The spatial self in schizophrenia and autism spectrum disorder
Section snippets
Schizophrenia and autism spectrum disorder as disturbances in “minimal selfhood”
Schizophrenia (SZ) and autism spectrum disorder (ASD) have long been characterized as disorders of the self (Bleuler, 1911, Kanner, 1943, Nasrallah, 2012). Both disorders are associated with the loss of a coherent sense of self, anomalous self-experience, and the blurring of the distinction between the self and other (Ferri et al., 2012, Parnas et al., 2002, Sass and Parnas, 2003, Hobson and Meyer, 2015). Accordingly, it has been argued that the poor social functioning exhibited by patients
The representation of peripersonal space as a proxy for self-other differentiation
Blanke and Metzinger (2009) put forward that minimal selfhood is composed of a process of self-identification, a first-person perspective, and self-location. The latter component, self-location, is amenable to experimental manipulation, as a number of paradigms have been developed that elicit perceived shifts in the location of a particular limb, or even of the entire body (Blanke et al., 2015). For example, in the Rubber-Hand Illusion (RHI; Botvinick and Cohen, 1998), a visible fake rubber
Schizophrenia as a disorder of self due to a shallow self-other gradient
Clinical reports and empirical studies have highlighted the wide array of body-related neurobiological processing abnormalities that characterizes SZ (Chang and Lenzenweger, 2001, Chang and Lenzenweger, 2005, Murakami et al., 2010, Agorastos et al., 2011, Holt et al., 2015). More recently, it has been suggested that a fragile bodily self-representation may be a core component of the pathology, and that the weaknesses in this representation may be caused by inadequate body-related multisensory
Autism spectrum disorder as a disorder of self due to a steep self-other gradient
In ASD, the most direct examinations of the sharpness differentiating the bodily self and the bodily other come from studies of the RHI, as well as from studies of the more sociological-rooted concept of personal space, which, if “invaded”, causes considerable social distress (Sommer, 1959).
Cascio et al. (2012) report that individuals with ASD do experience the RHI (and thus, demonstrate some malleability in their body representation), but that the susceptibility to this illusion is delayed.
Self-other differentiation as a continuum of peripersonal space representation
As highlighted above, available evidence suggests that both SZ and ASD may be disorders of the self, but may manifest in this domain in opposing ways. Although a detailed delineation of PPS has not been systematically studied in both ASD and SZ, the collective evidence seems to indicate that while individuals with SZ have an anomalously shallow PPS representation characterized by heightened variability, those with ASD seem to exhibit a steeper PPS gradient. To capture these findings, we have
Toward body-centered intervention?
We argue here that the self-other boundary plays an important role in successful social interactions. By extension, interventions designed to improve or ‘normalize’ the PPS boundary may hold therapeutic potential for those living with SZ and ASD. Seminal electrophysiological studies in monkeys (Iriki et al., 1996), as well as behavioral studies in humans (Maravita and Iriki, 2004), have established that the representation of the space around the hand is malleable and can be enlarged after the
Author contributions
Author JPN drafted the manuscript. All authors edited, contributed, and have approved the final manuscript. All authors report no conflict of interest.
Funding
This work was supported in part by NIH CA183492 and HD083211 and by the Simons Foundation Autism Research Initiative and the Wallace Research Foundation. No funding agency influenced any aspect of the current work nor in the decision to publish.
Conflict of interest
All authors report no conflict of interest.
Acknowledgments
This work was supported in part by NIH CA183492 and HD083211 and by the Simons Foundation Autism Research Initiative and the Wallace Research Foundation.
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2022, Schizophrenia ResearchCitation Excerpt :This view is based on the observation that patients with schizophrenia are more prone to experience bodily self-aberrations such as the Rubber Hand Illusion (RHI)2 (Thakkar et al., 2011) and the Pinocchio Illusion (PI)3 (Michael and Park, 2016; Prikken et al., 2019) (but see Shaqiri et al. (2018) for evidence of intact body ownership in SCZ). As a consequence, an initial working model was proposed suggesting that space representations in schizophrenia (SCZ) are characterised by a shallow gradient dividing the PPS and the extrapersonal space (Noel et al., 2017). A shallower demarcation of the PPS is thought be an indicator of reduced self-demarcation (i.e. confusion of boundaries between self and others and permeability of self-world boundaries).
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