In search of the self: On self-disturbances and social cognition in schizophrenia

Abstract

For most patients with schizophrenia it is difficult to sufficiently participate in the community, largely due to deficits in social interaction. The decreased ability to interact with other people and understand them is affected by the way patients perceive themselves. As schizophrenia is seen as a disorder of fundamental self-disturbances, in this thesis a series of empirical studies explore how schizophrenia is related to components that are crucial for making a distinction between oneself and others, hereby focusing on the concepts of body ownership, self-agency, and empathy. The feeling of body-ownership and the feeling of self-agency are considered the most important aspects for basic self-experience and contribute to a feeling of presence and being. Therefore, using a Rubber Hand Illusion paradigm, we provide insight into disturbances in the feeling of body ownership in patients with schizophrenia and in adolescents at increased familial risk to develop the disease. Second, self-agency inferences can result from implicitly associated cues or situations that can unconsciously pre-activate or prime an outcome representation in the agent’s mind. As previous studies found that patients with schizophrenia show specific impairments in these prime-based self-agency inferences, which are particularly important in social behavior, the current thesis provides insight in this topic. Third, as empathic abilities are an important predictor for functional outcome in schizophrenia, our research aims to increase knowledge about its etiology by focusing on the role of the self-reflection network in the brain. Summarizing, this thesis contributes to our understanding of self-disturbances in patients with schizophrenia by using experimental set-ups.