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21 - The cognitive neuroscience of agency in schizophrenia

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

Published online by Cambridge University Press:  18 December 2009

By
Henrik Walter  and
Manfred Spitzer
Edited by
Tilo Kircher  and
Anthony David
Henrik Walter
Affiliation:
Universitätsklinik für Psychiatrie, ULM, Germany
Manfred Spitzer
Affiliation:
Universitätsklinik für Psychiatrie, ULM, Germany
Tilo Kircher
Affiliation:
Eberhard-Karls-Universität Tübingen, Germany
Anthony David
Affiliation:
Institute of Psychiatry, London
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Summary

Abstract

Agency is the sense of ownership, i.e. the personal experience of being the originator of one's thoughts and actions (Walter, 2001). Disorders of agency are prominent in schizophrenia and may also be part of several other neuropsychiatric disorders and syndromes, e.g. alien-hand syndrome, drug-induced psychoses or anosognosia. In recent years, cognitive neuroscience has made considerable progress in understanding the neural basis of agency. In this chapter, current neurocognitive theories of agency are reviewed which are based on the assumption that an internal monitoring deficit lies at the core of disorders of agency in schizophrenia. It is demonstrated how they fail to explain several features of disturbed agency. A complementary theory is proposed which takes into account the experiences of reference and insertion of personal relatedness as well as the acknowledged role of dopamine for schizophrenia and its role as a neuromodulator regulating signal-to-noise ratio.

The psychopathology of agency in schizophrenia

Schizophrenic patients often report the immediate experience of someone else controlling their thoughts and actions. In addition, sometimes they feel they are in control of external events or are convinced they know what other people think. They think that things or events are related to themselves in a special way, have a personal significance or are made especially for them. The German psychiatrist Kurt Schneider emphasized these types of ideation as criteria for the diagnosis of schizophrenia, and because of their relative homogeneity and recognizability, they are frequently referred to as Schneiderian first-rank symptoms.

Type
Chapter
Information
The Self in Neuroscience and Psychiatry , pp. 436 - 444
Publisher: Cambridge University Press
Print publication year: 2003

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