Current Problems of Psychiatry

Current Problems of Psychiatry

Towards integrating phenomenology and neurocognition: Possible neurocognitive correlates of basic self-disturbance in schizophrenia

REVIEW PAPER
Curr Probl Psychiatry 2017; 18(3): 184-200
© 2017 Medical University of Lublin. This is an open access article distributed under the Creative Commons Attribution-NonComercial-No Derivs licence (http://creativecommons.org/licenses/by-nc-nd/3.0/)
DOI: 10.1515/cpp-2017-0015

Barnaby Nelson1,2, Louis A. Sass3

1 Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia
2 Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
3 Department of Clinical Psychology, Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA

 

 

 

Abstract

Phenomenological research indicates that disturbance of the basic sense of self may be a core phenotypic marker of schizophrenia spectrum disorders. Basic self-disturbance refers to disruption of the sense of ownership of experience and agency of action and is associated with a variety of anomalous subjective experiences. Little is known about the neurocognitive correlates of basic self-disturbance. In this paper, we review recent phenomenological and neurocognitive research and point to a convergence of these approaches around the concept of self-disturbance. Specifically, we propose that subjective anomalies associated with basic self-disturbance may be associated with: 1. source monitoring deficits, which may contribute particularly to disturbances of “ownership” and “mineness” (the phenomenological notion of presence) and 2. aberrant salience, and associated disturbances of memory, prediction, and attention processes, which may contribute to hyper-reflexivity, disturbed “grip” or “hold” on the perceptual and conceptual field, and disturbances of intuitive social understanding (“common sense”). These two streams of research are reviewed in turn before considering ways forward in integrative models, particularly regarding the role of early neurodevelopmental disturbances, primary versus secondary disturbances, and the state versus trait nature of such pathology. Empirical studies are required in a variety of populations in order to test the proposed associations between phenomenological and neurocognitive aspects of self-disturbance in schizophrenia. An integration of findings across the phenomenological and neurocognitive domains would represent a significant advance in the understanding of schizophrenia and possibly enhance early identification and intervention strategies.

 

Keywords: schizophrenia; psychosis; phenomenology; self; neurocognition

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