Impaired sense of agency and associated confidence in psychosis

Amit Regev Krugwasser, Yonatan Stern, Nathan Faivre, Eiran Vadim Harel, Roy Salomon

Research output: Contribution to journalArticlepeer-review

Abstract

The Sense of Agency (SoA), our sensation of control over our actions, is a fundamental mechanism for delineating the Self from the environment and others. SoA arises from implicit processing of sensorimotor signals as well as explicit higher-level judgments. Psychosis patients suffer from difficulties in the sense of control over their actions and accurate demarcation of the Self. Moreover, it is unclear if they have metacognitive insight into their aberrant abilities. In this pre-registered study, we examined SoA and its associated confidence judgments using an embodied virtual reality paradigm in psychosis patients and controls. Our results show that psychosis patients not only have a severely reduced ability for discriminating their actions but they also do not show proper metacognitive insight into this deficit. Furthermore, an exploratory analysis revealed that the SoA capacities allow for high levels of accuracy in clinical classification of psychosis. These results indicate that SoA and its metacognition are core aspects of the psychotic state and provide possible venues for understanding the underlying mechanisms of psychosis, that may be leveraged for novel clinical purposes.

Original languageEnglish
Article number32
JournalSchizophrenia
Volume8
Issue number1
DOIs
StatePublished - 2 Apr 2022
Externally publishedYes

Bibliographical note

Funding Information:
We would like to thank Viktoria Vul for her help in collecting the data and Yair Zvilichovsky for developing the software used to run the experiment. We would also like to thank the patients for taking part in the experiment. Y.S. was generously supported by an Azrieli graduate studies fellowship. This study was supported by Israeli Science Foundation Grant (#1169/17) and a National Institute for Psychobiology in Israel grant to R.S.

Publisher Copyright:
© 2022, The Author(s).

ASJC Scopus subject areas

  • Psychiatry and Mental health

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