Elsevier

Schizophrenia Research

Volume 197, July 2018, Pages 98-103
Schizophrenia Research

Delusions of control in schizophrenia: Resistant to the mind's best trick?

https://doi.org/10.1016/j.schres.2017.11.032Get rights and content

Abstract

The existence of a free will is fiercely debated in neuroscience and philosophy. The debate has great impact on society and our self-understanding as human beings. Behavioral and electrophysiological data have challenged the intuitive assumption that human behavior is the result of conscious intentions. This notion has important implications for delusions of control in schizophrenia, where patients experience bodily movements as not being controlled by themselves. Current theories explain control delusions as a deficit to perceive certain aspects of motor control, but many findings are inconsistent with this idea. Here, an alternative view is proposed: Control delusions might be triggered by an even more veridical perception of the temporal order of intentions and actions. This hypothesis is supported by evidence that (a) conscious intentions in healthy subjects are often based on retrospective inferences, (b) temporal recalibrations of conscious percepts occur in healthy subjects and are disturbed in schizophrenia and (c) basic perceptual functions of schizophrenic patients are less influenced by expectations and therefore they can sometimes be closer to physical reality than those of healthy subjects.

Section snippets

The temporal order of intention and action

When we observe someone reaching out for a pencil, we assume that he must have wanted it. When we see someone crying, we infer that she must be sad. When someone helps us without expecting a reward, we are likely to conclude that this person is inherently helpful. For all the actions and behaviors we observe in other people, we infer the existence of corresponding intentions or emotional states which have caused these actions. Influential theories like the self-perception theory (Bem, 1972) and

Delusions of control in schizophrenia

The notion that actions might not be preceded by corresponding intentions bears a striking resemblance to delusions of control, which are frequently reported by patients suffering from schizophrenia (Frith, 2005, Graham et al., 2014). These symptoms, also known as passivity delusions, denote the feeling that one's actions or thoughts are controlled by external forces. In contrast to other symptoms of impaired motor control, such as the alien hand sign, the experience of control delusions does

Temporal back-referral of conscious percepts

In recent years, a great deal of evidence confirmed that the perceived time of sensory events can deviate from their actual occurrence (Bechlivanidis and Lagnado, 2016, Fujisaki et al., 2004, Rohde and Ernst, 2016, Stetson et al., 2006). These perceptual shifts in time highly depend on prior expectations of sensory events and retrospective inferences regarding their causes (Dennett and Kinsbourne, 1992, Moore and Haggard, 2008, Voss et al., 2010). Stetson et al. (2006) presented brief light

Perceptual deficits in schizophrenia

The idea that schizophrenic patients – on a basic perceptual level – perceive some aspects of the world more accurately than healthy controls has been confirmed in many studies (Dima et al., 2009, Notredame et al., 2014, Silverstein and Keane, 2011, Tadin et al., 2006, White et al., 2014). In the healthy brain, external stimuli are not directly translated into conscious percepts. Instead, they are preprocessed according to expectations and prior experiences. A large part of the sensory input

Explanatory value and limitations

The previous considerations referred to very basic bodily movements like lifting a finger, but some schizophrenic patients also report the experience of being forced into more complex behaviors. To determine the scope of the proposed model, it is therefore necessary to distinguish between basic bodily movements, which can be initiated and performed almost without cognitive monitoring (e.g., putting forth one's hand to grasp a cup), and complex, sometimes long-lasting behaviors, which involve

Concluding remarks

Schizophrenia is a severe disorder affecting many aspects of cognition. The hypothesis that delusions of control result from a more veridical rather than an impaired perception is in line with many observations of a reduced susceptibility to perceptual illusions (Notredame et al., 2014) and with the finding of a distorted mechanism for illusory perceptual shifts in time (Voss et al., 2010). Furthermore, it is supported by accumulating evidence contradicting the perceived causal relation between

Conflict of interest

The author Martin Riemer declares no conflict of interest.

Role of the funding source

No funding source was involved.

Acknowledgement

No acknowledgements are made.

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