Elsevier

Schizophrenia Research

Volume 179, January 2017, Pages 8-12
Schizophrenia Research

The spatial self in schizophrenia and autism spectrum disorder

https://doi.org/10.1016/j.schres.2016.09.021Get rights and content

Abstract

Schizophrenia (SZ) and autism spectrum disorder (ASD) have been both described as disorders of the self. However, the manner in which the sense of self is impacted in these disorders is strikingly different. In the current review, we propose that SZ and ASD lay at opposite extremes of a particular component of the representation of self; namely, self-location and the construct of peripersonal space. We evaluate emerging literature suggesting that while SZ individuals possess an extremely weak or variable bodily boundary between self and other, ASD patients possess a sharper self-other boundary. Furthermore, based on recent behavioral and neural network modeling findings, we propose that multisensory training focused on either sharpening (for SZ) or making shallower (for ASD) the self-other boundary may hold promise as an interventional tool in the treatment of these disorders.

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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    1

    These authors contributed equally to the work.

    2

    These authors contributed equally to the work.

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