Disorders of self-monitoring and the symptoms of schizophrenia

doi:10.1017/CBO9780511543708.020

19 - Disorders of self-monitoring and the symptoms of schizophrenia

from Part III - Disturbances of the self: the case of schizophrenia

Published online by Cambridge University Press: 18 December 2009

Sarah-Jayne Blakemore

Edited by

Tilo Kircher and

Anthony David

Show author details

Sarah-Jayne Blakemore: Affiliation:
Wellcome Department of Cognitive Neurology, Institute of Neurology, University College London, London, UK
Tilo Kircher: Affiliation:
Eberhard-Karls-Universität Tübingen, Germany
Anthony David: Affiliation:
Institute of Psychiatry, London

Book contents

Get access

Summary

Abstract

In this chapter we attempt to explain one class of symptoms associated with schizophrenia. We concentrate on symptoms that are characterized by a confusion between the self and other, such as auditory hallucinations and delusions of control. We propose that such symptoms arise because of a failure in the mechanism by which the predicted consequences of self-produced actions are derived from an internal forward model. Normally the forward model predicts and cancels the sensory consequences of self-produced actions. We argue that an impairment in this prediction and cancellation mechanism can cause self-produced sensations to be classified as externally produced. This problem leads to a number of behavioural consequences, such as a lack of central error correction, many of which have been observed in patients with delusions of control and related symptoms. At the physiological level, delusions of control are associated with overactivity in the parietal cortex. We suggest that this overactivity results from a failure to attenuate responses to sensations of limb movements even though these sensations can be anticipated on the basis of the movements intended. The lack of attenuation may arise from corticocortical disconnections which prevent inhibitory signals arising in the frontal areas which generate motor commands from reaching the appropriate sensory areas.

Introduction

Auditory hallucinations and passivity symptoms in schizophrenia

Rather than attempting to elucidate a biological basis for schizophrenia, our aim in this chapter is to try and explain one class of symptoms.

Type: Chapter
Information: The Self in Neuroscience and Psychiatry , pp. 407 - 424

DOI: https://doi.org/10.1017/CBO9780511543708.020 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Andersson, G. & Armstrong, D. M. (1985). Climbing fibre input to b zone Purkinje cells during locomotor perturbation in the cat. Neuroscience Letters Supplement, 22, S27Google Scholar

Andersson, G. & Armstrong, D. M. (1987). Complex spikes in Purkinje cells in the lateral vermis of the cat cerebellum during locomotion. Journal of Physiology (London), 385, 107–34Google Scholar

Angel, R. W. & Malenka, R. C. (1982). Velocity-dependent suppression of cutaneous sensitivity during movement. Experimental Neurology, 77, 266–74Google Scholar

Barresi, J. & Moore, C. (1996). Intentional relations and social understanding. Behaviour and Brain Science, 19, 107–54Google Scholar

Bentall, R. P., Baker, G. A. & Havers, S. (1991). Reality monitoring and psychotic hallucinations. British Journal of Clinical Psychology, 30, 213–22Google Scholar

Bick, P. A. & Kinsbourne, M. (1987). Auditory hallucinations and subvocal speech in schizophrenic patients. American Journal of Psychiatry, 144, 222–5Google Scholar

Blakemore, S.-J., Wolpert, D. M. & Frith, C. D. (1998). Central cancellation of self-produced tickle sensation. Nature Neuroscience, 1, 635–40Google Scholar

Blakemore, S.-J., Frith, C. D. & Wolpert, D. W. (1999a). Spatiotemporal prediction modulates the perception of self-produced stimuli. Journal of Cognitive Neuroscience, 11, 551–9Google Scholar

Blakemore, S.-J., Wolpert, D. M. & Frith, C. D. (1999b). The cerebellum contributes to somatosensory cortical activity during self-produced tactile stimulation. NeuroImage, 10, 448–59Google Scholar

Blakemore, S.-J., Smith, J., Steel, R., Johnstone, E. & Frith, C. D. (2000). The perception of self-produced sensory stimuli in patients with auditory hallucinations and passivity experiences: evidence for a breakdown in self-monitoring. Psychological Medicine, 30, 1131–9Google Scholar

Blakemore, S.-J., Frith, C. D. & Wolpert, D. W. (2001). The cerebellum is involved in predicting the sensory consequences of action. NeuroReport, 12, 1879–85Google Scholar

Cahill, C., Silbersweig, D. & Frith, C. D. (1996). Psychotic experiences induced in deluded patients using distorted auditory feedback. Cognitive Neuropsychiatry, 1, 201–11Google Scholar

Chapin, J. K. & Woodward, D. J. (1982). Somatic sensory transmission to the cortex during movement: gating of single cell responses to touch. Experimental Neurology, 78, 654–69Google Scholar

Chapman, C. E. (1994). Active versus passive touch: factors influencing the transmission of somatosensory signals to primary somatosensory cortex. Canadian Journal of Physiology and Pharmacology, 72, 558–70Google Scholar

Chapman, C. E. & Ageranioti-Belanger, S. A. (1991). Comparison of the discharge of primary somatosensory cortical (SI) neurones during active and passive tactile discrimination. Proceedings of the Third IBRO World Congress of Neuroscience, p. 317. Oxford: Pergamon

Chapman, C. E., Bushnell, M. C., Miron, D., Duncan, G. H. & Lund, J. P. (1987). Sensory perception during movement in man. Experimental Brain Research, 68, 516–24Google Scholar

Claxton, G. (1975). Why can't we tickle ourselves? Perceptual and Motor Skills, 41, 335–8Google Scholar

Collins, D. F., Cameron, T., Gillard, D. M. & Prochazka, A. (1998). Muscular sense is attenuated when humans move. Journal of Physiology, 508, 635–43Google Scholar

Daprati, E., Franck, N., Georgieff, N. et al. (1997). Looking for the agent: an investigation into consciousness of action and self-consciousness in schizophrenic patients. Cognition, 65, 71–86Google Scholar

Decety, J. (1996). Neural representation for action. Reviews in the Neurosciences, 7, 285–97Google Scholar

Dolan, R. J., Fletcher, P., Frith, C. D. et al. (1995). Dopaminergic modulation of an impaired cognitive activation in the anterior cingulate cortex in schizophrenia. Nature, 378, 180–3Google Scholar

Ebmeier, K. P., Steele, J. D., MacKenzie, D. M. et al. (1995). Cognitive brain potentials and regional cerebral blood flow equivalents during two- and three-sound auditory ‘oddball tasks’. Electroencephalography and Clinical Neurophysiology, 95, 434–43Google Scholar

Feinberg, I. (1978). Efference copy and corollary discharge: implications for thinking and its disorders. Schizophrenia Bulletin, 4, 636–40Google Scholar

Franck, N., Rouby, P., Daprati, E. et al. (2000). Confusion between silent and overt reading in schizophrenia. Schizophrenia Research, 41, 357–64Google Scholar

Frith, C. D. (1987). The positive and negative symptoms of schizophrenia reflect impairments in the perception and initiation of action. Psychological medicine, 17, 631–48Google Scholar

Frith, C. D. (1992). The Cognitive Neuropsychology of Schizophrenia. Hove, Sussex: Lawrence Erlbaum Associates

Frith, C. D. (1995). Consciousness is for other people. Behavioural and Brain Sciences, 18, 682–3Google Scholar

Frith, C. D. & Done, D. J. (1989). Experiences of alien control in schizophrenia reflect a disorder in the central monitoring of action. Psychological Medicine, 19, 359–63Google Scholar

Frith, C. D. & Frith, U. (1999). Interacting minds – a biological basis. Science, 286, 1692–5Google Scholar

Frith, C. D., Friston, K. J., Herold, S. et al. (1995). Regional brain activity in chronic schizophrenic patients during the performance of a verbal fluency task. British Journal of Psychiatry, 167, 343–9Google Scholar

Frith, C. D., Blakemore, S.-J. & Wolpert, D. M. (2000a). Explaining the symptoms of schizophrenia: abnormalities in the awareness of action. Brain Research Reviews, 31, 357–63Google Scholar

Frith, C. D., Blakemore, S.-J. & Wolpert, D. M. (2000b). Abnormalities in the awareness and control of action. Philosophical Transactions of the Royal Society of London: Biological Sciences, 355, 1771–88Google Scholar

Gellman, R., Gibson, A. R. & Houk, J. C. (1985). Inferior olivary neurons in the awake cat: detection of contact and passive body displacement. Journal of Neurophysiology, 54, 40–60Google Scholar

Gould, L. N. (1949). Auditory hallucinations and subvocal speech. Journal of Nervous and Mental Disease, 109, 418–27Google Scholar

Green, P. & Preston, M. (1981). Reinforcement of vocal correlates of auditory hallucinations by auditory feedback: a case study. British Journal of Psychiatry, 139, 204–8Google Scholar

Hoffman, R. E. (1986). Verbal hallucinations and language production processes in schizophrenia. Behavioral and Brain Sciences, 9, 503–17Google Scholar

Hughlings Jackson, J. (1932). Selected Writings of John Hughlings Jackson. London: Hodder & Stoughton

Imamizu, H., Miyauchi, S., Tamada, T. et al. (2000). Human cerebellar activity reflecting an acquired internal model of a new tool. Nature, 403, 192–5Google Scholar

Ito, M. (1970). Neurophysiological aspects of the cerebellar motor control system. International Journal of Neurology, 7, 162–76Google Scholar

Jeannerod, M. (1988). The Neural and Behaviourial Organisation of Goal-directed Movements. Oxford: OUP

Jeannerod, M. (1994). The representing brain – neural correlates of motor intention and imagery. Behavioral and Brain Sciences, 17, 187–202Google Scholar

Jeannerod, M. (1997). The Cognitive Neuropsychology of Action. Cambridge: Blackwell

Jeannerod, M. (1999). To act or not to act: perspectives on the representation of actions. Quarterly Journal of Experimental Psychology A, 52, 981–1020Google Scholar

Jiang, W., Chapman, C. E. & Lamarre, Y. (1991). Modulation of the cutaneous responsiveness of neurones in the primary somatosensory cortex during conditioned arm movements in the monkey. Experimental Brain Research, 84, 342–54Google Scholar

Johns, L. C. & McGuire, P. K. (1999). Verbal self-monitoring and auditory hallucinations in schizophrenia. Lancet, 353, 469–70Google Scholar

Johns, L. C., Rossell, S., Frith, C. et al. (2001). Verbal self-monitoring and auditory verbal hallucinations in patients with schizophrenia. Psychological Medicine, 31, 705–15Google Scholar

Johnstone, E. C. (1991). Defining characteristics of schizophrenia. British Journal of Psychiatry, 13, (suppl.) 5–6Google Scholar

Kay, S., Fiszbein, A. & Opler, L. (1987). The positive and negative symptom scale for schizophrenia. Schizophrenia Bulletin, 13, 261–76Google Scholar

Lane, R. D., Fink, G. R., Chua, P. M. & Dolan, R. J. (1997). Neural activation during selective attention to subjective emotional responses. Neuroreport, 8, 3969–72Google Scholar

Locke, J. (1690). Essay Concerning Human Understanding, II.VI.2. Oxford: Clarendon Press (reprinted 1989)

Malenka, R. C., Angel, R. W., Hampton, B. & Berger, P. A. (1982). Impaired central error-correcting behavior in schizophrenia. Archives of General Psychiatry, 39, 101–7Google Scholar

McGuire, P. K. & Frith, C. D. (1996). Disordered functional connectivity in schizophrenia. Psychological Medicine, 26, 663–7Google Scholar

Mellors, C. S. (1970). First-rank symptoms of schizophrenia. British Journal of Psychiatry, 117, 15–23Google Scholar

Miall, R. C., Weir, D. J., Wolpert, D. M. & Stein, J. F. (1993). Is the cerebellum a Smith predictor? Journal of Motor Behaviour, 25, 203–16Google Scholar

Milne, R. J., Aniss, A. M., Kay, N. E. & Gandevia, S. C. (1988). Reduction in perceived intensity of cutaneous stimuli during movement: a quantitative study. Experimental Brain Research, 70, 569–76Google Scholar

Mlakar, J., Jensterle, J. & Frith, C. D. (1994). Central monitoring deficiency and schizophrenic symptoms. Psychological Medicine, 24, 557–64Google Scholar

Oscarsson, O. (1980). Functional organization of olivary projection to the cerebellar anterior lobe. In The Inferior Olivary Nucleus: Anatomy and Physiology, ed. J. Courville, C. DeMontigny & Y. Lamarre. New York: Raven Press

Paulin, M. G. (1989). A Kalman filter theory of the cerebellum. In Dynamic Interactions in Neural Networks: Models and Data, ed. E. M. A. Arbib & E. S. Amari, pp. 241–59. Berlin: Springer-Verlag

Porrino, L. J. (1993). Functional consequences of acute cocaine treatment depend on route of administration. Psychopharmacology Berlin, 112, 343–51Google Scholar

Schneider, K. (1959). Clinical Psychopathology. New York: Grune & Stratton

Simpson, J. L., Wylie, D. R. & Zeeuw, C. I. (1995). On climbing fiber signals and their consequence(s). Behavioural and Brain Sciences, 19, 384Google Scholar

Spence, S. A. (1996). Free will in the light of neuropsychiatry. Philosophy, Psychiatry and Psychology, 3, 75–90Google Scholar

Spence, S. A., Brooks, D. J., Hirsch, S. R. et al. (1997). A PET study of voluntary movement in schizophrenic patients experiencing passivity phenomena (delusions of alien control). Brain, 120, 1997–2011Google Scholar

Spence, S. A., Hirsch, S. R., Brooks, D. J. & Grasby, P. M. (1998). Prefrontal cortex activity in people with schizophrenia and control subjects. Evidence from positron emission tomography for remission of ‘hypofrontality’ with recovery from acute schizophrenia. British Journal of Psychiatry, 172, 316–23Google Scholar

Sperry, R. W. (1950). Neural basis of spontaneous optokinetic responses produced by visual inversion. Journal of Comparative Physiological Psychology, 43, 483–9Google Scholar

Stirling, J. D., Hellewell, J. S. E. & Quraishi, N. (1998). Self-monitoring dysfunction and the schizophrenic symptoms of alien control. Psychological Medicine, 28, 675–83Google Scholar

Vogt, B. A., Finch, D. M. & Olson, C. R. (1992). Functional heterogeneity in cingulate cortex: the anterior executive and posterior evaluative regions. Cerebral Cortex, 2, 435–43Google Scholar

Vogt, B. A., & Gabriel, M. (eds) (1993). Neurobiology of Cingulate Cortex and Limbic Thalamus. Boston: Birkauser

Von Helmholtz, H. (1867). Handbuch der Physiologischen Optik, 1st edn. Hamburg, Germany: Voss

Holst, E. (1954). Relations between the central nervous system and the peripheral organs. British Journal of Animal Behaviour, 2, 89–94Google Scholar

Watson, J. B. (1914). Behavior: An Introduction to Comparative Psychology. New York: Holt

Weiller, C., Juptner, M., Fellows, S. et al. (1996). Brain representation of active and passive movement. NeuroImage, 4, 105–10Google Scholar

Weiskrantz, L., Elliot, J. & Darlington, C. (1971). Preliminary observations of tickling oneself. Nature, 230, 598–9Google Scholar

Wing, J. K., Cooper, J. E. & Sartorius, N. (1974). Description and Classification of Psychiatric Symptoms. London: Cambridge University Press

Wolpert, D. M. (1997). Computational approaches to motor control. Trends in Cognitive Sciences, 1, 209–16Google Scholar

Wolpert, D. M., Miall, R. C. & Kawato, M. (1998). Internal models in the cerebellum. Trends in Cognitive Sciences, 2, 338–47Google Scholar

Wolpert, D. M., Ghahramani, Z. & Jordan, M. I. (1995). An internal model for sensorimotor integration. Science, 269, 1880–2Google Scholar

Wolpert, D. M., Ghahramani, Z. & Flanagan, R. (2001). Perspectives and problems in motor learning. Trends in Cognitive Sciences, 5, 487–94Google Scholar

Zahavi, D. (ed.) (2000). Advances in Consciousness Research. Amsterdam: John Benjamins