Association of impaired reality processing with psychotic symptoms in schizophrenia

Lee, Jung Suk; Chun, Ji Won; Lee, Sang hoon; Kang, Dong Il; Kim, Jae Jin

doi:10.1016/j.psychres.2013.07.035

Cited by 5 publications

(7 citation statements)

References 35 publications

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“…Consistent with our hypothesis and in agreement with our previous study [ 1 ], we found that patients with schizophrenia were less accurate during reality evaluation than healthy controls, suggesting that patients have deficits in reality evaluation. In addition, patients showed significantly decreased discriminability compared to controls, and this group difference remained significant even after controlling for the RCFT delayed recall scores.…”

Section: Discussionsupporting

confidence: 93%

“…Because the inferior parietal lobule and dorsolateral prefrontal cortex are the brain regions subserving relational reasoning [ 30 ], this finding can be interpreted in terms of reasoning abnormality. During reality evaluation process, subjects should judge the reality of stimuli according to norms of reality [ 1 ], which is closely related to relational reasoning. Our data suggest that anomalous reasoning may contribute to impairment in reality evaluation in schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

“…1 ): (i) a reality evaluation task, and (ii) a recognition task. We used a previously validated set of 36 real and 36 unreal pictures [ 1 ] as stimuli. In the reality evaluation task, 18 real and 18 unreal pictures were presented twice serially and randomly to subjects, who were instructed to click the left mouse button if the picture was perceived as real or the right mouse button if the picture was perceived as unreal.…”

Section: Methodsmentioning

confidence: 99%

“…Reality evaluation is defined as the process of discriminating between things existing outside of oneself and figments of others’ imagination [ 1 ]. Our previous study demonstrated that patients with schizophrenia showed impairment in reality evaluation, and this impairment was related to positive symptoms such as hallucinations and delusions [ 1 ]. Since hallucinations and delusions may stem from a reality evaluation deficit, determining the neural correlates of the reality evaluation process is important for investigating the pathophysiology of schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

“…Given that the level of cognitive insight was correlated with the severity of psychotic symptoms in schizophrenia [ 14 ], anomalous memory processes may underlie the formation of psychotic symptoms. Additionally, a discriminability, accuracy in discriminating targets from distracters, was also found to be related to hallucinations [ 1 ]. This finding suggests that low discriminability may make the real stimuli remain less vividly in memories, leading to distortion of reality norms, which then can contribute to the formation or maintenance of hallucinations and delusions.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Altered Neural Basis of the Reality Processing and Its Relation to Cognitive Insight in Schizophrenia

et al. 2015

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It has been reported that reality evaluation and recognition are impaired in patients with schizophrenia and these impairments are related to the severity of psychotic symptoms. The current study aimed to investigate the neural basis of impairments in reality evaluation and recognition and their relationships with cognitive insight in schizophrenia. During functional magnetic resonance imaging, 20 patients with schizophrenia and 20 healthy controls performed a set of reality evaluation and recognition tasks, in which subjects judged whether scenes in a series of drawings were real or unreal and whether they were familiar or novel. During reality evaluation, patients showed decreased activity in various regions including the inferior parietal lobule, retrosplenial cortex and parahippocampal gyrus, compared with controls. Particularly, parahippocampal gyrus activity was correlated with the severity of positive symptoms in patients. During recognition, patients also exhibited decreased activity in various regions, including the dorsolateral prefrontal cortex, inferior parietal lobule and posterior cingulate cortex. Particularly, inferior parietal lobule activity and posterior cingulate cortex activity were correlated with cognitive insight in patients. These findings provide evidence that neural impairments in reality evaluation and recognition are related to psychotic symptoms. Anomalous appraisal of context by dysfunctions in the context network may contribute to impairments in the reality processing in schizophrenia, and abnormal declarative memory processes may be involved in cognitive insight in patients with schizophrenia.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Altered Neural Basis of the Reality Processing and Its Relation to Cognitive Insight in Schizophrenia

et al. 2015

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Sex differences in the association between childhood adversities and schizotypal personality traits

Toutountzidis

Gale

Irvine

et al. 2018

Psychiatry Research

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Examining the relationships between cognition and auditory hallucinations: A systematic review

Bell,

Toh,

Allen

et al. 2024

Aust N Z J Psychiatry

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Objective: Auditory hallucinations (hearing voices) have been associated with a range of altered cognitive functions, pertaining to signal detection, source-monitoring, memory, inhibition and language processes. Yet, empirical results are inconsistent. Despite this, several theoretical models of auditory hallucinations persist, alongside increasing emphasis on the utility of a multidimensional framework. Thus, clarification of current evidence across the broad scope of proposed mechanisms is warranted. Method: A systematic search of the Web of Science, PubMed and Scopus databases was conducted. Records were screened to confirm the use of an objective behavioural cognitive task, and valid measurement of hallucinations specific to the auditory modality. Results: Auditory hallucinations were primarily associated with difficulties in perceptual decision-making (i.e. reduced sensitivity/accuracy for signal-noise discrimination; liberal responding to ambiguity), source-monitoring (i.e. self–other and temporal context confusion), working memory and language function (i.e. reduced verbal fluency). Mixed or limited support was observed for perceptual feature discrimination, imagery vividness/illusion susceptibility, source-monitoring for stimulus form and spatial context, recognition and recall memory, executive functions (e.g. attention, inhibition), emotion processing and language comprehension/hemispheric organisation. Conclusions: Findings were considered within predictive coding and self-monitoring frameworks. Of concern was the portion of studies which – despite offering auditory-hallucination-specific aims and inferences – employed modality-general measures, and/or diagnostic-based contrasts with psychologically healthy individuals. This review highlights disparities within the literature between theoretical conceptualisations of auditory hallucinations and the body of rigorous empirical evidence supporting such inferences. Future cognitive investigations, beyond the schizophrenia-spectrum, which explicitly define and measure the timeframe and sensory modality of hallucinations, are recommended.

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Association of impaired reality processing with psychotic symptoms in schizophrenia

Cited by 5 publications

References 35 publications

Altered Neural Basis of the Reality Processing and Its Relation to Cognitive Insight in Schizophrenia

Altered Neural Basis of the Reality Processing and Its Relation to Cognitive Insight in Schizophrenia

Sex differences in the association between childhood adversities and schizotypal personality traits

Examining the relationships between cognition and auditory hallucinations: A systematic review

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