40337-022-00664-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/19/2022] [Accepted: 09/18/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Psychotic disorders and eating disorders are complex mental illnesses associated with increased mortality and functional impairment. This study aimed to investigate the co-occurrence and relationships between eating disorders and psychotic disorders and assess the mediation effect of mood instability. METHODS This study used data from the Adult Psychiatric Morbidity Survey (APMS) 2014, a general population-based survey in England. Participants (total N = 7546, female N = 4488, male N = 3058, mean age = 52.3 years) were categorised based on psychotic disorder status into the groups of probable psychosis, diagnosed psychosis, and healthy controls without psychosis. The dependent variable of this study was the presence or absence of an eating disorder, with mood instability as the mediator. Logistic regression and mediation analyses were conducted to assess the relationships between these variables. RESULTS Both probable and diagnosed psychoses were significantly related to the presence of an eating disorder, and mood instability was found to be a mediating variable with moderate effect. CONCLUSION The present study demonstrates a significant relationship between eating disorders and psychotic disorders in the English general population, indicating higher levels of co-occurrence between these two groups of disorders than when compared with healthy controls. The findings also suggest the relationship between eating and psychotic disorders is mediated, to an extent, by the presence of mood instability traits. Future research could extend the present study's findings through assessing whether specific eating disorders are more significantly related to psychotic disorders than others.
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Affiliation(s)
- Ellen Rodgers
- Institute for Mental Health, School of Psychology, University of Birmingham, B15 2TT, Birmingham, UK
| | - Steven Marwaha
- Institute for Mental Health, School of Psychology, University of Birmingham, B15 2TT, Birmingham, UK.,Birmingham and Solihull Mental Health Foundation Trust, B1 3RB, Birmingham, UK
| | - Clara Humpston
- Institute for Mental Health, School of Psychology, University of Birmingham, B15 2TT, Birmingham, UK. .,Department of Psychology, University of York, YO10 5DD, York, UK.
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2
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Ciaunica A, Seth A, Limanowski J, Hesp C, Friston KJ. I overthink—Therefore I am not: An active inference account of altered sense of self and agency in depersonalisation disorder. Conscious Cogn 2022; 101:103320. [PMID: 35490544 PMCID: PMC9130736 DOI: 10.1016/j.concog.2022.103320] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 03/27/2022] [Accepted: 03/29/2022] [Indexed: 12/17/2022]
Abstract
This paper examines potential mechanisms behind atypical sense of self and agency in Depersonalisation Disorder (DPD). Using Active Inference, we argue that aberrant somatosensory attenuation and precision weighting underlies DPD. Failures of somatosensory attenuation may disrupt the sense of agency and control over one’s perceptions and actions. In DPD, individuals may believe ‘another agent’ is controlling their thoughts, perceptions or actions. Unlike psychosis however, in DPD the individual maintains the full insight that the ‘other agent’ is ‘me’ (the self).
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.
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3
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Laurin A, Ramoz N, Ameller A, Dereux A, Zajac J, Bonjour M, Tebeka S, Le Strat Y, Dubertret C. Self-consciousness impairments in schizophrenia with and without first rank symptoms using the moving rubber hand illusion. Conscious Cogn 2021; 93:103154. [PMID: 34052640 DOI: 10.1016/j.concog.2021.103154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/18/2021] [Accepted: 05/17/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The moving rubber hand illusion allows the evaluation both the sense of body ownership and agency using visuo-motor stimulations. METHODS We used the moving rubber hand illusion in anatomic congruence with explicit measures to compare active asynchronous and passive synchronous movements in patients diagnosed with schizophrenia with first rank symptoms (FRS) (n = 31) versus without FRS (n = 25). RESULTS Patients with FRS are characterized by a lack of agency in active asynchronous condition. The two groups had no sense of ownership in synchronous passive condition. Using a multivariate regression model, we found an association between agency and body ownership measures in the active asynchronous condition in two groups (OR: 1.825, p < 0.001). In the passive condition, this association was only present in the group with first rank symptoms (OR: 2.04, p < 0.001). CONCLUSION Temporal proximity and sensorimotor information are essential in the understanding of self-consciousness disorders in schizophrenia.
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Affiliation(s)
- Andrew Laurin
- AP-HP, Centre Hospitalier Universitaire de Colombes, Hôpital Louis Mourier, Colombes, France; INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France.
| | - Nicolas Ramoz
- INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Aurély Ameller
- INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Antoine Dereux
- INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Julie Zajac
- AP-HP, Centre Hospitalier Universitaire de Colombes, Hôpital Louis Mourier, Colombes, France
| | - Maxime Bonjour
- Hospices Civils de Lyon, Service de Biostatistique, Lyon, France; Université Claude Bernard Lyon 1, Faculté de Médecine Lyon Est, Lyon, France
| | - Sarah Tebeka
- AP-HP, Centre Hospitalier Universitaire de Colombes, Hôpital Louis Mourier, Colombes, France; INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France
| | - Yann Le Strat
- AP-HP, Centre Hospitalier Universitaire de Colombes, Hôpital Louis Mourier, Colombes, France; INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine Bichat-Lariboisière, France
| | - Caroline Dubertret
- AP-HP, Centre Hospitalier Universitaire de Colombes, Hôpital Louis Mourier, Colombes, France; INSERM UMRS1266, Institute of Psychiatry and Neurosciences of Paris, Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Faculté de Médecine Bichat-Lariboisière, France
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4
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Jensen RAA, Thomsen DK, Lind M, Ladegaard N, Bliksted VF. Storying the Past and the Future: Agency and Communion Themes Among Individuals With Schizophrenia and Depression. J Nerv Ment Dis 2021; 209:343-352. [PMID: 33835953 DOI: 10.1097/nmd.0000000000001302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
ABSTRACT Research has linked disturbances in narrative identity with schizophrenia and other psychiatric disorders. One such disturbance is diminished agency and communion themes in past life stories. However, projecting oneself into the future is also central to identity and potentially impacts recovery. Hence, we examined themes of agency and communion in both past and future life stories and related themes to psychosocial functioning in 20 individuals with schizophrenia, 20 individuals with depressive disorder, and 19 nonpsychiatric controls. Participants were asked to describe up to 10 past and future chapters in their life stories and were assessed on psychosocial functioning and neurocognition. Chapters were coded for agency and communion themes. Both clinical groups displayed diminished agency and communion themes in past but not future life story chapters compared with the nonpsychiatric controls. Furthermore, agency themes in future chapters explained variance in psychosocial functioning after controlling for neurocognition. The results suggest that constructing a narrative identity to foster agency and communion in both past and future chapters may be an important part of recovering from schizophrenia and depression.
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5
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de la Salle S, Choueiry J, Shah D, Bowers H, McIntosh J, Ilivitsky V, Carroll B, Knott V. Resting-state functional EEG connectivity in salience and default mode networks and their relationship to dissociative symptoms during NMDA receptor antagonism. Pharmacol Biochem Behav 2020; 201:173092. [PMID: 33385439 DOI: 10.1016/j.pbb.2020.173092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 01/28/2023]
Abstract
N-methyl-d-aspartate receptor (NMDAR) antagonists administered to healthy humans results in schizophrenia-like symptoms, which are thought in part to be related to glutamatergically altered electrophysiological connectivity in large-scale intrinsic functional brain networks. Here, we examine resting-state source electroencephalographic (EEG) connectivity within and between the default mode (DMN: for self-related cognitive activity) and salience networks (SN: for detection of salient stimuli in internal and external environments) in 21 healthy volunteers administered a subanesthetic dose of the dissociative anesthetic and NMDAR antagonist, ketamine. In addition to provoking symptoms of dissociation, which are thought to originate from an altered sense of self that is common to schizophrenia, ketamine induces frequency-dependent increases and decreases in connectivity within and between DMN and SN. These altered interactive network couplings together with emergent dissociative symptoms tentatively support an NMDAR-hypofunction hypothesis of disturbed electrophysiologic connectivity in schizophrenia.
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Affiliation(s)
| | - Joelle Choueiry
- Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dhrasti Shah
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Hayley Bowers
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Judy McIntosh
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Vadim Ilivitsky
- Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada; Royal Ottawa Mental Health Centre, Ottawa, ON, Canada
| | - Brooke Carroll
- University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada
| | - Verner Knott
- School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada; University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada; Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.
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6
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Leptourgos P, Corlett PR. Embodied Predictions, Agency, and Psychosis. Front Big Data 2020; 3:27. [PMID: 33693400 PMCID: PMC7931869 DOI: 10.3389/fdata.2020.00027] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/14/2020] [Indexed: 01/11/2023] Open
Abstract
Psychotic symptoms, i.e., hallucinations and delusions, involve gross departures from conscious apprehension of consensual reality; respectively, perceiving and believing things that, according to same culture peers, do not obtain. In schizophrenia, those experiences are often related to abnormal sense of control over one's own actions, often expressed as a distorted sense of agency (i.e., passivity symptoms). Cognitive and computational neuroscience have furnished an account of these experiences and beliefs in terms of the brain's generative model of the world, which underwrites inferences to the best explanation of current and future states, in order to behave adaptively. Inference then involves a reliability-based trade off of predictions and prediction errors, and psychotic symptoms may arise as departures from this inference process, either an over- or under-weighting of priors relative to prediction errors. Surprisingly, there is empirical evidence in favor of both positions. Relatedly, there is evidence for both an enhanced and a diminished sense of agency in schizophrenia. How can this be? We argue that there is more than one generative model in the brain, and that ego- and allo-centric models operate in tandem. In brief, ego-centric models implement corollary discharge signals that cancel out the effects of self-generated actions while allo-centric models compare several hypothesis regarding the causes of sensory inputs (including the self among the potential causes). The two parallel hierarchies give rise to different levels of agency, with ego-centric models subserving "feelings of agency" and allo-centric predictions giving rise to "judgements of agency." Those two components are weighted according to their reliability and combined, generating a higher-level "sense of agency." We suggest that in schizophrenia a failure of corollary discharges to suppress self-generated inputs results in the absence of a "feeling of agency" and in a compensatory enhancement of allo-centric priors, which might underlie hallucinations, delusions of control but also, under certain circumstances, the enhancement of "judgments of agency." We discuss the consequences of such a model, and potential courses of action that could lead to its falsification.
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Affiliation(s)
| | - Philip R. Corlett
- Department of Psychiatry, Connecticut Mental Health Center, Yale University, New Haven, CT, United States
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7
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O’Neill A, Carey E, Dooley N, Healy C, Coughlan H, Kelly C, Frodl T, O’Hanlon E, Cannon M. Multiple Network Dysconnectivity in Adolescents with Psychotic Experiences: A Longitudinal Population-Based Study. Schizophr Bull 2020; 46:1608-1618. [PMID: 32614036 PMCID: PMC7846103 DOI: 10.1093/schbul/sbaa056] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abnormal functional connectivity (FC, the temporal synchronization of activation across distinct brain regions) of the default mode (DMN), salience (SN), central executive (CEN), and motor (MN) networks is well established in psychosis. However, little is known about FC in individuals, particularly adolescents, reporting subthreshold psychotic experiences (PE) and their trajectory over time. Thus, the aim of this study was to investigate the FC of these networks in adolescents with PE. In this population-based case-control study, 24 adolescents (mean age = 13.58) meeting the criteria for PE were drawn from a sample of 211 young people recruited and scanned for a neuroimaging study, with a follow-up scan 2 years later (n = 18, mean age = 15.78) and compared to matched controls drawn from the same sample. We compared FC of DMN, SN, CEN, and MN regions between PE and controls using whole-brain FC analyses. At both timepoints, the PE group displayed significant hypoconnectivity compared to controls. At baseline, FC in the PE group was decreased between MN and DMN regions. At follow-up, dysconnectivity in the PE group was more widespread. Over time, controls displayed greater FC changes than the PE group, with FC generally increasing between MN, DMN, and SN regions. Adolescents with PE exhibit hypoconnectivity across several functional networks also found to be hypoconnected in established psychosis. Our findings highlight the potential for studies of adolescents reporting PE to reveal early neural correlates of psychosis and support further investigation of the role of the MN in PE and psychotic disorders.
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Affiliation(s)
- Aisling O’Neill
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland,Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland,To whom correspondence should be addressed; Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin 9, Ireland; tel: +353-1-896 8484, fax: +353-1-896 3183, e-mail:
| | - Eleanor Carey
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland,Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland
| | - Niamh Dooley
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland,Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland
| | - Clare Kelly
- Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland
| | - Thomas Frodl
- Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland,Department of Psychiatry and Psychotherapy, University Hospital Magdeburg A.ö.R., Magdeburg, Germany
| | - Erik O’Hanlon
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland,Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Smurfit Building, Royal College of Surgeons Ireland at Beaumont Hospital, Dublin, Ireland,Trinity College Institute of Neuroscience, Room 336, Lloyd Building, Trinity College Dublin, Dublin, Ireland
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8
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Hummer TA, Yung MG, Goñi J, Conroy SK, Francis MM, Mehdiyoun NF, Breier A. Functional network connectivity in early-stage schizophrenia. Schizophr Res 2020; 218:107-115. [PMID: 32037204 DOI: 10.1016/j.schres.2020.01.023] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/29/2022]
Abstract
Schizophrenia is a disorder of altered neural connections resulting in impaired information integration. Whole brain assessment of within- and between-network connections may determine how information processing is disrupted in schizophrenia. Patients with early-stage schizophrenia (n = 56) and a matched control sample (n = 32) underwent resting-state fMRI scans. Gray matter regions were organized into nine distinct functional networks. Functional connectivity was calculated between 278 gray matter regions for each subject. Network connectivity properties were defined by the mean and variance of correlations of all regions. Whole-brain network measures of global efficiency (reflecting overall interconnectedness) and locations of hubs (key regions for communication) were also determined. The control sample had greater connectivity between the following network pairs: somatomotor-limbic, somatomotor-default mode, dorsal attention-default mode, ventral attention-limbic, and ventral attention-default mode. The patient sample had greater variance in interactions between ventral attention network and other functional networks. Illness duration was associated with overall increases in the variability of network connections. The control group had higher global efficiency and more hubs in the cerebellum network, while patient group hubs were more common in visual, frontoparietal, or subcortical networks. Thus, reduced functional connectivity in patients was largely present between distinct networks, rather than within-networks. The implications of these findings for the pathophysiology of schizophrenia are discussed.
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Affiliation(s)
- Tom A Hummer
- Department of Psychiatry, Indiana University School of Medicine, United States of America; Indiana University Psychotic Disorders Program, Indiana University School of Medicine, United States of America.
| | - Matthew G Yung
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Joaquín Goñi
- Center for Neuroimaging, Indiana University School of Medicine, United States of America; Weldon School of Biomedical Engineering, Purdue University, United States of America
| | - Susan K Conroy
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Michael M Francis
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Nicole F Mehdiyoun
- Department of Psychiatry, Indiana University School of Medicine, United States of America
| | - Alan Breier
- Department of Psychiatry, Indiana University School of Medicine, United States of America
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9
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Rossetti I, Romano D, Florio V, Doria S, Nisticò V, Conca A, Mencacci C, Maravita A. Defective Embodiment of Alien Hand Uncovers Altered Sensorimotor Integration in Schizophrenia. Schizophr Bull 2020; 46:294-302. [PMID: 31150551 PMCID: PMC7406197 DOI: 10.1093/schbul/sbz050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The observation that people with schizophrenia misattribute the source of their own actions has led to the hypothesis that they suffer from altered sensorimotor processes underlying sense of agency. Furthermore, rubber hand studies suggest an abnormal experience of embodiment in schizophrenia. However, this latter finding is based on a procedure that elicits ownership sensations for a fake hand by visuo-tactile stimulation, leaving the agency subcomponent of embodiment relatively untouched. By using a visuo-motor version of the embodiment illusion able to actively elicit also sense of agency for an alien hand, we tested whether the putative sensorimotor deficits are also involved in altering embodiment sensations in schizophrenia. Subjective (questionnaire) and perceptual (forearm bisection performance) indexes of the embodiment illusion were collected. Differently from controls, both the explicit agency component and the implicit body metrics update were not modulated by the extent of visuo-motor congruency in participants with schizophrenia. We conclude that motor prediction and/or temporal binding window impairments may alter the feeling of embodiment and body representation in schizophrenia.
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Affiliation(s)
- Ileana Rossetti
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, Milan, Italy
| | - Daniele Romano
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, Milan, Italy,Neuromi—Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy
| | - Vincenzo Florio
- Department of Psychiatry, Comprensorio Sanitario di Bolzano, Bolzano, Italy
| | - Stefania Doria
- Department of SMD—Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Veronica Nisticò
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, Milan, Italy
| | - Andreas Conca
- Department of Psychiatry, Comprensorio Sanitario di Bolzano, Bolzano, Italy
| | - Claudio Mencacci
- Department of SMD—Neuroscience, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Angelo Maravita
- Department of Psychology, University of Milano-Bicocca, Piazza dell’Ateneo Nuovo 1, Milan, Italy,Neuromi—Milan Center for Neuroscience, University of Milano-Bicocca, Milan, Italy,To whom correspondence should be addressed: tel: +39-02-64483768 fax: +39-02-64483788; e-mail:
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10
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Whitford TJ. Speaking-Induced Suppression of the Auditory Cortex in Humans and Its Relevance to Schizophrenia. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:791-804. [PMID: 31399393 DOI: 10.1016/j.bpsc.2019.05.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 01/13/2023]
Abstract
Speaking-induced suppression (SIS) is the phenomenon that the sounds one generates by overt speech elicit a smaller neurophysiological response in the auditory cortex than comparable sounds that are externally generated. SIS is a specific example of the more general phenomenon of self-suppression. SIS has been well established in nonhuman animals and is believed to involve the action of corollary discharges. This review summarizes, first, the evidence for SIS in heathy human participants, where it has been most commonly assessed with electroencephalography and/or magnetoencephalography using an experimental paradigm known as "Talk-Listen"; and second, the growing number of Talk-Listen studies that have reported subnormal levels of SIS in patients with schizophrenia. This result is theoretically significant, as it provides a plausible explanation for some of the most distinctive and characteristic symptoms of schizophrenia, namely the first-rank symptoms. In particular, while the failure to suppress the neural consequences of self-generated movements (such as those associated with overt speech) provides a prima facie explanation for delusions of control, the failure to suppress the neural consequences of self-generated inner speech provides a plausible explanation for certain classes of auditory-verbal hallucinations, such as audible thoughts. While the empirical evidence for a relationship between SIS and the first-rank symptoms is currently limited, I predict that future studies with more sensitive experimental designs will confirm its existence. Establishing the existence of a causal, mechanistic relationship would represent a major step forward in our understanding of schizophrenia, which is a necessary precursor to the development of novel treatments.
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Affiliation(s)
- Thomas J Whitford
- School of Psychology, The University of New South Wales, Sydney, New South Wales, Australia.
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11
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Ferroni F, Ardizzi M, Sestito M, Lucarini V, Daniel BD, Paraboschi F, Tonna M, Marchesi C, Gallese V. Shared multisensory experience affects Others' boundary: The enfacement illusion in schizophrenia. Schizophr Res 2019; 206:225-235. [PMID: 30473209 DOI: 10.1016/j.schres.2018.11.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/15/2018] [Accepted: 11/16/2018] [Indexed: 02/07/2023]
Abstract
Schizophrenia has been described as a psychiatric condition characterized by deficits in one's own and others' face recognition, as well as by a disturbed sense of body-ownership. To date, no study has integrated these two lines of research with the aim of investigating Enfacement Illusion (EI) proneness in schizophrenia. To accomplish this goal, the classic EI protocol was adapted to test the potential plasticity of both Self-Other and Other-Other boundaries. Results showed that EI induced the expected malleability of Self-Other boundary among both controls and patients. Interestingly, for the first time, the present study demonstrates that also the Other-Other boundary was influenced by EI. Furthermore, comparing the two groups, the malleability of the Other-Other boundary showed an opposite modulation. These results suggest that, instead of greater Self-Other boundary plasticity, a qualitative difference can be detected between schizophrenia patients and controls in the malleability of the Other-Other boundary. The present study points out a totally new aspect about body-illusions and schizophrenia disorder, demonstrating that EI is not only confined to self-sphere but it also affects the way we discriminate others, representing a potential crucial aspect in the social domain.
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Affiliation(s)
- F Ferroni
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - M Ardizzi
- Department of Medicine and Surgery, University of Parma, Parma, Italy.
| | - M Sestito
- Department of Psychology, Wright State University, Dayton, OH, United States
| | - V Lucarini
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
| | - B D Daniel
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
| | - F Paraboschi
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
| | - M Tonna
- Department of Mental Health, Local Health Service, Parma, Italy
| | - C Marchesi
- Department of Medicine and Surgery, Psychiatry Unit, University of Parma, Parma, Italy
| | - V Gallese
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Institute of Philosophy, School of Advanced Study, University of London, London, UK
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12
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Zhang Y, Guo G, Tian Y. Increased Temporal Dynamics of Intrinsic Brain Activity in Sensory and Perceptual Network of Schizophrenia. Front Psychiatry 2019; 10:484. [PMID: 31354546 PMCID: PMC6639429 DOI: 10.3389/fpsyt.2019.00484] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 06/19/2019] [Indexed: 12/12/2022] Open
Abstract
Schizophrenic subject is thought as a self-disorder patient related with abnormal brain functional network. It has been hypothesized that self-disorder is associated with the deficient functional integration of multisensory body signals in schizophrenic subjects. To further verify this assumption, 53 chronic schizophrenic subjects and 67 healthy subjects were included in this study and underwent resting-state functional magnetic resonance imaging. The data-driven methods, whole-brain temporal variability of fractional amplitude of low-frequency fluctuations and regional homogeneity (ReHo), were used to investigate dynamic local functional connectivity and dynamic local functional activity changes in schizophrenic subjects. Patients with schizophrenia exhibited increased temporal variability ReHo and fractional amplitude of low-frequency fluctuations across time windows within sensory and perception network (such as occipital gyrus, precentral and postcentral gyri, superior temporal gyrus, and thalamus). Critically, the increased dynamic ReHo of thalamus is significantly correlated with positive and total symptom of schizophrenic subjects. Our findings revealed that deficit in sensory and perception functional networks might contribute to neural physiopathology of self-disorder in schizophrenic subjects.
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Affiliation(s)
- Youxue Zhang
- School of Psychology, Chengdu Normal University, Chengdu, China
| | - Gang Guo
- School of Psychology, Chengdu Normal University, Chengdu, China
| | - Yuan Tian
- School of Foreign Languages, Chengdu Normal University, Chengdu, China
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Van Doorn G, De Foe A, Wood A, Wagstaff D, Hohwy J. Down the rabbit hole: assessing the influence of schizotypy on the experience of the Barbie Doll Illusion. Cogn Neuropsychiatry 2018; 23:284-298. [PMID: 29975156 DOI: 10.1080/13546805.2018.1495623] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION "Body swapping" illusions have been used to explore factors contributing to the experience of "owning" an artificial body. Preliminary research indicated that those people diagnosed with schizophrenia experience more vivid illusions of this kind than do "normal" individuals. OBJECTIVES Here, we explored whether participants who rated themselves "high" on the cognitive-perceptual factor of the Schizotypal Personality Questionnaire (SPQ) experienced a more compelling sense of immersion in a variation of the body swapping illusion: The Barbie Doll Illusion. We also hypothesised that these individuals would experience a change in size perception when immersed in the illusion. METHOD Forty-four participants wore a pair of Head-Mounted Display goggles connected to a video-camera, and thus a doll's body replaced their own body in their visual field. In two conditions, touch was either applied synchronously or asynchronously to the doll's and each participant's leg. After each condition, participants filled out a questionnaire relating to their experience in the illusion. When both conditions were completed, they filled out the SPQ. RESULTS Our first hypothesis was confirmed, which suggested that people with higher cognitive-perceptual SPQ scores do indeed experience a more compelling Barbie Doll Illusion; however, our second hypothesis was not supported. CONCLUSION Our study demonstrated, for the first time, that proneness to the positive and interpersonal factors of schizotypy in a normal population is sufficient to produce a compelling sense of swapping bodies.
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Affiliation(s)
- George Van Doorn
- a School of Health and Life Sciences, Department of Psychology , Federation University Australia , Churchill , Australia
| | - Alexander De Foe
- b School of Health Sciences and Biomedical Sciences, Discipline of Psychology , RMIT University , Melbourne , Australia
| | - Alle Wood
- a School of Health and Life Sciences, Department of Psychology , Federation University Australia , Churchill , Australia
| | - Danielle Wagstaff
- a School of Health and Life Sciences, Department of Psychology , Federation University Australia , Churchill , Australia
| | - Jakob Hohwy
- c Cognition & Philosophy Laboratory, Department of Philosophy , Monash University , Melbourne , Australia
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14
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Bansal S, Ford JM, Spering M. The function and failure of sensory predictions. Ann N Y Acad Sci 2018; 1426:199-220. [PMID: 29683518 DOI: 10.1111/nyas.13686] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/26/2018] [Accepted: 02/27/2018] [Indexed: 01/24/2023]
Abstract
Humans and other primates are equipped with neural mechanisms that allow them to automatically make predictions about future events, facilitating processing of expected sensations and actions. Prediction-driven control and monitoring of perceptual and motor acts are vital to normal cognitive functioning. This review provides an overview of corollary discharge mechanisms involved in predictions across sensory modalities and discusses consequences of predictive coding for cognition and behavior. Converging evidence now links impairments in corollary discharge mechanisms to neuropsychiatric symptoms such as hallucinations and delusions. We review studies supporting a prediction-failure hypothesis of perceptual and cognitive disturbances. We also outline neural correlates underlying prediction function and failure, highlighting similarities across the visual, auditory, and somatosensory systems. In linking basic psychophysical and psychophysiological evidence of visual, auditory, and somatosensory prediction failures to neuropsychiatric symptoms, our review furthers our understanding of disease mechanisms.
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Affiliation(s)
- Sonia Bansal
- Maryland Psychiatric Research Center, University of Maryland, Catonsville, Maryland
| | - Judith M Ford
- University of California and Veterans Affairs Medical Center, San Francisco, California
| | - Miriam Spering
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, British Columbia, Canada
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Shaqiri A, Roinishvili M, Kaliuzhna M, Favrod O, Chkonia E, Herzog MH, Blanke O, Salomon R. Rethinking Body Ownership in Schizophrenia: Experimental and Meta-analytical Approaches Show no Evidence for Deficits. Schizophr Bull 2018; 44:643-652. [PMID: 29036731 PMCID: PMC5890460 DOI: 10.1093/schbul/sbx098] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Schizophrenia is a severe psychiatric disorder, in which patients experience an abnormal sense of self. While deficits in sensorimotor self-representation (agency) are well documented in schizophrenia, less is known about other aspects of bodily self-representation (body ownership). Here, we tested a large cohort (N = 59) of chronic schizophrenia patients and matched controls (N = 30) on a well-established body illusion paradigm, the Full Body Illusion (FBI). In this paradigm, changes in body ownership are induced through prolonged multisensory stimulation, in which participants are stroked on their back while seeing the stroking on the back of a virtual body. When the felt and seen stroking are synchronous, participants typically feel higher identification with the seen body as well as a drift in self-location towards it. However, when the stroking is asynchronous, no such changes occur. Our results show no evidence for abnormal body ownership in schizophrenia patients. A meta-analysis of previous work corroborates this result. Thus, while schizophrenia patients may be impaired in the sense of agency, their multisensory bodily self-representation, as tested here, seems to be unaffected by the illness.
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Affiliation(s)
- Albulena Shaqiri
- Laboratory of Psychophysics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Maya Roinishvili
- Vision Research Laboratory, Beritashvili Centre of Experimental Biomedicine, Tbilisi, Georgia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
| | - Mariia Kaliuzhna
- Laboratory of Cognitive Neuroscience, Brain Mind Institute, EPFL, Lausanne, Switzerland
- Chair in Cognitive Neuroprosthetics, Center for Neuroprosthetics, School of Life Science, EPFL, Geneva, Switzerland
- Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Ophélie Favrod
- Laboratory of Psychophysics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Eka Chkonia
- Institute of Cognitive Neurosciences, Agricultural University of Georgia, Tbilisi, Georgia
- Department of Psychiatry, Tbilisi State Medical University, Tbilisi, Georgia
| | - Michael H Herzog
- Laboratory of Psychophysics, Brain Mind Institute, EPFL, Lausanne, Switzerland
| | - Olaf Blanke
- Laboratory of Cognitive Neuroscience, Brain Mind Institute, EPFL, Lausanne, Switzerland
- Chair in Cognitive Neuroprosthetics, Center for Neuroprosthetics, School of Life Science, EPFL, Geneva, Switzerland
| | - Roy Salomon
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
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He H, Yang M, Duan M, Chen X, Lai Y, Xia Y, Shao J, Biswal BB, Luo C, Yao D. Music Intervention Leads to Increased Insular Connectivity and Improved Clinical Symptoms in Schizophrenia. Front Neurosci 2018; 11:744. [PMID: 29410607 PMCID: PMC5787137 DOI: 10.3389/fnins.2017.00744] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 12/20/2017] [Indexed: 01/08/2023] Open
Abstract
Schizophrenia is a syndrome that is typically accompanied by delusions and hallucinations that might be associated with insular pathology. Music intervention, as a complementary therapy, is commonly used to improve psychiatric symptoms in the maintenance stage of schizophrenia. In this study, we employed a longitudinal design to assess the effects of listening to Mozart music on the insular functional connectivity (FC) in patients with schizophrenia. Thirty-six schizophrenia patients were randomly divided into two equal groups as follows: the music intervention (MTSZ) group, which received a 1-month music intervention series combined with antipsychotic drugs, and the no-music intervention (UMTSZ) group, which was treated solely with antipsychotic drugs. Resting-state functional magnetic resonance imaging (fMRI) scans were performed at the following three timepoints: baseline, 1 month after baseline and 6 months after baseline. Nineteen healthy participants were recruited as controls. An FC analysis seeded in the insular subregions and machine learning techniques were used to examine intervention-related changes. After 1 month of listening to Mozart music, the MTSZ showed increased FC in the dorsal anterior insula (dAI) and posterior insular (PI) networks, including the dAI-ACC, PI-pre/postcentral cortices, and PI-ACC connectivity. However, these enhanced FCs had vanished in follow-up visits after 6 months. Additionally, a support vector regression on the FC of the dAI-ACC at baseline yielded a significant prediction of relative symptom remission in response to music intervention. Furthermore, the validation analyses revealed that 1 month of music intervention could facilitate improvement of the insular FC in schizophrenia. Together, these findings revealed that the insular cortex could potentially be an important region in music intervention for patients with schizophrenia, thus improving the patients' psychiatric symptoms through normalizing the salience and sensorimotor networks.
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Affiliation(s)
- Hui He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Mi Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Four People's Hospital of Chengdu, Chengdu, China
| | - Mingjun Duan
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China.,The Four People's Hospital of Chengdu, Chengdu, China
| | - Xi Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongxiu Lai
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Yang Xia
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Junming Shao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Bharat B Biswal
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Dezhong Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Impaired self-agency inferences in schizophrenia: The role of cognitive capacity and causal reasoning style. Eur Psychiatry 2017; 47:27-34. [PMID: 29096130 DOI: 10.1016/j.eurpsy.2017.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 08/28/2017] [Accepted: 08/29/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The sense of self-agency, i.e., experiencing oneself as the cause of one's own actions, is impaired in patients with schizophrenia. Normally, inferences of self-agency are enhanced when actual outcomes match with pre-activated outcome information, where this pre-activation can result from explicitly set goals (i.e., goal-based route) or implicitly primed outcome information (i.e., prime-based route). Previous research suggests that patients show specific impairments in the prime-based route, implicating that they do not rely on matches between implicitly available outcome information and actual action-outcomes when inferring self-agency. The question remains: Why? Here, we examine whether neurocognitive functioning and self-serving bias (SSB) may explain abnormalities in patients' agency inferences. METHODS Thirty-six patients and 36 healthy controls performed a commonly used agency inference task to measure goal- and prime-based self-agency inferences. Neurocognitive functioning was assessed with the Brief Assessment of Cognition in Schizophrenia (BACS) and the SSB was assessed with the Internal Personal and Situational Attributions Questionnaire. RESULTS Results showed a substantial smaller effect of primed outcome information on agency experiences in patients compared with healthy controls. Whereas patients and controls differed on BACS and marginally on SSB scores, these differences were not related to patients' impairments in prime-based agency inferences. CONCLUSIONS Patients showed impairments in prime-based agency inferences, thereby replicating previous studies. This finding could not be explained by cognitive dysfunction or SSB. Results are discussed in the context of the recent surge to understand and examine deficits in agency experiences in schizophrenia.
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Bortolon C, Capdevielle D, Altman R, Macgregor A, Attal J, Raffard S. Mirror self-face perception in individuals with schizophrenia: Feelings of strangeness associated with one's own image. Psychiatry Res 2017; 253:205-210. [PMID: 28390296 DOI: 10.1016/j.psychres.2017.03.055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 02/26/2017] [Accepted: 03/17/2017] [Indexed: 10/19/2022]
Abstract
Self-face recognition is crucial for sense of identity and for maintaining a coherent sense of self. Most of our daily life experiences with the image of our own face happen when we look at ourselves in the mirror. However, to date, mirror self-perception in schizophrenia has received little attention despite evidence that face recognition deficits and self abnormalities have been described in schizophrenia. Thus, this study aims to investigate mirror self-face perception in schizophrenia patients and its correlation with clinical symptoms. Twenty-four schizophrenia patients and twenty-five healthy controls were explicitly requested to describe their image in detail during 2min whilst looking at themselves in a mirror. Then, they were asked to report whether they experienced any self-face recognition difficulties. Results showed that schizophrenia patients reported more feelings of strangeness towards their face compared to healthy controls (U=209.5, p=0.048, r=0.28), but no statistically significant differences were found regarding misidentification (p=0.111) and failures in recognition (p=0.081). Symptoms such as hallucinations, somatic concerns and depression were also associated with self-face perception abnormalities (all p-values>0.05). Feelings of strangeness toward one's own face in schizophrenia might be part of a familiar face perception deficit or a more global self-disturbance, which is characterized by a loss of self-other boundaries and has been associated with abnormal body experiences and first rank symptoms. Regarding this last hypothesis, multisensorial integration might have an impact on the way patients perceive themselves since it has an important role in mirror self-perception.
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Affiliation(s)
- Catherine Bortolon
- Epsylon Laboratory, EA 4556, University Montpellier 3, Montpellier, France; University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France.
| | - Delphine Capdevielle
- University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France; French National Institute of Health and Medical Research (INSERM), U1061Pathologies of the Nervous System: Epidemiological and Clinical Research, Montpellier, France
| | - Rosalie Altman
- Epsylon Laboratory, EA 4556, University Montpellier 3, Montpellier, France; University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France
| | - Alexandra Macgregor
- University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France
| | - Jérôme Attal
- University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France
| | - Stéphane Raffard
- Epsylon Laboratory, EA 4556, University Montpellier 3, Montpellier, France; University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France
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Korzyukov O, Bronder A, Lee Y, Patel S, Larson CR. Bioelectrical brain effects of one's own voice identification in pitch of voice auditory feedback. Neuropsychologia 2017; 101:106-114. [PMID: 28461225 DOI: 10.1016/j.neuropsychologia.2017.04.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Revised: 03/04/2017] [Accepted: 04/27/2017] [Indexed: 01/22/2023]
Abstract
Control of voice fundamental frequency (F0) relies in part on comparison of the intended F0 level and auditory feedback. This comparison impacts "sense of agency", or SoA, commonly defined as being the agent of one's own actions and plays a key role for self-awareness and social interactions. SoA is aberrant in several psychiatric disorders. Knowledge about brain activity reflecting SoA can be used in clinical practice for these disorders. It was shown that perception of voice feedback as one's own voice, reflecting the recognition of SoA, alters auditory sensory processing. Using a voice perturbation paradigm we contrasted vocal and bioelectrical brain responses to auditory stimuli that differed in magnitude: 100 and 400 cents. Results suggest the different magnitudes were perceived as a pitch error in self-vocalization (100 cents) or as a pitch shift generated externally (400 cents). Vocalizations and neural responses to changes in pitch of self-vocalization were defined as those made to small magnitude pitch-shifts (100 cents) and which did not show differential neural responses to upward versus downward changes in voice pitch auditory feedback. Vocal responses to large magnitude pitch shifts (400 cents) were smaller than those made to small pitch shifts, and neural responses differed according to upwards versus downward changes in pitch. Our results suggest that the presence of SoA for self-produced sounds may modify bioelectrical brain responses reflecting differences in auditory processing of the direction of a pitch shift. We suggest that this modification of bioelectrical response can be used as a biological index of SoA. Possible neuronal mechanisms of this modification of bioelectrical brain response are discussed.
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Affiliation(s)
- Oleg Korzyukov
- Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Dr., Evanston, IL 60208, USA; Neuromagnetic Brain Imaging Laboratory, Meadowlands Medical Center, 55 Meadowlands Parkway, Secaucus, NJ 07094, USA.
| | - Alexander Bronder
- Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Dr., Evanston, IL 60208, USA
| | - Yunseon Lee
- Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Dr., Evanston, IL 60208, USA
| | - Sona Patel
- Department of Speech-Language Pathology, Seton Hall University, 400 South Orange Ave, South Orange, NJ 07079, USA
| | - Charles R Larson
- Department of Communication Sciences and Disorders, Northwestern University, 2240 Campus Dr., Evanston, IL 60208, USA
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20
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Prikken M, van der Weiden A, Renes RA, Koevoets MGJC, Heering HD, Kahn RS, Aarts H, van Haren NEM. Abnormal agency experiences in schizophrenia patients: Examining the role of psychotic symptoms and familial risk. Psychiatry Res 2017; 250:270-276. [PMID: 28189096 DOI: 10.1016/j.psychres.2016.10.077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 09/01/2016] [Accepted: 10/30/2016] [Indexed: 11/24/2022]
Abstract
Experiencing self-agency over one's own action outcomes is essential for social functioning. Recent research revealed that patients with schizophrenia do not use implicitly available information about their action-outcomes (i.e., prime-based agency inference) to arrive at self-agency experiences. Here, we examined whether this is related to symptoms and/or familial risk to develop the disease. Fifty-four patients, 54 controls, and 19 unaffected (and unrelated) siblings performed an agency inference task, in which experienced agency was measured over action-outcomes that matched or mismatched outcome-primes that were presented before action performance. The Positive and Negative Syndrome Scale (PANSS) and Comprehensive Assessment of Symptoms and History (CASH) were administered to assess psychopathology. Impairments in prime-based inferences did not differ between patients with symptoms of over- and underattribution. However, patients with agency underattribution symptoms reported significantly lower overall self-agency experiences. Siblings displayed stronger prime-based agency inferences than patients, but weaker prime-based inferences than healthy controls. However, these differences were not statistically significant. Findings suggest that impairments in prime-based agency inferences may be a trait characteristic of schizophrenia. Moreover, this study may stimulate further research on the familial basis and the clinical relevance of impairments in implicit agency inferences.
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Affiliation(s)
- Merel Prikken
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
| | | | - Robert A Renes
- Utrecht University, Department of Psychology, Utrecht, The Netherlands
| | | | - Henriette D Heering
- Academic Medical Center, Department of Psychiatry, Amsterdam, The Netherlands
| | - René S Kahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henk Aarts
- Utrecht University, Department of Psychology, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Fierro M, Hernández AM, Malcolm J. The Psychopathology of Delusion of Control According to Subjective Experience. ACTA ACUST UNITED AC 2017; 47:221-228. [PMID: 30286844 DOI: 10.1016/j.rcp.2017.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2016] [Revised: 01/05/2017] [Accepted: 02/20/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Delusion of control, including thought insertion, occurs in 20% of patients with schizophrenia. However little is known of its psychopathology, and studies involving patients are scarce. AIMS To explore the subjective experience of patients with delusion of control and to propose a psychopathological explanation based on empirical evidence. METHODS Qualitative exploratory study of 7 patients (6 with schizophrenia and 1 with schizophreniform disorder). A phenomenologically-oriented semi-structured interview was used. RESULTS Delusion of control is not an isolated and pure symptom; it is always immersed in the context of a persecutory delusion and other psychiatric symptoms. The patient experiences partial control, i.e. the control is never complete. In all cases, it is possible to trace the history of the narrative formation of delusion of control from its origins in persecutory delusions and other concomitant symptoms. CONCLUSIONS The delusion of control is a narrative resulting from the joint presence of a persecutory delusion and other psychiatric symptoms. For the patient, the delusion of control is the narrative of the elaborate expression of the meaning of the anomalous experience. Delusion of control is a narrative variety of persecutory delusion.
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Affiliation(s)
- Marco Fierro
- Fundación Universitaria Sanitas, Bogotá, Colombia.
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22
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Rosen C, Jones N, Chase KA, Melbourne JK, Grossman LS, Sharma RP. Immersion in altered experience: An investigation of the relationship between absorption and psychopathology. Conscious Cogn 2017; 49:215-226. [PMID: 28219788 DOI: 10.1016/j.concog.2017.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 10/10/2016] [Accepted: 01/13/2017] [Indexed: 12/20/2022]
Abstract
Understanding alterations in perceptual experiences as a component of the basic symptom structure of psychosis may improve early detection and the identification of subtle shifts that can precede symptom onset or exacerbation. We explored the phenomenological construct of absorption and psychotic experiences in both clinical (bipolar psychosis and schizophrenia spectrum) and non-clinical participants. Participants with psychosis endorsed significantly higher absorption compared to the non-clinical group. Absorption was positively correlated with all types of hallucinations and multiple types of delusions. The analysis yielded two distinct cluster groups that demarcated a distinction along the continuum of self-disturbance: on characterized by attenuated ego boundaries and the other stable ego boundaries. The study suggests that absorption is a potentially important but under-researched component of psychosis that overlaps with, but is not identical to the more heavily theorized constructs of aberrant salience and hyperreflexivity.
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Affiliation(s)
- Cherise Rosen
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States.
| | - Nev Jones
- Felton Institute, 1500 Franklin Street, San Francisco, CA 94109, United States
| | - Kayla A Chase
- University of California, Department of Psychiatry, 9500 Gilman Drive, MC 8505, La Jolla, CA 92037, United States
| | - Jennifer K Melbourne
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States
| | - Linda S Grossman
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States
| | - Rajiv P Sharma
- University of Illinois at Chicago, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612, United States; Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue, Chicago, IL 60612, United States
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23
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Ricarte JJ, Ros L, Latorre JM, Watkins E. Mapping autobiographical memory in schizophrenia: Clinical implications. Clin Psychol Rev 2016; 51:96-108. [PMID: 27846438 DOI: 10.1016/j.cpr.2016.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 10/11/2016] [Accepted: 11/07/2016] [Indexed: 01/08/2023]
Abstract
Increasing evidence suggests that impaired autobiographical memory (AM) mechanisms may be associated with the onset and maintenance of psychopathology. However, there is not yet a comprehensive review of the components of autobiographical memory in schizophrenic patients. The first aim of this review is a synthesis of evidence about the functioning of AM in schizophrenic patients. The main autobiographical elements reviewed in schizophrenic patients include the study of overgeneral memory (form); self-defining memories (contents); consciousness during the process of retrieval (awareness), and the abnormal early reminiscence bump (distribution). AM impairments have been involved in the clinical diagnosis and prognosis of other psychopathologies, especially depression. The second aim is to examine potential parallels between the mechanisms responsible for the onset and maintenance of disturbed AM in other clinical diagnosis and the mechanisms of disturbed autobiographical memory functioning in schizophrenic patients. Cognitive therapies for schizophrenic patients are increasingly demanded. The third aim is the suggestion of key elements for the adaptation of components of autobiographical recall in cognitive therapies for the treatment of symptoms and consequences of schizophrenia.
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Affiliation(s)
- J J Ricarte
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Albacete 02006, Spain
| | - L Ros
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Albacete 02006, Spain.
| | - J M Latorre
- Department of Psychology, Faculty of Medicine, University of Castilla La Mancha, Albacete 02006, Spain
| | - E Watkins
- School of Psychology, University of Exeter and Sir Henry Welcome Building for Mood Disorders Research, Exeter, EX4 4QG, UK
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Chen X, Duan M, He H, Yang M, Klugah-Brown B, Xu H, Lai Y, Luo C, Yao D. Functional abnormalities of the right posterior insula are related to the altered self-experience in schizophrenia. Psychiatry Res Neuroimaging 2016; 256:26-32. [PMID: 27662482 DOI: 10.1016/j.pscychresns.2016.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 09/13/2016] [Accepted: 09/15/2016] [Indexed: 01/29/2023]
Abstract
The insula is involved in detecting the salience of internal and external stimuli, and it plays a critical role in psychosis. Previous studies have demonstrated the structural and functional alterations of the insula in schizophrenia. To acquire a full picture of the functional alterations of the insula in schizophrenia, the resting-state fMRI data of 46 patients with schizophrenia and 46 healthy control subjects were collected. We used clustering analysis to divide the insula into three subregions: the dorsal anterior insula (dAI), ventral anterior insula (vAI) and posterior insula (PI). Then, whole-brain functional connectivity analysis was conducted based on these subregions. The results showed that the right dAI and PI in patients exhibited altered functional connections with the primary sensorimotor area. In addition, the right PI of the patients exhibited increased functional correlations with the thalamus. More importantly, the altered functional properties of the right PI were significantly correlated with the severity of the delusion and poor insight in schizophrenia. The results suggested that the right PI might play an important role in self-experience processing in schizophrenia. Accordingly, the right PI should be considered very important in the pathological mechanism of schizophrenia.
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Affiliation(s)
- Xi Chen
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Mingjun Duan
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; Department of Psychiatry, Chengdu Mental Health Center, Chengdu, China
| | - Hui He
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Mi Yang
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; Department of Psychiatry, Chengdu Mental Health Center, Chengdu, China
| | - Benjamin Klugah-Brown
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Hao Xu
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongxiu Lai
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
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Anxiety modulates cognitive deficits in a perinatal glutathione deficit animal model of schizophrenia. Brain Res 2016; 1648:459-468. [PMID: 27485658 DOI: 10.1016/j.brainres.2016.07.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 07/05/2016] [Accepted: 07/29/2016] [Indexed: 11/23/2022]
Abstract
In this study, we investigated long-term repercussion of early glutathione deficit by l-buthionine-(S,R)-sulfoximine (BSO) injections as a rat model of schizophrenia. BSO rats were tested through various behavioral tasks requiring animals to take into account previously delivered information. We showed that relative to controls, BSO rats (1) were less active and more anxious in an Elevated Plus Maze test, allowing us to split them into two subgroups with high and low anxiety levels; (2) demonstrated normal abilities of behavioral flexibility tested with a rat-adapted version of the Wisconsin Card Sorting Test (WCST), with even higher abilities in anxious BSO rats suggesting reduced interference of previously acquired rules; (3) did not forage normally in radial arm mazes and mainly used clockwise strategies; (4) exhibited a lack of habituation during a startle response task; and (5) showed a normal prepulse inhibition of the startle response (PPI) and a normal conditioned taste aversion (CTA). All these results indicate that early glutathione deficit provokes persistent changes in adulthood and improves the validity of this animal model of schizophrenia. They further suggest difficulties binding temporally separated events (WCST), except when the salience of this information is very strong (CTA). We propose that the transient glutathione deficit during cerebral development could alter a "cognitive binding" process in interaction with the emotional state that could possibly account for the disruption of integrative function that characterizes schizophrenia.
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Graham-Schmidt KT, Martin-Iverson MT, Holmes NP, Waters FAV. When one's sense of agency goes wrong: Absent modulation of time perception by voluntary actions and reduction of perceived length of intervals in passivity symptoms in schizophrenia. Conscious Cogn 2016; 45:9-23. [PMID: 27544689 DOI: 10.1016/j.concog.2016.08.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 07/08/2016] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
Abstract
Passivity symptoms in schizophrenia are characterised by an absence of agency for actions, thoughts and other somatic experiences. Time perception and intentional binding have both been linked to agency and schizophrenia but have not been examined in passivity symptoms. Time perception and intentional binding were assessed in people with schizophrenia (n=15 with, n=24 without passivity symptoms) and 43 healthy controls using an interval estimation procedure (200, 400 and 600ms intervals) with active, passive and observed movements. People with passivity symptoms did not display action-modulation of time perception, while those without passivity symptoms estimated intervals to be the same after active and observed movements. Additionally, both clinical samples reported intervals to be shorter with increasing interval length. We propose that impaired predictive processes may produce an overreliance on external cues and, together with shorter perceived intervals, lead to the subjective loss of agency.
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Affiliation(s)
- Kyran T Graham-Schmidt
- Pharmacology, Pharmacy & Anaesthesiology Unit, School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, WA, Australia.
| | - Mathew T Martin-Iverson
- Pharmacology, Pharmacy & Anaesthesiology Unit, School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, WA, Australia; Statewide Department of Neurophysiology, Graylands Hospital, North Metropolitan Health Services - Mental Health, WA, Australia
| | | | - Flavie A V Waters
- School of Psychiatry and Clinical Neurosciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, WA, Australia; Clinical Research Centre, Graylands Hospital, North Metropolitan Health Services - Mental Health, WA, Australia
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Ardizzi M, Ambrosecchia M, Buratta L, Ferri F, Peciccia M, Donnari S, Mazzeschi C, Gallese V. Interoception and Positive Symptoms in Schizophrenia. Front Hum Neurosci 2016; 10:379. [PMID: 27512369 PMCID: PMC4961721 DOI: 10.3389/fnhum.2016.00379] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 07/13/2016] [Indexed: 11/13/2022] Open
Abstract
The present study focuses on the multifaceted concept of self-disturbance in schizophrenia, adding knowledge about a not yet investigated aspect, which is the interoceptive accuracy. Starting from the assumption that interoceptive accuracy requires an intact sense of self, which otherwise was proved to be altered in schizophrenia, the aim of the present study was to explore interoceptive accuracy in a group of schizophrenia patients, compared to healthy controls. Furthermore, the possible association between interoceptive accuracy and patients' positive and negative symptomatology was assessed. To pursue these goals, a group of 23 schizophrenia patients and a group of 23 healthy controls performed a heartbeat perception task. Patients' symptomatology was assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results demonstrated significantly lower interoceptive accuracy in schizophrenia patients compared to healthy controls. This difference was not accounted for participants' age, BMI, anxiety levels, and heart rate. Furthermore, patients' illness severity, attention and pharmacological treatment did not influence their interoceptive accuracy levels. Interestingly, a strong positive relation between interoceptive accuracy and positive symptoms severity, especially Grandiosity, was found. The present results demonstrate for the first time that interoceptive accuracy is altered in schizophrenia. Furthermore, they prove a specific association between interoceptive accuracy and positive symptomatology, suggesting that the symptom Grandiosity might be protective against an altered basic sense of self in patients characterized by higher sensibility to their inner bodily sensations.
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Affiliation(s)
- Martina Ardizzi
- Department of Neuroscience, University of Parma Parma, Italy
| | | | - Livia Buratta
- Department of Human Science and Education, University of Perugia Perugia, Italy
| | - Francesca Ferri
- Department of Psychology, University of Essex Colchester, UK
| | - Maurizio Peciccia
- Department of Human Science and Education, University of Perugia Perugia, Italy
| | | | - Claudia Mazzeschi
- Department of Human Science and Education, University of Perugia Perugia, Italy
| | - Vittorio Gallese
- Department of Neuroscience, University of ParmaParma, Italy; Institute of Philosophy, School of Advanced Study, University of LondonLondon, UK
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Graham-Schmidt KT, Martin-Iverson MT, Holmes NP, Waters F. Body representations in schizophrenia: an alteration of body structural description is common to people with schizophrenia while alterations of body image worsen with passivity symptoms. Cogn Neuropsychiatry 2016; 21:354-368. [PMID: 27646600 DOI: 10.1080/13546805.2016.1231111] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Individuals with schizophrenia, particularly those with passivity symptoms, often feel that their actions and thoughts are controlled by an external agent. Recent evidence has elucidated the role of body representations in the aetiology of passivity symptoms, yet one representation - body structural description - has not yet been examined. Additionally, body image has rarely been examined outside of bodily illusions (e.g., rubber hand experiments) and external validation is required. METHODS Body structural description was assessed with an in-between task and a matching body parts by location task, and body image with a questionnaire examining body distortion experiences (containing subscales assessing boundary loss, depersonalisation and body size distortions). Individuals with schizophrenia (20 with current, 12 with past and 21 with no history of passivity symptoms) and 48 healthy controls participated in the study. RESULTS People with schizophrenia (as a group) made more errors on the in-between task, but not on the matching body parts by location task. Individuals with current passivity symptoms reported greater distortions on all subscales relative to the other clinical samples, except for experiences of boundary loss which were common to both passivity symptom groups. CONCLUSIONS The results indicate that body structural description may be altered in schizophrenia generally and body image alterations are worsened in passivity symptoms, and these alterations likely contribute to the emergence of passivity symptoms.
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Affiliation(s)
- Kyran T Graham-Schmidt
- a School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences , The University of Western Australia , Perth , Australia.,b Statewide Department of Neurophysiology and Clinical Research Centre , Graylands Hospital, North Metropolitan Health Services - Mental Health , Perth , Australia
| | - Mathew T Martin-Iverson
- a School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences , The University of Western Australia , Perth , Australia.,b Statewide Department of Neurophysiology and Clinical Research Centre , Graylands Hospital, North Metropolitan Health Services - Mental Health , Perth , Australia
| | | | - Flavie Waters
- b Statewide Department of Neurophysiology and Clinical Research Centre , Graylands Hospital, North Metropolitan Health Services - Mental Health , Perth , Australia.,d School of Psychiatry and Clinical Neurosciences , The University of Western Australia , Perth , Australia
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Klaver M, Dijkerman HC. Bodily Experience in Schizophrenia: Factors Underlying a Disturbed Sense of Body Ownership. Front Hum Neurosci 2016; 10:305. [PMID: 27378895 PMCID: PMC4911393 DOI: 10.3389/fnhum.2016.00305] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 06/03/2016] [Indexed: 11/24/2022] Open
Abstract
Emerging evidence is now challenging the view that patients diagnosed with schizophrenia experience a selective deficit in their sense of agency. Additional disturbances seem to exist in their sense of body ownership. However, the factors underlying this disturbance in body ownership remain elusive. Knowledge of these factors, and increased understanding of how body ownership is related to other abnormalities seen in schizophrenia, could ultimately advance development of new treatments. Research on body ownership in schizophrenia has mainly been investigated with the rubber hand illusion (RHI). Schizophrenia patients show higher susceptibility to the RHI, which may be explained by a stronger reliance on multisensory information over weaker stored body representations. This review shows that a coherent sense of body ownership arises from the integration of both bottom-up sensory processes and higher order, top-down bodily- and perceptual representations. Multisensory integration, temporal binding, anticipation, intention and efferent signals all partly modulate the complex experience of body ownership. Specifically, we propose that patients with schizophrenia have weaker stored body representations, and rely to a greater extent on external stimuli, such as visual information, due to imprecise or highly variable internal predictions. Moreover, the reduced sense of agency in schizophrenia may additionally contribute to the disturbed sense of body ownership, as evidence from healthy participants suggests that agency and body ownership are interrelated. Vice versa, a reduced sense of body ownership may also contribute to a reduced sense of agency. Future studies should explicitly target the precise relationship between the two in schizophrenia.
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Affiliation(s)
- Maayke Klaver
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University CS Utrecht, Netherlands
| | - H Chris Dijkerman
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University CS Utrecht, Netherlands
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Rosen C, Chase KA, Jones N, Grossman LS, Gin H, Sharma RP. Listening to Schneiderian Voices: A Novel Phenomenological Analysis. Psychopathology 2016; 49:163-71. [PMID: 27304081 PMCID: PMC4990463 DOI: 10.1159/000446546] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 05/02/2016] [Indexed: 01/05/2023]
Abstract
BACKGROUND/AIMS This paper reports on analyses designed to elucidate phenomenological characteristics, content and experience specifically targeting participants with Schneiderian voices conversing/commenting (VC) while exploring differences in clinical presentation and quality of life compared to those with voices not conversing (VNC). METHODS This mixed-method investigation of Schneiderian voices included standardized clinical metrics and exploratory phenomenological interviews designed to elicit in-depth information about the characteristics, content, meaning, and personification of auditory verbal hallucinations. RESULTS The subjective experience shows a striking pattern of VC, as they are experienced as internal at initial onset and during the longer-term course of illness when compared to VNC. Participants in the VC group were more likely to attribute the origin of their voices to an external source such as God, telepathic communication, or mediumistic sources. VC and VNC were described as characterological entities that were distinct from self (I/we vs. you). We also found an association between VC and the positive, cognitive, and depression symptom profile. However, we did not find a significant group difference in overall quality of life. CONCLUSIONS The clinical portrait of VC is complex, multisensory, and distinct, and suggests a need for further research into the biopsychosocial interface between subjective experience, socioenvironmental constraints, individual psychology, and the biological architecture of intersecting symptoms.
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Affiliation(s)
- Cherise Rosen
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
| | - Kayla A. Chase
- University of California, Department of Psychiatry, 9500 Gilman Drive, MC 8505, La Jolla, CA 92037, San Diego, USA
| | - Nev Jones
- Stanford University, Department of Anthropology, 450 Serra Mall, Stanford, CA 94305
| | - Linda S. Grossman
- University of Illinois at Chicago, Neuropsychiatric Institute, Department of Psychiatry, 912 S. Wood St., Chicago, IL 60612
| | - Hannah Gin
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
| | - Rajiv P. Sharma
- University of Illinois at Chicago, The Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
- Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL 60612
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Rosen C, Jones N, Chase KA, Gin H, Grossman LS, Sharma RP. The intrasubjectivity of self, voices and delusions: A phenomenological analysis. PSYCHOSIS 2016; 8:357-368. [PMID: 27829870 PMCID: PMC5098808 DOI: 10.1080/17522439.2016.1162839] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
To advance the area of phenomenology of voices and their interrelatedness to forms of delusions this study investigated the prevalence and interrelatedness of co-occurring auditory verbal hallucinations (AVHs) and delusions. Additionally we explored the characterization of distinct sub-categories/clusters of AVHs and delusions. Ninety-two participants experiencing psychosis were administered standardized clinical measures. We found a significant diagnostic difference with increased prevalence of co-occurring AVHs and delusions within the schizophrenia group compared to the bipolar with psychosis group. Regardless of diagnosis, there was a significant positive correlation between AVHs and delusions of reference, persecution, control, thought insertion, thought withdrawal and thought broadcasting. However, no significant relationship was found between AVHs and grandiose, somatic, religious, guilty or jealousy-themed delusions. Cluster analysis yielded two distinct cluster groups. Cluster One: Voices and Thought Delusions, and Cluster Two: Voices and Thematic Delusions. Cluster One participants showed elevated disorganized, cognitive and depressive symptoms, but not negative symptoms or excitement. This study underscores the need for expanded clinical and phenomenological research into the intersection of AVHs and delusions, including work that seeks to deconstruct conventional divisions between ostensible symptoms of perception' (hallucinations) and belief' (delusions).
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Affiliation(s)
- Cherise Rosen
- University of Illinois at Chicago, Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
| | - Nev Jones
- Stanford University, Department of Anthropology, 450 Serra Mall, Stanford, CA 94305
| | - Kayla A. Chase
- University of California, Department of Psychiatry, 9500 Gilman Drive, MC 8505, La Jolla, CA 92037, San Diego, USA
| | - Hannah Gin
- University of Illinois at Chicago, Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
| | - Linda S. Grossman
- University of Illinois at Chicago, Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
| | - Rajiv P. Sharma
- University of Illinois at Chicago, Psychiatric Institute, Department of Psychiatry, 1601 W. Taylor St., Chicago, IL 60612
- Jesse Brown Veterans Affairs Medical Center, 820 South Damen Avenue (M/C 151), Chicago, IL 60612
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Hedlund L, Gyllensten AL, Waldegren T, Hansson L. Assessing movement quality in persons with severe mental illness – Reliability and validity of the Body Awareness Scale Movement Quality and Experience. Physiother Theory Pract 2016; 32:296-306. [DOI: 10.3109/09593985.2015.1138008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Lena Hedlund
- Department of Health Sciences, Lund University, Lund, Sweden
| | | | - Tomas Waldegren
- The Country Hospital of Jönköping, Psychiatric Clinic, Jönköping, Sweden
| | - Lars Hansson
- Department of Health Sciences, Lund University, Lund, Sweden
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Tikka SK, Nizamie SH, Das AK, Agarwal N, Goyal N. Schneiderian first rank symptoms in schizophrenia: A developmental neuroscience evaluation. Int J Dev Neurosci 2016; 50:39-46. [PMID: 26952695 DOI: 10.1016/j.ijdevneu.2016.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 02/03/2016] [Accepted: 02/15/2016] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION Self disorders in schizophrenia have been suggested to have distinct neurobiological underpinnings. Using comprehensive neuro-scientific assessments including a neurophysiological, a neurochemical and a neuropsychological marker, this study assesses disordered-"self" in schizophrenia. METHODS Twenty schizophrenia patients with first rank symptoms (FRS;FRS+), 20 patients without FRS (FRS-) and 20 healthy controls (HC) were assessed for psychopathology, especially on specially designed FRS score sheets with a narrow and a broad definition. Resting state electroencephalography was acquired using 256-electrodes; gamma spectral-power was measured in 8 regions of interest. Serum BDNF and self-monitoring were also assessed. Comparative and correlation analysis were conducted in addition to a step-wise discriminant function analysis. RESULTS FRS+ group with greater positive symptom score and a lower negative symptom score, showed significantly increased gamma spectral power, especially on right hemispheric regions, along with lower BDNF levels and lower scores on self-monitoring compared to FRS- and HC. Serum BDNF levels and gamma spectral power in the region corresponding right inferior parietal lobule were identified as predictors that most accurately classified the defined groups. CONCLUSIONS Schizophrenia patients satisfying the criteria of presence of first rank symptoms represent a distinct neurodevelopmental subgroup with associated features of predominantly positive symptoms, significantly lower neurotrophin levels, aberrant resting state brain activity in the heteromodal association cortex and performing poorer on self-monitoring tasks.
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Affiliation(s)
- Sai Krishna Tikka
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi 834006, Jharkhand, India.
| | - S Haque Nizamie
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi 834006, Jharkhand, India
| | - Archana Kumari Das
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi 834006, Jharkhand, India
| | - Nidhi Agarwal
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi 834006, Jharkhand, India
| | - Nishant Goyal
- KS Mani Center for Cognitive Neurosciences and Department of Psychiatry, Central Institute of Psychiatry, Kanke, Ranchi 834006, Jharkhand, India
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The effects of stimulus complexity on the preattentive processing of self-generated and nonself voices: An ERP study. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2015; 16:106-23. [PMID: 26415897 DOI: 10.3758/s13415-015-0376-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ability to differentiate one's own voice from the voice of somebody else plays a critical role in successful verbal self-monitoring processes and in communication. However, most of the existing studies have only focused on the sensory correlates of self-generated voice processing, whereas the effects of attentional demands and stimulus complexity on self-generated voice processing remain largely unknown. In this study, we investigated the effects of stimulus complexity on the preattentive processing of self and nonself voice stimuli. Event-related potentials (ERPs) were recorded from 17 healthy males who watched a silent movie while ignoring prerecorded self-generated (SGV) and nonself (NSV) voice stimuli, consisting of a vocalization (vocalization category condition: VCC) or of a disyllabic word (word category condition: WCC). All voice stimuli were presented as standard and deviant events in four distinct oddball sequences. The mismatch negativity (MMN) ERP component peaked earlier for NSV than for SGV stimuli. Moreover, when compared with SGV stimuli, the P3a amplitude was increased for NSV stimuli in the VCC only, whereas in the WCC no significant differences were found between the two voice types. These findings suggest differences in the time course of automatic detection of a change in voice identity. In addition, they suggest that stimulus complexity modulates the magnitude of the orienting response to SGV and NSV stimuli, extending previous findings on self-voice processing.
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Torbet G, Schulze D, Fiedler A, Reuter B. Assessment of self-disorders in a non-clinical population: Reliability and association with schizotypy. Psychiatry Res 2015; 228:857-65. [PMID: 26032462 DOI: 10.1016/j.psychres.2015.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 05/06/2015] [Accepted: 05/10/2015] [Indexed: 11/29/2022]
Abstract
This study explores whether self-disorders occur and can be assessed reliably in a non-clinical sample, and whether the prevalence of these anomalies depends upon the degree of psychometrically defined schizotypy. Participants with either high (n=30) or low (n=20) schizotypy scores were interviewed using a modified version of the Examination of Anomalous Self-Experience (EASE). The degree to which interviewees experienced self-disorder symptoms was rated by the interviewer and an independent rater. Inter-rater reliability was calculated for each item, domain scores and the total score. For the total, sample most items (=66) showed substantial or perfect agreement (κ>0.61), with a few (=6) showing moderate agreement (κ>0.41). Reliability scores were only slightly lower when just the more homogeneous group of individuals with high Schizotypal Personality Questionnaire (SPQ) scores were examined. As expected, high SPQ scores were associated with a high level of self-disorders. In sum, the results suggest that self-disorders can be measured reliably in non-clinical samples and are particularly frequent in individuals with pronounced schizotypical traits.
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Affiliation(s)
- Georgina Torbet
- Berlin School of Mind and Brain, Berlin, Germany; Institute of Psychology, Humboldt-Universiät zu Berlin, Berlin, Germany.
| | - Dani Schulze
- Institute of Psychology, Humboldt-Universiät zu Berlin, Berlin, Germany
| | - Anna Fiedler
- Institute of Psychology, Humboldt-Universiät zu Berlin, Berlin, Germany
| | - Benedikt Reuter
- Institute of Psychology, Humboldt-Universiät zu Berlin, Berlin, Germany
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36
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Chen X, Duan M, Xie Q, Lai Y, Dong L, Cao W, Yao D, Luo C. Functional disconnection between the visual cortex and the sensorimotor cortex suggests a potential mechanism for self-disorder in schizophrenia. Schizophr Res 2015; 166:151-7. [PMID: 26143483 DOI: 10.1016/j.schres.2015.06.014] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 05/05/2015] [Accepted: 06/15/2015] [Indexed: 11/25/2022]
Abstract
UNLABELLED Self-disorder is a hallmark characteristic of schizophrenia. This deficit may stem from an inability to efficiently integrate multisensory bodily signals. Twenty-nine schizophrenia patients and thirty-one healthy controls underwent resting-state fMRI in this study. A data-driven method, functional connectivity density mapping (FCD), was used to investigate cortical functional connectivity changes in the patients. Areas with significantly different FCD were chosen to calculate functional connectivity maps. The schizophrenia patients exhibited increased local FCD in frontal areas while demonstrating decreased local FCD in the primary sensorimotor area and in the occipital lobe. The functional connectivity analysis illustrated decreased functional connectivity between visual areas and the primary sensorimotor area. These findings suggest disturbed integration in perception-motor processing, which may contribute to mapping the neural physiopathology associated with self-disorder in schizophrenia patients. CLINICAL TRIAL REGISTRATION Chinese Clinical Trial Registry. Registration number. ChiCTR-RCS-14004878.
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Affiliation(s)
- Xi Chen
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Mingjun Duan
- Department of Science and Education, The Fourth People's Hospital Chengdu, Chengdu, China
| | - Qiankun Xie
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongxiu Lai
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Li Dong
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Weifang Cao
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Dezhong Yao
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
| | - Cheng Luo
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
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Conde T, Gonçalves ÓF, Pinheiro AP. Paying attention to my voice or yours: An ERP study with words. Biol Psychol 2015; 111:40-52. [PMID: 26234962 DOI: 10.1016/j.biopsycho.2015.07.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 07/27/2015] [Accepted: 07/28/2015] [Indexed: 11/16/2022]
Abstract
Self-related stimuli-such as one's own face or name-seem to be processed differently from non-self stimuli and to involve greater attentional resources, as indexed by larger amplitude of the P3 event-related potential (ERP) component. Nonetheless, the differential processing of self-related vs. non-self information using voice stimuli is still poorly understood. The present study investigated the electrophysiological correlates of processing self-generated vs. non-self voice stimuli, when they are in the focus of attention. ERP data were recorded from twenty right-handed healthy males during an oddball task comprising pre-recorded self-generated (SGV) and non-self (NSV) voice stimuli. Both voices were used as standard and deviant stimuli in distinct experimental blocks. SGV was found to elicit more negative N2 and more positive P3 in comparison with NSV. No association was found between ERP data and voice acoustic properties. These findings demonstrated an earlier and later attentional bias to self-generated relative to non-self voice stimuli. They suggest that one's own voice representation may have a greater affective salience than an unfamiliar voice, confirming the modulatory role of salience on P3.
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Affiliation(s)
- Tatiana Conde
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Óscar F Gonçalves
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Ana P Pinheiro
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal; Cognitive Neuroscience Lab, Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Ciufolini S, Morgan C, Morgan K, Fearon P, Boydell J, Hutchinson G, Demjaha A, Girardi P, Doody GA, Jones PB, Murray R, Dazzan P. Self esteem and self agency in first episode psychosis: Ethnic variation and relationship with clinical presentation. Psychiatry Res 2015; 227:213-8. [PMID: 25868868 DOI: 10.1016/j.psychres.2015.03.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 02/28/2015] [Accepted: 03/03/2015] [Indexed: 11/15/2022]
Abstract
The impact of self esteem and Locus of Control (LoC) on clinical presentation across different ethnic groups of patients at their first psychotic episode (FEP) remains unknown. We explored these constructs in 257 FEP patients (Black n=95; White British n=119) and 341 controls (Black n=70; White British n=226), and examined their relationship with symptom dimensions and pathways to care. FEP patients presented lower self-esteem and a more external LoC than controls. Lower self esteem was associated with a specific symptoms profile (more manic and less negative symptoms), and with factors predictive of poorer outcome (longer duration of untreated psychosis (DUP) and compulsory mode of admission). A more external LoC was associated with more negative symptoms and an insidious onset. When we explored these constructs across different ethnic groups, we found that Black patients had significantly higher self esteem than White British. This was again associated with specific symptom profiles. While British patients with lower self esteem were more likely to report delusions, hallucinations and negative symptoms, Black patients with a lower self esteem showed less disorganization symptoms. These findings suggest that self esteem and LoC may represent one way in which social experiences and contexts differentially influence vulnerable individuals along the pathway to psychosis.
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Affiliation(s)
- Simone Ciufolini
- King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King׳s College London, London, UK.
| | - Craig Morgan
- King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Kevin Morgan
- University of Westminster, Department of Psychology, London, UK
| | - Paul Fearon
- Trinity College Dublin, Department of Psychiatry, Dublin, Ireland
| | - Jane Boydell
- King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Gerard Hutchinson
- University of West Indies, Department of Psychiatry, St. Augustine, Trinidad and Tobago
| | - Arsjme Demjaha
- King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Paolo Girardi
- University of La Sapienza, Department of Psychiatry, Rome, Italy
| | - Gill A Doody
- University of Nottingham, Department of Psychiatry, Nottingham, UK
| | - Peter B Jones
- University of Cambridge, Department of Psychiatry, Addenbrooke׳s Hospital, Cambridge, UK
| | - Robin Murray
- King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Paola Dazzan
- King׳s College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King׳s College London, London, UK
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Louzolo A, Kalckert A, Petrovic P. When Passive Feels Active--Delusion-Proneness Alters Self-Recognition in the Moving Rubber Hand Illusion. PLoS One 2015; 10:e0128549. [PMID: 26090797 PMCID: PMC4474665 DOI: 10.1371/journal.pone.0128549] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 04/28/2015] [Indexed: 11/19/2022] Open
Abstract
Psychotic patients have problems with bodily self-recognition such as the experience of self-produced actions (sense of agency) and the perception of the body as their own (sense of ownership). While it has been shown that such impairments in psychotic patients can be explained by hypersalient processing of external sensory input it has also been suggested that they lack normal efference copy in voluntary action. However, it is not known how problems with motor predictions like efference copy contribute to impaired sense of agency and ownership in psychosis or psychosis-related states. We used a rubber hand illusion based on finger movements and measured sense of agency and ownership to compute a bodily self-recognition score in delusion-proneness (indexed by Peters' Delusion Inventory - PDI). A group of healthy subjects (n=71) experienced active movements (involving motor predictions) or passive movements (lacking motor predictions). We observed a highly significant correlation between delusion-proneness and self-recognition in the passive conditions, while no such effect was observed in the active conditions. This was seen for both ownership and agency scores. The result suggests that delusion-proneness is associated with hypersalient external input in passive conditions, resulting in an abnormal experience of the illusion. We hypothesize that this effect is not present in the active condition because deficient motor predictions counteract hypersalience in psychosis proneness.
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Affiliation(s)
- Anaïs Louzolo
- Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Kalckert
- Department of neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Predrag Petrovic
- Department of clinical neuroscience, Karolinska Institutet, Stockholm, Sweden
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Renes RA, van der Weiden A, Prikken M, Kahn RS, Aarts H, van Haren NEM. Abnormalities in the experience of self-agency in schizophrenia: A replication study. Schizophr Res 2015; 164:210-3. [PMID: 25843918 DOI: 10.1016/j.schres.2015.03.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 03/17/2015] [Indexed: 10/23/2022]
Abstract
People usually experience agency over their actions and subsequent outcomes. These agency inferences over action-outcomes are essential to social interaction, and occur when an actual outcome corresponds with either a specific goal (goal-based), and matches with action-outcome information that is subtly pre-activated in the situation at hand (prime-based). Recent research showed that schizophrenia patients exhibit goal-based inferences, but not prime-based inferences. Intrigued by these findings, and underscoring their potential role in explaining poor social functioning, we replicate patients' deficit in prime-based agency inferences. Additionally, we exclude the account that patients are unable to visually process and attend to primed information.
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Affiliation(s)
- Robert A Renes
- Department of Psychology, Utrecht University, Utrecht, The Netherlands.
| | - Anouk van der Weiden
- Department of Psychiatry of the Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Merel Prikken
- Department of Psychiatry of the Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - René S Kahn
- Department of Psychiatry of the Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Henk Aarts
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Neeltje E M van Haren
- Department of Psychiatry of the Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
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Woods A, Jones N, Alderson-Day B, Callard F, Fernyhough C. Experiences of hearing voices: analysis of a novel phenomenological survey. Lancet Psychiatry 2015; 2:323-31. [PMID: 26360085 PMCID: PMC4580735 DOI: 10.1016/s2215-0366(15)00006-1] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/06/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Auditory hallucinations--or voices--are a common feature of many psychiatric disorders and are also experienced by individuals with no psychiatric history. Understanding of the variation in subjective experiences of hallucination is central to psychiatry, yet systematic empirical research on the phenomenology of auditory hallucinations remains scarce. We aimed to record a detailed and diverse collection of experiences, in the words of the people who hear voices themselves. METHODS We made a 13 item questionnaire available online for 3 months. To elicit phenomenologically rich data, we designed a combination of open-ended and closed-ended questions, which drew on service-user perspectives and approaches from phenomenological psychiatry, psychology, and medical humanities. We invited people aged 16-84 years with experience of voice-hearing to take part via an advertisement circulated through clinical networks, hearing voices groups, and other mental health forums. We combined qualitative and quantitative methods, and used inductive thematic analysis to code the data and χ(2) tests to test additional associations of selected codes. FINDINGS Between Sept 9 and Nov 29, 2013, 153 participants completed the study. Most participants described hearing multiple voices (124 [81%] of 153 individuals) with characterful qualities (106 [69%] individuals). Less than half of the participants reported hearing literally auditory voices--70 (46%) individuals reported either thought-like or mixed experiences. 101 (66%) participants reported bodily sensations while they heard voices, and these sensations were significantly associated with experiences of abusive or violent voices (p=0·024). Although fear, anxiety, depression, and stress were often associated with voices, 48 (31%) participants reported positive emotions and 49 (32%) reported neutral emotions. Our statistical analysis showed that mixed voices were more likely to have changed over time (p=0·030), be internally located (p=0·010), and be conversational in nature (p=0·010). INTERPRETATION This study is, to our knowledge, the largest mixed-methods investigation of auditory hallucination phenomenology so far. Our survey was completed by a diverse sample of people who hear voices with various diagnoses and clinical histories. Our findings both overlap with past large-sample investigations of auditory hallucination and suggest potentially important new findings about the association between acoustic perception and thought, somatic and multisensorial features of auditory hallucinations, and the link between auditory hallucinations and characterological entities. FUNDING Wellcome Trust.
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Affiliation(s)
- Angela Woods
- Centre for Medical Humanities and School of Medicine, Pharmacy and Health, Durham University, Durham, UK.
| | - Nev Jones
- Department of Anthropology, Stanford University, Stanford, CA, USA; Lived Experience Research Network, Baltimore, MD, USA
| | | | - Felicity Callard
- Centre for Medical Humanities and Department of Geography, Durham University, Durham, UK
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The Spectra of Soundless Voices and Audible Thoughts: Towards an Integrative Model of Auditory Verbal Hallucinations and Thought Insertion. ACTA ACUST UNITED AC 2015. [DOI: 10.1007/s13164-015-0232-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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44
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Basavaraju R, Mehta UM, Thirthalli J, Gangadhar BN. Mirror neuron dysfunction and ego-boundary disturbances in schizophrenia: a transcranial magnetic stimulation study. Indian J Psychol Med 2015; 37:58-65. [PMID: 25722514 PMCID: PMC4341313 DOI: 10.4103/0253-7176.150821] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Ego-boundary disturbance (EBD) is a unique symptom cluster characterized by passivity experiences (involving thoughts, actions, emotions and sensations) attributed by patients to some external agency. The neurobiology of these "first rank" symptoms is poorly understood. Aberrant mirror neuron activation may explain impaired self-monitoring and agency attribution underlying these symptoms. We aim to study mirror neuron activity (MNA) in schizophrenia patients with and without EBD using transcranial magnetic stimulation (TMS). MATERIALS AND METHODS 50 right-handed schizophrenia patients (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) were evaluated using the Mini-International Neuropsychiatric Interview and the Positive and Negative Syndrome Scale. They completed a TMS experiment to assess putative premotor MNA. Motor evoked potential (MEP) was recorded in the right first dorsal interosseous muscle (FDI) with (a) 120% of resting motor threshold (RMT), (b) stimulus intensity set to evoke MEP of motor threshold 1 mV amplitude (MT1), (c) two paired pulse paradigms (short- and long interval intra-cortical inhibition). These were done in three states: Actual observation of an action using the FDI, virtual-observation (video) of this action and resting state. The percent change of MEP from resting to action-observation states formed the measure of putative MNA. RESULTS MNA measured using MT1 and 120% RMT paradigms was significantly lower in the 18 patients with EBD (thought-broadcast/withdrawal/insertion, made-act/impulse/affect and somatic passivity) than the 32 patients without EBD (t = 2.431, P = 0.020; t = 2.051, P = 0.04 respectively for the two paradigms). The two groups did not differ on age, gender, education and total symptom scores. CONCLUSION Schizophrenia patients with EBD have lower premotor MNA. This highlights the role of MNA dysfunction in the pathophysiology of this unique and intriguing symptom cluster in schizophrenia.
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Affiliation(s)
- Rakshathi Basavaraju
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Urvakhsh Meherwan Mehta
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Jagadisha Thirthalli
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Bangalore N Gangadhar
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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45
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The projected hand illusion: component structure in a community sample and association with demographics, cognition, and psychotic-like experiences. Atten Percept Psychophys 2014; 77:207-19. [DOI: 10.3758/s13414-014-0748-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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46
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Postmes L, Sno HN, Goedhart S, van der Stel J, Heering HD, de Haan L. Schizophrenia as a self-disorder due to perceptual incoherence. Schizophr Res 2014; 152:41-50. [PMID: 23973319 DOI: 10.1016/j.schres.2013.07.027] [Citation(s) in RCA: 111] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2013] [Revised: 07/09/2013] [Accepted: 07/11/2013] [Indexed: 10/26/2022]
Abstract
The aim of this review is to describe the potential relationship between multisensory disintegration and self-disorders in schizophrenia spectrum disorders. Sensory processing impairments affecting multisensory integration have been demonstrated in schizophrenia. From a developmental perspective multisensory integration is considered to be crucial for normal self-experience. An impairment of multisensory integration is called 'perceptual incoherence'. We theorize that perceptual incoherence may evoke incoherent self-experiences including depersonalization, ambivalence, diminished sense of agency, and 'loosening of associations' between thoughts, feelings and actions that lie within the framework of 'self-disorders' as described by Sass and Parnas (2003). We postulate that subconscious attempts to restore perceptual coherence may induce hallucinations and delusions. Increased insight into mechanisms underlying 'self-disorders' may enhance our understanding of schizophrenia, improve recognition of early psychosis, and extend the range of therapeutic possibilities.
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Affiliation(s)
- L Postmes
- GGZ Leiden, Department Early Psychosis (KEP) Leiden, Sandifortdreef 19, 2333 ZZ Leiden, the Netherlands.
| | - H N Sno
- ZMC, Zaans Medical Centre, the Netherlands
| | - S Goedhart
- ZMC, Zaans Medical Centre, the Netherlands
| | | | - H D Heering
- AMC, Academic Psychiatric Centre, Department Early Psychosis, Amsterdam, the Netherlands
| | - L de Haan
- AMC, Academic Psychiatric Centre, Department Early Psychosis, Amsterdam, the Netherlands
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Graham KT, Martin-Iverson MT, Holmes NP, Jablensky A, Waters F. Deficits in agency in schizophrenia, and additional deficits in body image, body schema, and internal timing, in passivity symptoms. Front Psychiatry 2014; 5:126. [PMID: 25309460 PMCID: PMC4159976 DOI: 10.3389/fpsyt.2014.00126] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 08/27/2014] [Indexed: 11/13/2022] Open
Abstract
Individuals with schizophrenia, particularly those with passivity symptoms, may not feel in control of their actions, believing them to be controlled by external agents. Cognitive operations that contribute to these symptoms may include abnormal processing in agency as well as body representations that deal with body schema and body image. However, these operations in schizophrenia are not fully understood, and the questions of general versus specific deficits in individuals with different symptom profiles remain unanswered. Using the projected-hand illusion (a digital video version of the rubber-hand illusion) with synchronous and asynchronous stroking (500 ms delay), and a hand laterality judgment task, we assessed sense of agency, body image, and body schema in 53 people with clinically stable schizophrenia (with a current, past, and no history of passivity symptoms) and 48 healthy controls. The results revealed a stable trait in schizophrenia with no difference between clinical subgroups (sense of agency) and some quantitative (specific) differences depending on the passivity symptom profile (body image and body schema). Specifically, a reduced sense of self-agency was a common feature of all clinical subgroups. However, subgroup comparisons showed that individuals with passivity symptoms (both current and past) had significantly greater deficits on tasks assessing body image and body schema, relative to the other groups. In addition, patients with current passivity symptoms failed to demonstrate the normal reduction in body illusion typically seen with a 500 ms delay in visual feedback (asynchronous condition), suggesting internal timing problems. Altogether, the results underscore self-abnormalities in schizophrenia, provide evidence for both trait abnormalities and state changes specific to passivity symptoms, and point to a role for internal timing deficits as a mechanistic explanation for external cues becoming a possible source of self-body input.
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Affiliation(s)
- Kyran T Graham
- Pharmacology, Pharmacy and Anaesthesiology Unit, School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia , Perth, WA , Australia ; Statewide Department of Neurophysiology and Clinical Research Centre, Graylands Hospital, North Metropolitan Health Services - Mental Health , Perth, WA , Australia
| | - Mathew T Martin-Iverson
- Pharmacology, Pharmacy and Anaesthesiology Unit, School of Medicine and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia , Perth, WA , Australia ; Statewide Department of Neurophysiology and Clinical Research Centre, Graylands Hospital, North Metropolitan Health Services - Mental Health , Perth, WA , Australia
| | - Nicholas P Holmes
- Centre for Integrative Neuroscience and Neurodynamics, School of Psychology and Clinical Language Sciences, University of Reading , Reading , UK
| | - Assen Jablensky
- Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia , Perth, WA , Australia
| | - Flavie Waters
- Statewide Department of Neurophysiology and Clinical Research Centre, Graylands Hospital, North Metropolitan Health Services - Mental Health , Perth, WA , Australia ; Centre for Clinical Research in Neuropsychiatry, School of Psychiatry and Clinical Neurosciences, The University of Western Australia , Perth, WA , Australia
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Hur JW, Kwon JS, Lee TY, Park S. The crisis of minimal self-awareness in schizophrenia: a meta-analytic review. Schizophr Res 2014; 152:58-64. [PMID: 24055201 DOI: 10.1016/j.schres.2013.08.042] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 08/28/2013] [Accepted: 08/30/2013] [Indexed: 11/26/2022]
Abstract
Disturbances of the minimal self, characterized by abnormal sense of the body, body ownership and agency have been proposed as the phenomenological phenotype of schizophrenia. However, self-disturbances have not been extensively investigated, in part, due to the subjective nature of such processes, and the associated difficulty of studying these phenomena using empirical methodology. Of 115 potential studies on self-awareness in schizophrenia, a total of 25 studies met the inclusion criteria for the meta-analysis comprising 690 patients with schizophrenia and 979 healthy controls. We calculated Hedge's g to obtain a better estimate for the standardized mean difference in small samples. We identified significant basic self-disturbance in schizophrenia, as compared with healthy controls (25 studies, effect size=0.51). Additional comparison of three sub-categories of the sense of body ownership (4 studies, effect size=0.91), the sense of agency (15 studies, effect size=0.49), and self-reported subjective experiences (6 studies, effect size=0.57) also confirmed group differences. The complete set of 25 studies, and the studies in the sub-categories showed the statistical homogeneity of the characteristics. After a correction for potential publication bias using the trim-and-fill method, the main findings for all studies combined remained significant. Overall, patients with schizophrenia showed deficits in the sense of the minimal self, driven by abnormal sense of body ownership and sense of agency. Interestingly, the disturbed sense of agency in schizophrenia suggests an exaggerated self-consciousness rather than a diminished sense of self. Further research that utilizes sophisticated study designs is needed to examine the nature of self-disturbances in schizophrenia.
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Affiliation(s)
- Ji-Won Hur
- Department of Brain and Cognitive Sciences, World Class University Program, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, World Class University Program, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea; Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN 37240, USA; Department of Psychiatry, Vanderbilt University, Nashville, TN 37240, USA.
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49
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Upcoming tactile events and body ownership in schizophrenia. Schizophr Res 2014; 152:51-7. [PMID: 23835002 DOI: 10.1016/j.schres.2013.06.026] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 06/07/2013] [Accepted: 06/10/2013] [Indexed: 11/24/2022]
Abstract
Schizophrenic patients may report unusual perception of their own body. Studies using the rubber hand illusion (RHI) proposed that they exhibit a distorted sense of body ownership. However, since the RHI is mostly achieved with the contribution of visuo-tactile integration, the stronger RHI observed in schizophrenic patients could reflect either a general increase of the response to multisensory stimuli or a larger influence of visual cues on the tactile sensory experience. The purpose of the present study is to investigate patients' perception of their own body by means of a behavioral paradigm that measures their proneness to the RHI without relying on multisensory integration occurring during actual experience of touch. In a previous study we demonstrated in healthy participants that expectation of touch experience arising at the sight of a human hand approaching a rubber hand is enough to induce a sense of ownership over the same hand. Here we take advantage of the same paradigm to investigate body ownership in schizophrenia. Patients observed the experimenter's hand while approaching--without touching--either a rubber hand or a piece of wood placed in front of them. The seen object could be either aligned to participant's hand or rotated by 180°. Phenomenology of the illusion revealed that schizophrenic patients exhibited sense of ownership over the rubber hand, but more weakly than healthy controls. The present study sheds new light on the experience of body ownership in schizophrenic patients, corroborating the notion that alterations of bodily self-awareness play an important role in schizophrenia.
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50
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Hirjak D, Breyer T, Thomann PA, Fuchs T. Disturbance of intentionality: a phenomenological study of body-affecting first-rank symptoms in schizophrenia. PLoS One 2013; 8:e73662. [PMID: 24019932 PMCID: PMC3760919 DOI: 10.1371/journal.pone.0073662] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 07/19/2013] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVES In 1950, Kurt Schneider proposed that a considerable number of schizophrenia patients develop first-rank symptoms (FRS). In such cases, patients report made experiences, replaced control of will, thought insertion, broadcast or withdrawal and delusional perception, respectively. Although a number of recent studies tend to explain FRS in terms of neurobiological and neuropsychological processes, the origin of these symptoms still remains unknown. In this paper, we explore the subjective experience of patients with the following two FRS: (1) "made" impulses and (2) "made" volitional acts. METHOD The method applied for the study of two FRS consists first in the overview of psychiatric and philosophical literature and second in the further investigation of subjective experience in patients with FRS. Psychopathological and phenomenological aspects of FRS are discussed by means of patient cases. RESULTS We discovered a profound transformation of intentionality and agency in schizophrenia patients with body-affecting FRS. This concept offers an insight into the interrelatedness between particular FRS. CONCLUSION We propose that the subjective experience of schizophrenia patients with body-affecting FRS is rooted in the disturbance of intentionality and diminished sense of agency. This theoretical account of body-affecting FRS will open up new directions in both phenomenological and neurobiological psychiatric research.
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Affiliation(s)
- Dusan Hirjak
- Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
- Structural Neuroimaging Group, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Thiemo Breyer
- Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Philipp Arthur Thomann
- Structural Neuroimaging Group, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Thomas Fuchs
- Section Phenomenological Psychopathology and Psychotherapy, Department of General Psychiatry, Center of Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
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