Neurobiological Models of Self-Disorders in Early Schizophrenia

Mishara, Aaron L.; Bonoldi, Ilaria; Allen, Paul; Rutigliano, Grazia; Pérez, Jesús; Fusar‐Poli, Paolo; McGuire, Philip

doi:10.1093/schbul/sbv123

Cited by 35 publications

(34 citation statements)

References 38 publications

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“…This result is in line with recent studies investigating automatic temporal expectation mechanisms in the tens of milliseconds range in schizophrenia 28 , 29 , 32 , 64 , and generalizes these results to durations in the hundreds of milliseconds range. As indicated by correlations between EASE scores and the hazard function effect, this disturbance could lead to minimal self disorders, especially disturbances of the sense of self-awareness and presence as postulated by psychiatric phenomenology 3 , 4 , 6 , 65 . By losing the sense of time, patients also lose their sense of immersion or pre-reflexive tuning to their environment.…”

Section: Discussionmentioning

confidence: 98%

“…Indeed, it has been proposed that predictions help to bridge isolated events together and to build the sense of stability and continuity that constitutes our subjective life 1 . Its disruption in patients with schizophrenia 2 – 4 might be involved in minimal self disorders 5 , 6 , which are core disorders affecting the inner experience of patients. Self-disorders can already be observed during the prodromal phase of schizophrenia, and are possibly related to all cardinal symptoms of schizophrenia 7 .…”

Section: Introductionmentioning

confidence: 99%

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Fragile temporal prediction in patients with schizophrenia is related to minimal self disorders

Martin

Franck

Cermolacce

et al. 2017

Sci Rep

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Patients with schizophrenia have difficulty in making sensory predictions, in the time domain, which have been proposed to be related to self-disorders. However experimental evidence is lacking. We examined both voluntary and automatic forms of temporal prediction in 28 patients and 24 matched controls. A visual cue predicted (temporal cue) or not (neutral cue) the time (400 ms/1000 ms) at which a subsequent target was presented. In both patients and controls, RTs were faster for targets presented after long versus short intervals due to the temporal predictability inherent in the elapse of time (“hazard function”). This RT benefit was correlated with scores on the EASE scale, which measures disorders of the self: patients with a high ‘self-awareness and presence’ score did not show any significant benefit of the hazard function, whereas this ability was preserved in patients with a low score. Moreover, all patients were abnormally sensitive to the presence of “catch” trials (unexpected absence of a target) within a testing block, with RTs actually becoming slower at long versus short intervals. These results indicate fragility in patients’ ability to continuously extract temporally predictive information from the elapsing interval. This deficit might contribute to perturbations of the minimal self in patients.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Fragile temporal prediction in patients with schizophrenia is related to minimal self disorders

Martin

Franck

Cermolacce

et al. 2017

Sci Rep

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“…Though tentative and preliminary, our account amounts to a spatiotemporal theory of egodisturbances that is based on spontaneous activity and its spatiotemporal structure. Such a spatiotemporal approach (see also (Robinson, Wagner, & Northoff, 2015) must be distinguished from other theories of ego-disturbances in schizophrenia that are either bottom-up and sensorybased or, alternatively, top-down as related to cognitive functions like source monitoring (see (Mishara et al, 2015;Nelson, Whitford, Lavoie, & Sass, 2014a, 2014b. Rather than being based on task-evoked activity as related to either sensory (as in bottom-up models) or cognitive (as in topdown models) functions, the spatiotemporal approach is more basic and fundamental than both since it is based on the spontaneous activity and its spatiotemporal structure.…”

Section: Abnormal Temporal and Spatial Structure In The Dmn And Ego Dmentioning

confidence: 99%

How do abnormalities in the brain’s spontaneous activity translate into symptoms in schizophrenia? From an overview of resting state activity findings to a proposed spatiotemporal psychopathology

Northoff

Duncan

2016

Progress in Neurobiology

126

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Schizophrenia is a complex neuropsychiatric disorder with a variety of symptoms that include sensorimotor, affective, cognitive, and social changes. The exact neuronal mechanisms underlying these symptoms remain unclear though. Neuroimaging has focused mainly on the brain's extrinsic activity, specifically task-evoked or stimulus-induced activity, as related to the sensorimotor, affective, cognitive, and social functions. Recently, the focus has shifted to the brain's spontaneous activity, otherwise known as its resting state activity. While various spatial and temporal abnormalities have been observed in spontaneous activity in schizophrenia, their meaning and significance for the different psychopathological symptoms in schizophrenia, are yet to be defined. The first aim in this paper is to provide an overview of recent findings concerning changes in the spatial (e.g., functional connectivity) and temporal (e.g., couplings between different frequency fluctuations) properties of spontaneous activity in schizophrenia. The second aim is to link these spatiotemporal changes to the various psychopathological symptoms of schizophrenia, with a specific focus on basic symptoms, formal thought disorder, and ego-disturbances. Based on the various findings described, we postulate that the spatiotemporal changes on the neuronal level of the brain's spontaneous activity transform into corresponding spatiotemporal changes on the psychological level which, in turn, leads to the different kinds of psychopathological symptoms. We consequently suggest a spatiotemporal rather than cognitive or sensory approach to the condition, amounting to what we describe as "Spatiotemporal Psychopathology".

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“…Apart from clinical studies' increasing adoption of this approach (see the review by Parnas & Henriksen, 2014; mentioned above), emerging neurobiological theories (Mishara et al, 2016) and recent empirical studies on neurophysiology (Sestito, Parnas, Maggini, & Gallese, 2017;Sestito et al, 2015), the notion of a fragmented self is also heavily reflected in first-person accounts of schizophrenia-spectrum psychoses (Humpston & Broome, 2016b;Payne, 2012).…”

Section: Schizophrenia As a Self-disturbancementioning

confidence: 99%

The paradoxical self: Awareness, solipsism and first-rank symptoms in schizophrenia

Humpston

2017

Philosophical Psychology

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Schizophrenia as a pathology of self-awareness has attracted much attention from philosophical theorists and empirical scientists alike. I view schizophrenia as a basic self-disturbance leading to a lifeworld of solipsism adopted by the sufferer and explain how this adoption takes place, which then manifests in ways such as first-rank psychotic symptoms. I then discuss the relationships between these symptoms, not as isolated mental events, but as end-products of a loss of agency and ownership, and argue that symptoms like thought insertion and other ego-boundary disorders are by nature a multitude of paradoxes created by a fragmented awareness. I argue that such fragmentation does not always require or lead to a delusional elaboration as the definitive feature of its phenomenology, and present reasons for the role of the first-person pronoun as a mere metaphor used to represent the patient's bizarre experiences where sensory perception and thinking processes converge. Further, I discuss the initial benefits of adopting a solipsistic stance and how despite being a maladaptive strategy, it nevertheless acts as a protective barrier for the integrity of one's self. Lastly, I offer some suggestions for clinical practice, emphasizing the importance of understanding the patient's suffering in any therapeutic alliance.

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Neurobiological Models of Self-Disorders in Early Schizophrenia

Cited by 35 publications

References 38 publications

Fragile temporal prediction in patients with schizophrenia is related to minimal self disorders

Fragile temporal prediction in patients with schizophrenia is related to minimal self disorders

How do abnormalities in the brain’s spontaneous activity translate into symptoms in schizophrenia? From an overview of resting state activity findings to a proposed spatiotemporal psychopathology

The paradoxical self: Awareness, solipsism and first-rank symptoms in schizophrenia

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