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In schizophrenia, there is evidence for anomalies in the extension and plasticity of the peripersonal space (PPS), the portion of space surrounding our body, plastically shaped through motor experiences. An impaired multisensory integration at the PPS level would underpin the disembodiment, a core feature of the disorder linked to subjective perturbations of the sense of self (“Self-disorders”) and of the intersubjective dimension (“schizophrenic autism”).
The present study was aimed at: 1) exploring possible associations between PPS data, psychopathological dimensions, and subjective experiences in schizophrenia; 2) identifying a specific PPS profile in patients with early-onset schizophrenia.
A motor training with a tool was used to assess the PPS size and boundaries demarcation in twenty-seven schizophrenia outpatients. Moreover, they underwent a thorough psychopathological evaluation with the Positive And Negative Syndrome Scale (PANSS), the Examination of Anomalous Self Experience scale (EASE) and the Autism Rating Scale (ARS). Subsequently, the sample was divided into early (EOS) and adult-onset (AOS) subgroups, that were compared with respect to their PPS and psychopathological profiles.
PPS features (size and boundaries demarcation) were associated with PANSS negative score, subjective experiences of existential reorientation (EASE Domain 5 scores) and traits of schizophrenic autism (ARS scores; Fig. 1). PPS parameters (Fig. 2) and ARS scores, but not PANSS and EASE differentiated between early and adult-onset subgroups.
Our results suggest a link between PPS patterns, negative symptoms, and disturbances of the subjective experience, particularly in the intersubjective domain, in schizophrenia. Moreover, they candidate specific PPS profiles and schizophrenic autism traits as EOS markers.
A primary disruption of the bodily self is considered a core feature of schizophrenia patients (SCZ). The “disembodied” self would be underpinned by an inefficient body-related multisensory integration mechanism occurring in the Peripersonal Space (PPS). PPS is a plastic sector of space surrounding our body, whose extent is altered in SCZ. Although PPS represents a malleable interface marking the perceptual border between self and others, no study has investigated the potential alteration of its plasticity in SCZ.
We investigated the PPS extension and its plasticity in SCZ and their potential correlations with the clinical scales.
Thirty SCZ and thirty healthy controls (HC) underwent a multisensory task to estimate PPS boundary before and after a motor training. Patients were also administered the Positive And Negative Syndrome Scale (PANSS) and the Examination of Anomalous Self-Experience (EASE).
Data confirm a narrower PPS extent in SCZ than in HC, whereas no differences in PPS expansion was found in the two groups after the motor training (Figure 1). Positive symptoms were associated directly with PPS extent and inversely with PPS plasticity. No associations were found between PPS and EASE domains. Figure1: Graphical representation of PPS expansion in SCZ and HC. Both panels show individual normalized sigmoid fits
The present study suggests a narrower PPS extent and a preserved PPS plasticity in SCZ with respect to HC. Both PPS extent and plasticity are related to the severity of positive symptoms. These results highlight the potential role of rehabilitation interventions in order to improve patients’ weakened body boundary.
In spite of the historically consolidated psychopathological perspective, neuroscientific research applied to schizophrenia has so far almost entirely neglected the first-person experiential dimension of this syndrome, mainly focusing on higher-order cognitive functions such as executive function, working memory, theory of mind, and the like. An alternative view posits that schizophrenia is a self-disorder characterized by anomalous self-experience and awareness. This view may not only shed new light on the psychopathological features of psychosis but also inspire empirical research targeting the bodily and neurobiological changes underpinning this disorder. Recent empirical evidence on the neurobiological basis of a minimal notion of the self, the bodily self, will be presented. The relationship between the body, its motor potentialities and the notion of minimal self will be illustrated. I will posit that this approach can shed new light on the self-disturbances and social deficits characterizing schizophrenia. I will propose that cognitive neuroscience can today address classic topics of psychopathology by adding a new level of description, finally enabling the correlation between the first-person experiential aspects of psychiatric diseases and their neurobiological roots. To this purpose, I’ll describe putative neural mechanisms underpinning the blurring of self-other distinction in schizophrenic patients. I will posit that brain function anomalies of multisensory integration, differential processing of self- and other-related bodily information, mediating self-experience, might be at the basis of the imbalance in the pre-reflective relationship of the embodied self to the social world observed in schizophrenia.
Our seemingly effortless capacity of conceiving of the acting bodies inhabiting our social world as goal-oriented individuals like us depends on the constitution of a shared “we-centric” space. I have proposed that this shared manifold space can be characterized at the functional level as embodied simulation, a basic functional mechanism by means of which our brain/body system models its interactions with the world.
The mirroring mechanism for action and other mirroring mechanisms in our brain represent sub-personal instantiations of embodied simulation. Embodied simulation provides a new empirically based notion of intersubjectivity, viewed first and foremost as intercorporeity. Embodied simulation challenges the notion that Folk-psychology is the sole account of interpersonal understanding. Before and below mind reading is intercorporeity as the main source of knowledge we directly gather about others.
By means of embodied simulation we can map others’ actions onto our own motor representations, as well as others’ emotions and sensations onto our own viscero-motor and somatosensory representations. “Representation”, as used here, refers to a particular type of content, generated by the relations that our situated and inter-acting brain-body system instantiates with the world. Such content is pre-linguistic and pre-theoretical, but nevertheless has attributes normally and uniquely attributed to conceptual content.Social cognition is not only explicitly reasoning about the contents of someone else's mind. Embodied simulation, gives us a direct insight of other minds thus enabling our capacity to empathize with others.
This proposal opens new perspectives on our understanding of autism and other psychopathological states such as schizophrenia.
Anomalous experiences such as Basic Symptoms (BS) are considered to be the first subjective manifestation of the neurobiological substrate of schizophrenia. Recently it has been outlined indeed, how various aspects of the phenomenological basic self-disorders occurring in schizophrenia may correlate with neurocognitive disturbances.
The purpose of this study is to explore whether a low or high emotional motor resonance occurring in Schizophrenia Spectrum (SzSp) patients is related to patients' clinical features and to their anomalous subjective experiences as indexed by the Bonn Scale for the Assessment of Basic Symptoms (BSABS).
We employed a validated paradigm sensitive in evoking a congruent facial mimicry (measured by means of facial Electromyographic activity, EMG) through multimodal positive and negative emotional stimuli presentation.
Results showed that SzSp patients more resonating with negative emotional stimuli (i.e., Externalizersfor negative emotions), had significantly higher scores in BSABS Cluster 3 (Vulnerability) and more psychotic episodes than patients belonging to the Internalizers group. On the other hand, SzSp patients more resonating with positive emotional stimuli (i.e., Externalizers for positive emotions), scored higher in BSABS Cluster 5 (Interpersonal Irritation) than patients belonging to the Internalizers group.
Drawing upon a phenomenological-based perspective, we shed new light on the abnormal experiences characterizing SzSp conditions, explaining them in terms of a disruption of the normal self-perception conveyed by the more basic, automatic, low-level emotional motor mechanisms. The importance of adopting a trans-domain approach integrating findings from the phenomenological and the neurophysiological levels of analysis is further emphasized.
The awareness of one's body constitutes a basic experience of Self which modulates the individual engagement in social interactions. Indeed, Interoception Sensitivity (IS), an index of individual ability to represent one’s own internal body states, is implicated in the autonomic regulation in interpersonal context. Schizophrenia deficits in Self-experience and awareness, which frequently entail anomalies in self-other relationship, capture the ever-growing attention of researchers. Nevertheless, IS and autonomic regulation of schizophrenic patients in social context are completely new and not yet investigated aspects of Schizophrenia.
To investigate whether Schizophrenia could be associated with lower IS and with a dysfunctional autonomic regulation during social interaction.
24 chronic schizophrenia patients, and a matched group of healthy controls, performed a Social and a Non-social task while respiratory sinus arrhythmia (an index of autonomic regulation) was measured. In the Social task participants viewed an experimenter performing a caress-like movement at different distances from their hand. In the Non-social task a metal stick was moved at the same distances from the participants’ hand. As measure of IS, a cardiac Mental Tacking Task was performed.
Comparing to controls, Schizophrenia patients presented lower IS, absence of relation between IS and autonomic regulation, and an anomalous autonomic regulation in social and non-social contexts.
Deficits in Self-experience, associated with Schizophrenia, could be extended to patients’ sensitivity to internal bodily signals. Moreover, the observed altered autonomic regulation will be part of interpersonal interaction deficit frequently associated to Schizophrenia.
Anorexia Nervosa (AN) is characterized by body-size overestimation that reflects a distortion of body-representation. Self-body recognition can be both implicit and explicit. The former is based on cognitive and perceptual mechanisms, the latter relies on motor simulation. Previous studies showed that participants, when submitted to a hand laterality judgment task (Implicit task) that required mental rotation showed better performances when the stimuli consisted of their own rather than other's hand (self-advantage). By contrast, the self-advantage was absent when self-recognition (Explicit task) was explicitly required.
This study aimed to investigate whether the overestimation of anorexic's own body size extended to the motor representation of the bodily-self influencing the implicit self-advantage. Furthermore, we assessed the possible relationship between the implicitly recognition of one's own body part and Interoceptive Sensitivity (IS; sensitivity to stimuli originating inside of the body).
Healthy Controls (HC) and restrictive AN patients were submitted both to Implicit and Explicit tasks with self and other's hands presented in the original size or modified to look fatter or thinner. We also assessed participants’ IS by means of a heartbeat perception task.
As previously reported, HC showed specific self-advantage effect only when a motor simulation is required. Furthermore higher IS is related to faster performances only in the implicit task in which a mental motor rotation. The differences between AN patients and HC concerning IS and bodily-self recognition will be also discussed.
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