Sense of agency is altered in patients with a putative psychotic prodrome

Imitative inhibitory control is associated with psychotic experiences in a sample from the general population

Psychotic experiences (PE) are prevalent and associated with several negative mental health outcomes in both clinical and general population, particularly in young people. A promising avenue to understand the mechanisms underlying PE is to investigate functions that may be related to specific neural systems. One of these key cognitive mechanisms is the ability to control our imitative responses, which is strongly linked to an adequate social functioning. Emergent evidence suggests that impairments in this function might be involved in the early expressions of psychosis, but few studies have investigated its association with PE in a sample from the general population. Using an imitation-inhibition paradigm we examined this relationship in a community sample of young healthy individuals (N=204) and found that increased levels of PE levels were associated with lower imitative inhibitory control. These effects seem to be specific to imitation-inhibition as no correlation was found for a more general cognitive control as addressed by a Stroop-like task. In addition, these effects seem to be more evident for paranoid ideations. Overall, our results suggest that imitative inhibitory control can serve as a proxy to detect abnormalities associated with psychotic experiences.

Temporal binding and sense of agency in major depression

Background

Alterations in the experience of controlling oneself and one's environment are of high relevance to understanding the psychopathology of depression. This study investigated the relationship between Temporal Binding for action-event sequences, sense of agency, self-efficacy and symptom severity in Major Depressive Disorder.

Method

We employed the Sense of Agency Scale (SoAS) and the General Self-Efficacy Scale (GSE) to assess explicit Sense of Agency and self-efficacy in a group of 42 persons diagnosed with Major Depressive Disorder (MDD) [20 identifying as female, 19 as male; mean age 37.8 years (± 13.3)] and 40 control persons without a psychiatric diagnosis (CG) [22 identifying as female, 20 as male; mean age 38.0 years ( ± 13.3)]. Depressive symptom severity was measured using the BDI-II. We additionally performed a temporal binding paradigm as a potential correlate to Sense of Agency. Participants partook in a time estimation task judging three intervals (250ms, 450ms, 650ms) while either observing or causing stimulus presentations. The underestimation of intervals following intentional actions causing stimulus presentations (compared to merely observing the stimulus presentation) is interpreted as temporal binding.

Results

SoAS scores demonstrated an inverse correlation with depressive symptoms (CG: p=.032, R2=.113; MDD: p<.001, R2=.260) and a positive correlation with GSE scores (CG: p<.001, R2=.379; MDD: p<.001, R2=.254). We found distinct differences in temporal binding between healthy participants and the Major Depressive Disorder group without significant correlation between temporal binding and the SoAS or GSE scores. The data suggest group differences in time estimation particular pertaining to time intervals involving intentional action and increasingly complex multisensory stimuli.

Discussion

We investigated parameters of subjective control, namely Sense of Agency and Self Efficacy. Here, we were able to reveal their inverse relationship with depressive symptoms in patients with major depressive disorder, highlighting a profound experience of loss of control with increasing symptom load. Deficits in experiencing control, particularly involving intentional motor actions (and more complex multisensory stimuli), appear to be more pronounced in Major Depressive Disorder, involving not only negative self-efficacy expectations but also an altered Sense of Agency and temporal binding. Temporal binding and SoAS scores did not correlate, adding to the growing evidence that the two measures may not be directly related. We propose that future research be directed at this contiguous relationship between Sense of Agency and Self Efficacy in Major Depressive Disorder.

Sense of agency and its disturbances: A systematic review targeting the intentional binding effect in neuropsychiatric disorders

Sense of agency (SoA) indicates a person's ability to perceive her/his own motor acts as actually being her/his and, through them, to exert control over the course of external events. Disruptions in SoA may profoundly affect the individual's functioning, as observed in several neuropsychiatric disorders. This is the first article to systematically review studies that investigated intentional binding (IB), a quantitative proxy for SoA measurement, in neurological and psychiatric patients. Eligible were studies of IB involving patients with neurological and/or psychiatric disorders. We included 15 studies involving 692 individuals. Risk of bias was low throughout studies. Abnormally increased action-outcome binding was found in schizophrenia and in patients with Parkinson's disease taking dopaminergic medications or reporting impulsive-compulsive behaviors. A decreased IB effect was observed in Tourette's disorder and functional movement disorders, whereas increased action-outcome binding was found in patients with the cortico-basal syndrome. The extent of IB deviation from healthy control values correlated with the severity of symptoms in several disorders. Inconsistent effects were found for autism spectrum disorders, anorexia nervosa, and borderline personality disorder. Findings pave the way for treatments specifically targeting SoA in neuropsychiatric disorders where IB is altered.

Impaired perception of temporal contiguity between action and effect is associated with disorders of agency in schizophrenia

Delusions of control in schizophrenia are characterized by the striking feeling that one's actions are controlled by external forces. We here tested qualitative predictions inspired by Bayesian causal inference models, which suggest that such misattributions of agency should lead to decreased intentional binding. Intentional binding refers to the phenomenon that subjects perceive a compression of time between their intentional actions and consequent sensory events. We demonstrate that patients with delusions of control perceived less self-agency in our intentional binding task. This effect was accompanied by significant reductions of intentional binding as compared to healthy controls and patients without delusions. Furthermore, the strength of delusions of control tightly correlated with decreases in intentional binding. Our study validated a critical prediction of Bayesian accounts of intentional binding, namely that a pathological reduction of the prior likelihood of a causal relation between one's actions and consequent sensory events-here captured by delusions of control-should lead to lesser intentional binding. Moreover, our study highlights the import of an intact perception of temporal contiguity between actions and their effects for the sense of agency.

Sense of agency during and following recovery from anorexia nervosa

The need to feel in control is central to anorexia nervosa (AN). The sense of control in AN has only been studied through self-report. This study investigated whether implicit sense of control (sense of agency; SoA) differs across AN patients, recovered AN (RAN) patients and healthy controls (HC). Furthermore, we assessed whether state anxiety is influenced by negative emotional states. SoA was measured with the intentional binding task (IB) and state-anxiety levels through a questionnaire. We did not find any evidence of differences in SoA between groups. Furthermore, state anxiety was not a significant predictor of SoA. Further research into SoA in AN should focus on other features of the SoA that are not targeted by the IB task.

New measures of agency from an adaptive sensorimotor task

Self-agency, the sense that one is the author or owner of one’s behaviors, is impaired in multiple psychological and neurological disorders, including functional movement disorders, Parkinson’s Disease, alien hand syndrome, schizophrenia, and dystonia. Existing assessments of self-agency, many of which focus on agency of movement, can be prohibitively time-consuming and often yield ambiguous results. Here, we introduce a short online motion tracking task that quantifies movement agency through both first-order perceptual and second-order metacognitive judgments. The task assesses the degree to which a participant can distinguish between a motion stimulus whose trajectory is influenced by the participant’s cursor movements and a motion stimulus whose trajectory is random. We demonstrate the task’s reliability in healthy participants and discuss how its efficiency, reliability, and ease of online implementation make it a promising new tool for both diagnosing and understanding disorders of agency.

Influence of arousal on intentional binding: Impaired action binding, intact outcome binding

Emotional states have been indicated to affect intentional binding, resulting in an increase or decrease as a function of valence and arousal. Sexual arousal is a complex emotional state proven to impair attentional and perceptual processes, and is therefore highly relevant to feeling in control over one’s actions. We suggest that sexual arousal affects intentional binding in the same way as highly negative arousing states such as fear and anger. Ninety participants performed the intentional binding task before and after watching an either sexually arousing or emotionally neutral film clip. Analyses were conducted for the subcomponents action and outcome binding separately including the change in arousal before and after the emotion induction as a continuous measure. Results showed an interactive effect for time of measurement (before and after emotion induction) and arousal change on action binding: a decrease in action binding was noted in participants who reported to be more aroused and an increase in action binding was observed for participants who reported to be less aroused. Results emphasize that alterations in action binding are likely to reflect the deficits in the dopaminergic system involved in action execution. An impaired feeling of control in aroused states may play a crucial role for the underlying psychological mechanisms of impulsive violent behavior.

Embodied Predictions, Agency, and Psychosis

Psychotic symptoms, i.e., hallucinations and delusions, involve gross departures from conscious apprehension of consensual reality; respectively, perceiving and believing things that, according to same culture peers, do not obtain. In schizophrenia, those experiences are often related to abnormal sense of control over one's own actions, often expressed as a distorted sense of agency (i.e., passivity symptoms). Cognitive and computational neuroscience have furnished an account of these experiences and beliefs in terms of the brain's generative model of the world, which underwrites inferences to the best explanation of current and future states, in order to behave adaptively. Inference then involves a reliability-based trade off of predictions and prediction errors, and psychotic symptoms may arise as departures from this inference process, either an over- or under-weighting of priors relative to prediction errors. Surprisingly, there is empirical evidence in favor of both positions. Relatedly, there is evidence for both an enhanced and a diminished sense of agency in schizophrenia. How can this be? We argue that there is more than one generative model in the brain, and that ego- and allo-centric models operate in tandem. In brief, ego-centric models implement corollary discharge signals that cancel out the effects of self-generated actions while allo-centric models compare several hypothesis regarding the causes of sensory inputs (including the self among the potential causes). The two parallel hierarchies give rise to different levels of agency, with ego-centric models subserving "feelings of agency" and allo-centric predictions giving rise to "judgements of agency." Those two components are weighted according to their reliability and combined, generating a higher-level "sense of agency." We suggest that in schizophrenia a failure of corollary discharges to suppress self-generated inputs results in the absence of a "feeling of agency" and in a compensatory enhancement of allo-centric priors, which might underlie hallucinations, delusions of control but also, under certain circumstances, the enhancement of "judgments of agency." We discuss the consequences of such a model, and potential courses of action that could lead to its falsification.

Dopamine and sense of agency: Determinants in personality and substance use

Sense of agency refers to the feeling of control over one's own actions. The strength of this sense varies inter-individually. This means that people differ in their perception concerning the intensity of their intentions and actions. The current study aims to determine the factors influencing this sense of agency on a personality level. Furthermore, it gives insight into the correlative relation between the strength of the sense of agency and substance use. The study involved 210 participants who were tested for the experiment (intentional binding paradigm for sense of agency, hand paradigm for intentionality bias, questionnaires FAD-Plus, NI-20, substance use). Significant determinants in personality were narcissism (vulnerable subtype) and substance use (consumption in general beyond cannabis, and particularly for the substances cannabis, ecstasy, and cocaine). Both personality types were associated with a weaker sense of agency compared to controls. For both results, alterations in the dopaminergic system need to be discussed. The present results confirm prior hypotheses that dopamine seems to play a crucial role in perception of agency. Possibly a higher accessibility of dopamine increases sense of agency (hyper-binding), whereas a lower accessibility of dopamine decreases sense of agency (hypo-binding). A second aim of the study was to see whether there is a connection between sense of agency and intentionality bias. The perception of intention in others differs widely; some people tend to see arbitrary or accidental actions as unintentional, and others quickly label actions as 'intentional' although the information is not distinct for a categorization. This cognitive error is called intentionality bias. Results could not confirm a relationship between the two constructs-one's own intention and judging intention in others. This may be due to a lack of connection between the two constructs or to methodological aspects. Further directions and limitations are discussed.

Hallucinations and Strong Priors

Hallucinations, perceptions in the absence of objectively identifiable stimuli, illustrate the constructive nature of perception. Here, we highlight the role of prior beliefs as a critical elicitor of hallucinations. Recent empirical work from independent laboratories shows strong, overly precise priors can engender hallucinations in healthy subjects and that individuals who hallucinate in the real world are more susceptible to these laboratory phenomena. We consider these observations in light of work demonstrating apparently weak, or imprecise, priors in psychosis. Appreciating the interactions within and between hierarchies of inference can reconcile this apparent disconnect. Data from neural networks, human behavior, and neuroimaging support this contention. This work underlines the continuum from normal to aberrant perception, encouraging a more empathic approach to clinical hallucinations.

Insight and Dissociation in Lucid Dreaming and Psychosis

Dreams and psychosis share several important features regarding symptoms and underlying neurobiology, which is helpful in constructing a testable model of, for example, schizophrenia and delirium. The purpose of the present communication is to discuss two major concepts in dreaming and psychosis that have received much attention in the recent literature: insight and dissociation. Both phenomena are considered functions of higher order consciousness because they involve metacognition in the form of reflective thought and attempted control of negative emotional impact. Insight in dreams is a core criterion for lucid dreams. Lucid dreams are usually accompanied by attempts to control the dream plot and dissociative elements akin to depersonalization and derealization. These concepts are also relevant in psychotic illness. Whereas insightfulness can be considered innocuous in lucid dreaming and even advantageous in psychosis, the concept of dissociation is still unresolved. The present review compares correlates and functions of insight and dissociation in lucid dreaming and psychosis. This is helpful in understanding the two concepts with regard to psychological function as well as neurophysiology.

The varieties of inner speech questionnaire - Revised (VISQ-R): Replicating and refining links between inner speech and psychopathology

Inner speech is a common experience for many but hard to measure empirically. The Varieties of Inner Speech Questionnaire (VISQ) has been used to link everyday phenomenology of inner speech - such as inner dialogue - to various psychopathological traits. However, positive and supportive aspects of inner speech have not always been captured. This study presents a revised version of the scale - the VISQ-R - based on factor analyses in two large samples: respondents to a survey on inner speech and reading (N = 1412) and a sample of university students (N = 377). Exploratory factor analysis indicated a five-factor structure including three previous subscales (dialogic, condensed, and other people in inner speech), an evaluative/critical factor, and a new positive/regulatory factor. Confirmatory factor analysis then replicated this structure in sample 2. Hierarchical regression analyses also replicated a number of relations between inner speech, hallucination-proneness, anxiety, depression, self-esteem, and dissociation.

A Developmental Perspective on Social-Cognition Difficulties in Youth at Clinical High Risk for Psychosis

After participating in this activity, learners should be better able to:• Evaluate the evolution of social cognitive abilities as a developmental process• Assess the evidence regarding social cognition difficulties in youth at clinical high risk for psychosisIndividuals at clinical high risk (CHR) for psychosis exhibit a broad range of difficulties, including impaired social cognition, which may represent a target for early identification and intervention. Several studies have examined various domains of social cognition in CHR individuals. Most focus on adolescent and young adult populations, but given the accumulating evidence that impairment exists before the onset of psychotic disorders, it is critically important to begin to look for these risk markers in younger children. The present article reviews 25 studies on CHR that examine any of the following four domains of social cognition: emotion processing, theory of mind, social perception, or attribution bias. Eligible studies were identified through a comprehensive literature search, conducted using electronic databases, including PubMed/MEDLINE and PsycINFO, and combinations of key social-cognition and CHR search terms. Despite some mixed results, the existing literature establishes that CHR individuals display social-cognitive impairment, though it remains unclear as to how and when that impairment develops. Thus, by using the literature on social cognition in typically developing children as a model and reference, and by looking at the evolution of social-cognitive abilities as a developmental process, our review presents a valuable new perspective that indicates the necessity of further investigation in younger, at-risk populations. Implications for treatment and future research are discussed.

Know thy agency in predictive coding: Meta-monitoring over forward modeling

Though the computation of agency is thought to be based on prediction error, it is important for us to grasp our own reliability of that detected error. Here, the current study shows that we have a meta-monitoring ability over our own forward model, where the accuracy of motor prediction and therefore of the felt agency are implicitly evaluated. Healthy participants (N=105) conducted a simple motor control task and SELF or OTHER visual feedback was given. The relationship between the accuracy and confidence in a mismatch detection task and in a self-other attribution task was examined. The results suggest an accuracy-confidence correlation in both tasks, indicating our meta-monitoring ability over such decisions. Furthermore, a statistically identified group with low accuracy and low confidence was characterized as higher schizotypal people. Finally, what we can know about our own forward model and how we can know it is discussed.

Self is "other", other is "self": poor self-other discriminability explains schizotypal twisted agency judgment

Anomalous agency has been reported clinically and empirically for people with schizophrenia. This finding is expected to contribute to understanding positive symptomatology in schizophrenia in terms of a general neurocomputational model of motor control, because anomalous agency has also been reported in schizotypal traits in the general population. However, superficially opposite conclusions have been suggested: over-attributed or under-attributed agency in patients. In this work, healthy participants (N=104) were presented continuous morphed self-other visual feedback of their reaching movements and rated the agency they felt for it. The slope of the regression line in stimuli-response coordination as a function of self-other discriminability was estimated for each participant. The estimated slopes were significantly associated with positive schizotypal symptomatology. Higher schizotypal participants exhibited a lower slope, indicating poorer discriminability between their own and others' movements. Furthermore, the estimated regression lines in the high and low groups are predicted to cross at the approximately center point in the coordinates, which should produce both over-attribution and under-attribution errors for the high group compared with low group. The pattern of schizotypal attribution error depends on the S/N (signal-to-noise) ratio of the given stimuli within our sensorimotor system where the self-originated stimulus is the signal to be detected. The current study, for the first time, suggests both over- and under-attribution within participants scoring high on schizotypy.

Prediction error, ketamine and psychosis: An updated model

In 2007, we proposed an explanation of delusion formation as aberrant prediction error-driven associative learning. Further, we argued that the NMDA receptor antagonist ketamine provided a good model for this process. Subsequently, we validated the model in patients with psychosis, relating aberrant prediction error signals to delusion severity. During the ensuing period, we have developed these ideas, drawing on the simple principle that brains build a model of the world and refine it by minimising prediction errors, as well as using it to guide perceptual inferences. While previously we focused on the prediction error signal per se, an updated view takes into account its precision, as well as the precision of prior expectations. With this expanded perspective, we see several possible routes to psychotic symptoms - which may explain the heterogeneity of psychotic illness, as well as the fact that other drugs, with different pharmacological actions, can produce psychotomimetic effects. In this article, we review the basic principles of this model and highlight specific ways in which prediction errors can be perturbed, in particular considering the reliability and uncertainty of predictions. The expanded model explains hallucinations as perturbations of the uncertainty mediated balance between expectation and prediction error. Here, expectations dominate and create perceptions by suppressing or ignoring actual inputs. Negative symptoms may arise due to poor reliability of predictions in service of action. By mapping from biology to belief and perception, the account proffers new explanations of psychosis. However, challenges remain. We attempt to address some of these concerns and suggest future directions, incorporating other symptoms into the model, building towards better understanding of psychosis.

Understanding schizophrenia as a disorder of consciousness: biological correlates and translational implications from quantum theory perspectives

From neurophenomenological perspectives, schizophrenia has been conceptualized as "a disorder with heterogeneous manifestations that can be integrally understood to involve fundamental perturbations in consciousness". While these theoretical constructs based on consciousness facilitate understanding the 'gestalt' of schizophrenia, systematic research to unravel translational implications of these models is warranted. To address this, one needs to begin with exploration of plausible biological underpinnings of "perturbed consciousness" in schizophrenia. In this context, an attractive proposition to understand the biology of consciousness is "the orchestrated object reduction (Orch-OR) theory" which invokes quantum processes in the microtubules of neurons. The Orch-OR model is particularly important for understanding schizophrenia especially due to the shared 'scaffold' of microtubules. The initial sections of this review focus on the compelling evidence to support the view that "schizophrenia is a disorder of consciousness" through critical summary of the studies that have demonstrated self-abnormalities, aberrant time perception as well as dysfunctional intentional binding in this disorder. Subsequently, these findings are linked with 'Orch-OR theory' through the research evidence for aberrant neural oscillations as well as microtubule abnormalities observed in schizophrenia. Further sections emphasize the applicability and translational implications of Orch-OR theory in the context of schizophrenia and elucidate the relevance of quantum biology to understand the origins of this puzzling disorder as "fundamental disturbances in consciousness".

Subanesthetic ketamine treatment promotes abnormal interactions between neural subsystems and alters the properties of functional brain networks

Acute treatment with subanesthetic ketamine, a non-competitive N-methyl-D-aspartic acid (NMDA) receptor antagonist, is widely utilized as a translational model for schizophrenia. However, how acute NMDA receptor blockade impacts on brain functioning at a systems level, to elicit translationally relevant symptomatology and behavioral deficits, has not yet been determined. Here, for the first time, we apply established and recently validated topological measures from network science to brain imaging data gained from ketamine-treated mice to elucidate how acute NMDA receptor blockade impacts on the properties of functional brain networks. We show that the effects of acute ketamine treatment on the global properties of these networks are divergent from those widely reported in schizophrenia. Where acute NMDA receptor blockade promotes hyperconnectivity in functional brain networks, pronounced dysconnectivity is found in schizophrenia. We also show that acute ketamine treatment increases the connectivity and importance of prefrontal and thalamic brain regions in brain networks, a finding also divergent to alterations seen in schizophrenia. In addition, we characterize how ketamine impacts on bipartite functional interactions between neural subsystems. A key feature includes the enhancement of prefrontal cortex (PFC)-neuromodulatory subsystem connectivity in ketamine-treated animals, a finding consistent with the known effects of ketamine on PFC neurotransmitter levels. Overall, our data suggest that, at a systems level, acute ketamine-induced alterations in brain network connectivity do not parallel those seen in chronic schizophrenia. Hence, the mechanisms through which acute ketamine treatment induces translationally relevant symptomatology may differ from those in chronic schizophrenia. Future effort should therefore be dedicated to resolve the conflicting observations between this putative translational model and schizophrenia.

The crisis of minimal self-awareness in schizophrenia: a meta-analytic review

Disturbances of the minimal self, characterized by abnormal sense of the body, body ownership and agency have been proposed as the phenomenological phenotype of schizophrenia. However, self-disturbances have not been extensively investigated, in part, due to the subjective nature of such processes, and the associated difficulty of studying these phenomena using empirical methodology. Of 115 potential studies on self-awareness in schizophrenia, a total of 25 studies met the inclusion criteria for the meta-analysis comprising 690 patients with schizophrenia and 979 healthy controls. We calculated Hedge's g to obtain a better estimate for the standardized mean difference in small samples. We identified significant basic self-disturbance in schizophrenia, as compared with healthy controls (25 studies, effect size=0.51). Additional comparison of three sub-categories of the sense of body ownership (4 studies, effect size=0.91), the sense of agency (15 studies, effect size=0.49), and self-reported subjective experiences (6 studies, effect size=0.57) also confirmed group differences. The complete set of 25 studies, and the studies in the sub-categories showed the statistical homogeneity of the characteristics. After a correction for potential publication bias using the trim-and-fill method, the main findings for all studies combined remained significant. Overall, patients with schizophrenia showed deficits in the sense of the minimal self, driven by abnormal sense of body ownership and sense of agency. Interestingly, the disturbed sense of agency in schizophrenia suggests an exaggerated self-consciousness rather than a diminished sense of self. Further research that utilizes sophisticated study designs is needed to examine the nature of self-disturbances in schizophrenia.

Reduced sense of agency in chronic schizophrenia with predominant negative symptoms

Self-disturbances in schizophrenia have been regarded as a fundamental vulnerability marker for this disease, and have begun to be studied from the standpoint of an abnormal "sense of agency (SoA)" in cognitive neuroscience. To clarify the nature of aberrant SoA in schizophrenia, it needs to be investigated in various clinical subtypes and stages. The residual type of chronic schizophrenia with predominant negative symptoms (NS) has never been investigated for SoA. Accordingly, we investigated SoA by an original agency attribution task in NS-predominant schizophrenia, and evaluated the dynamic interplay between the predictive and postdictive components of SoA in the optimal cue integration framework. We studied 20 patients with NS-predominant schizophrenia, and compared with 30 patients with paranoid-type schizophrenia and 35 normal volunteers. NS-predominant schizophrenia showed markedly diminished SoA compared to normal controls and paranoid-type schizophrenia, indicating a completely opposite direction in agency attribution compared with excessive SoA demonstrated in paranoid-type schizophrenia. Reduced SoA was detected in experimental studies of schizophrenia for the first time. According to the optimal cue integration framework, these results indicate that there was no increase in compensatory contributions of the postdictive processes despite the existence of inadequate predictions, contrary to the exaggerated postdictive component in paranoid-type schizophrenia.

Impaired Representation of Time in Schizophrenia Is Linked to Positive Symptoms and Cognitive Demand

Time processing critically relies on the mesencephalic dopamine system and striato-prefrontal projections and has thus been suggested to play a key role in schizophrenia. Previous studies have provided evidence for an acceleration of the internal clock in schizophrenia that may be linked to dopaminergic pathology. The present study aimed to assess the relationship between altered time processing in schizophrenia and symptom manifestation in 22 patients and 22 controls. Subjects were required to estimate the time needed for a visual stimulus to complete a horizontal movement towards a target position on trials of varying cognitive demand. It was hypothesized that patients – compared to controls – would be less accurate at estimating the movement time, and that this effect would be modulated by symptom manifestation and task difficulty. In line with the notion of an accelerated internal clock due to dopaminergic dysregulation, particularly patients with severe positive symptoms were expected to underestimate movement time. However, if altered time perception in schizophrenia was better explained in terms of cognitive deficits, patients with severe negative symptoms should be specifically impaired, while generally, task performance should correlate with measures of processing speed and cognitive flexibility. Patients underestimated movement time on more demanding trials, although there was no link to disease-related cognitive dysfunction. Task performance was modulated by symptom manifestation. Impaired estimation of movement time was significantly correlated with PANSS positive symptom scores, with higher positive symptom scores associated with stronger underestimation of movement time. The present data thus support the notion of a deficit in anticipatory and predictive mechanisms in schizophrenia that is modulated both by symptom manifestation and by cognitive demand.

Why must we attribute our own action to ourselves? Auditory hallucination like-experiences as the results both from the explicit self-other attribution and implicit regulation in speech

The sense of agency, which is the awareness that "I am the one who causes action," is important in understanding passive schizophrenic symptoms and bodily self-consciousness. However, this potential linkage between subjective self-other attribution (explicit agency) and automatic self-monitoring of an action (implicit agency) has not been examined fully. The present study included two experiments conducted with the same group of healthy participants (N=48) in order to examine explicit (Exp. 1) and implicit (Exp. 2) measures of the sense of agency in speech. Exp. 1 suggested that participants who tend not to attribute a fed-back voice to themselves (the other-attribution group) might have a stronger tendency toward auditory hallucinations, as measured by the Auditory Hallucination Experience Scale 17 (AHES-17). Furthermore, the results of Exp. 2 suggested that this other-attribution group might not utilize auditory feedback during speech production, indicating the expected link between explicit and implicit agency. These results are discussed in relation to the sense-of-agency model, wherein people are understood to construct the online "self" monitoring of action.

The experience of agency: an interplay between prediction and postdiction

The experience of agency, i.e., the registration that I am the initiator of my actions, is a basic and constant underpinning of our interaction with the world. Whereas several accounts have underlined predictive processes as the central mechanism (e.g., the comparator model by C. Frith), others emphasized postdictive inferences (e.g., post-hoc inference account by D. Wegner). Based on increasing evidence that both predictive and postdictive processes contribute to the experience of agency, we here present a unifying but at the same time parsimonious approach that reconciles these accounts: predictive and postdictive processes are both integrated by the brain according to the principles of optimal cue integration. According to this framework, predictive and postdictive processes each serve as authorship cues that are continuously integrated and weighted depending on their availability and reliability in a given situation. Both sensorimotor and cognitive signals can serve as predictive cues (e.g., internal predictions based on an efferency copy of the motor command or cognitive anticipations based on priming). Similarly, other sensorimotor and cognitive cues can each serve as post-hoc cues (e.g., visual feedback of the action or the affective valence of the action outcome). Integration and weighting of these cues might not only differ between contexts and individuals, but also between different subject and disease groups. For example, schizophrenia patients with delusions of influence seem to rely less on (probably imprecise) predictive motor signals of the action and more on post-hoc action cues like e.g., visual feedback and, possibly, the affective valence of the action outcome. Thus, the framework of optimal cue integration offers a promising approach that directly stimulates a wide range of experimentally testable hypotheses on agency processing in different subject groups.

It's not my fault: postdictive modulation of intentional binding by monetary gains and losses

Sense of agency refers to the feeling that one’s voluntary actions caused external events. Past studies have shown that compression of the subjective temporal interval between actions and external events, called intentional binding, is closely linked to the experience of agency. Current theories postulate that the experience of agency is constructed via predictive and postdictive pathways. One remaining problem is the source of human causality bias; people often make misjudgments on the causality of voluntary actions and external events depending on their rewarding or punishing outcomes. Although human causality bias implies that sense of agency can be modified by post-action information, convincing empirical findings for this issue are lacking. Here, we hypothesized that sense of agency would be modified by affective valences of action outcomes. To examine this issue, we investigated how rewarding and punishing outcomes following voluntary action modulate behavioral measures of agency using intentional binding paradigm and classical conditioning procedures. In the acquisition phase, auditory stimuli were paired with positive, neutral or negative monetary outcomes. Tone-reward associations were evaluated using reaction times and preference ratings. In the experimental session, participants performed a variant of intentional binding task, where participants made timing judgments for onsets of actions and sensory outcomes while playing simple slot games. Our results showed that temporal binding was modified by affective valences of action outcomes. Specifically, intentional binding was attenuated when negative outcome occurred, consistent with self-serving bias. Our study not only provides evidence for postdictive modification of agency, but also proposes a possible mechanism of human causality bias.

Activating memories of depression alters the experience of voluntary action

The sense of agency is a profoundly important human experience and is strongly linked to volitional action. The importance of this experience is underscored by the fact that many neurological and psychiatric disorders are partially characterized by an abnormal sense of agency (e.g., schizophrenia, anxiety disorders, depression). Healthy participants perceive the temporal interval between a voluntary action and its effect to be shorter than it actually is, and this illusion has been suggested as an implicit index of agency. Here, we investigated whether activating memories of depression alters perception of this action-effect interval, compared to activating memories of the previous day, or a baseline condition in which specific memories were not activated. Results showed that action-effect interval estimates were significantly longer after remembering a depressing episode than after remembering the previous day, or in the baseline condition. Thus, activating memories of depression alters the experience of voluntary actions and effects. We suggest that interval estimation measures could be useful in clinical settings, to implicitly assess the sense of agency in patients with disorders affecting their sense of control. In this way, obtaining action-effect interval estimates, pre-, during, and post-treatment, could aid in tracking treatment-induced changes in the sense of agency.

Time, action and psychosis: using subjective time to investigate the effects of ketamine on sense of agency

Sense of agency refers to the experience of initiating and controlling actions in order to influence events in the outside world. A disturbed sense of agency is found in certain psychiatric and neurological disorders, most notably schizophrenia. Sense of agency is associated with a subjective compression of time: actions and their outcomes are perceived as bound together in time. This is known as 'intentional binding' and, in healthy adults, depends partly on advance prediction of action outcomes. Notably, this predictive contribution is disrupted in patients with schizophrenia. In the present study we aimed to characterise the psychotomimetic effect of ketamine, a drug model for psychosis, on the predictive contribution to intentional binding. It was shown that ketamine produced a disruption that closely resembled previous data from patients in the early, prodromal, stage of schizophrenic illness. These results are discussed in terms of established models of delusion formation in schizophrenia. The link between time and agency, more generally, is also considered.

Aberrant sense of agency in patients with schizophrenia: forward and backward over-attribution of temporal causality during intentional action

Self-disturbances in schizophrenia have been explained and studied from the standpoint of an abnormal sense of agency. We devised an agency-attribution task that evaluated explicit experiences of the temporal causal relations between an intentional action and an external event, without any confounding from sense of ownership of body movement. In each trial, a square piece appeared on the bottom of a computer screen and moved upward. Subjects were instructed to press a key when they heard a beep. When the key was pressed, the piece jumped with various temporal biases. Subjects were instructed to make an agency judgment for each trial. We demonstrated that an excessive sense of agency was observed in patients with schizophrenia compared with normal controls. Moreover, patient groups had a greater tendency to feel a sense of agency even when external events were programmed to precede their action. Therefore, patients felt both forward and backward exaggerated causal efficacy in the temporal event sequence during the intentional action. Confusion in the experience of temporal causal relations between the self and the external world may underlie self-disturbances in schizophrenia.

Motor agency: a new and highly sensitive measure to reveal agency disturbances in early psychosis

Background

Early diagnosis of young adults at risk of schizophrenia is essential for preventive approaches of the illness. Nevertheless, classic screening instruments are difficult to use because of the non-specific nature of the signs at this pre-onset phase of illness. The objective of the present contribution was to propose an innovating test that can probe the more specific symptom of psychosis, i.e., the sense of agency, which is defined as being the immediate experience of oneself as the cause of an action. More specifically, we tested whether motor agency is abnormal in early psychosis.

Methods

Thirty-two young symptomatic patients and their age-matched controls participated in the study. 15 of these patients were at ultra high-risk for developing psychosis (UHR), and 17 patients were suffering from first-episode psychosis (FEP). Patients' neurocognitive capacities were assessed through the use of seven neuropsychological tests. A motor agency task was also introduced to obtain an objective indicator of the degree of sense of agency, by contrasting force levels applied during other and self-produced collisions between a hand-held objet and a pendulum.

Results

As reported in the literature for adult controls, healthy adolescents used more efficient force levels in self than in other-imposed collisions. For both UHR and FEP patients, abnormally high levels of grip force were used for self-produced collisions, leading to an absence of difference between self and other. The normalized results revealed that motor agency differentiated patients from controls with a higher level of sensitivity than the more classic neuropsychological test battery.

Conclusions

This study is in favour of the existence of an abnormal sense of agency early in the psychotic illness. Because it is quick and none verbal, motor agency may be a valuable tool to use in complement to classic interviews, especially when investigating complex ineffable experiences that are difficult to explicitly describe.

An interoceptive predictive coding model of conscious presence

We describe a theoretical model of the neurocognitive mechanisms underlying conscious presence and its disturbances. The model is based on interoceptive prediction error and is informed by predictive models of agency, general models of hierarchical predictive coding and dopaminergic signaling in cortex, the role of the anterior insular cortex (AIC) in interoception and emotion, and cognitive neuroscience evidence from studies of virtual reality and of psychiatric disorders of presence, specifically depersonalization/derealization disorder. The model associates presence with successful suppression by top-down predictions of informative interoceptive signals evoked by autonomic control signals and, indirectly, by visceral responses to afferent sensory signals. The model connects presence to agency by allowing that predicted interoceptive signals will depend on whether afferent sensory signals are determined, by a parallel predictive-coding mechanism, to be self-generated or externally caused. Anatomically, we identify the AIC as the likely locus of key neural comparator mechanisms. Our model integrates a broad range of previously disparate evidence, makes predictions for conjoint manipulations of agency and presence, offers a new view of emotion as interoceptive inference, and represents a step toward a mechanistic account of a fundamental phenomenological property of consciousness.