Defective Relationship Between Subjective Experience and Behavior in Schizophrenia

Danion, Jean-Marie; Gokalsing, Erick; Robert, Philippe; Massin-Krauss, Marilyne; Bacon, Élisabeth

doi:10.1176/appi.ajp.158.12.2064

Cited by 61 publications

(36 citation statements)

References 6 publications

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“…Thus these results support the assumption that schizophrenia patients possess a diminished capacity to metamnestically assess their own cognitive processes [11] . In these previous studies [10,12] , however, the groups were not matched for memory performance.…”

Section: Introductionmentioning

confidence: 97%

Metacognition and Reflexivity in Patients with Schizophrenia

et al. 2007

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Background: Many patients with schizophrenia demonstrate a lack of insight into their disorder and often do not complain about their cognitive impairments. This might be due to generally reduced metacognitive abilities. Sampling and Methods: Twenty-seven patients with a DSM IV diagnosis of schizophrenia and 19 healthy control subjects performed 2 separate tasks tapping into metacognitive functions. In the first experiment the participants encoded words. In the following recognition part they judged their level of subjective confidence in the correctness of their answer. In the second experiment reaction time was measured, whilst judgments were made about personality trait adjectives describing the subjects themselves or other familiar people. Results: Although the recognition rate in the first experiment was equal between the groups, the patients showed a significantly reduced ability to correctly judge their memory performance. There was no correlation between metamemory and psychopathology nor insight measures. The patients further needed significantly more time to characterize themselves compared to the healthy participants. The response rates for self-characterization correlated with the ability to recognize symptoms as part of a disorder but did not correlate with psychopathology. Conclusions: Metacognitive faculties seem to be, at least in part, a separable cognitive entity. Patients with schizophrenia demonstrate impaired metacognitive capacities, independent of current symptoms or memory performance.

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Section: Introductionmentioning

confidence: 97%

Metacognition and Reflexivity in Patients with Schizophrenia

et al. 2007

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“…Spontaneous control of learning seems to be impaired in patients with schizophrenia (references), but procedures based on 'monitoring-affects-control' seem promising, insofar as patients' control abilities may be enhanced in response to monitoring support at the encoding phase. At retrieval, patients' behavior has been shown to be less determined by subjective experience than that of normal subjects (Danion et al, 2001a). Research into memory-related metacognition in patients with schizophrenia provides some rather optimistic data regarding the ability of patients with schizophrenia to improve their memory efficiency.…”

Section: Resultsmentioning

confidence: 99%

“…It has repeatedly been observed that the retrospective confidence judgments for incorrect answers expressed by patients with schizophrenia are higher than those of matched healthy participants (Danion et al, 2001a;Moritz and Woodward, 2006;Moritz et al, 2003;Moritz et al, 2005). In the meantime, the prospective metamemory judgments of patients with schizophrenia are lower than those of healthy participants (Bacon et al, 2001;Bacon et al, 2007;Souchay et al, 2006;Thuaire et al, 2012.…”

Section: Metamemory Monitoring In Patients With Schizophreniamentioning

confidence: 97%

“…However, as patients are subject to a dissociation between thought and action, it could be that they do not follow the output of monitoring (thought) to control their behavior (action) of an ongoing task. This relationship has been explored in studies exploring episodic (Thuaire et al, 2012) and semantic memory (Danion et al, 2001a).…”

Section: When Control Follows Monitoring or The Monitoring-affectscomentioning

confidence: 99%

“…Danion et al (2001a) presented their participants (schizophrenia and healthy participants) with a general knowledge task in which they had to answer under forced-report instructions (i.e., they had to answer each question) and then rate their confidence in the correctness of the response. They were then asked to answer the same question under free-report instructions (i.e., they could refrain from answering some questions), with or without a monetary incentive.…”

Section: When Control Follows Monitoring or The Monitoring-affectscomentioning

confidence: 99%

See 2 more Smart Citations

Memory-Related Metacognition in Patients with Schizophrenia

Bacon¹,

Izaute

2014

Social Cognition and Metacognition in Schizophrenia

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Disruptions of frontoparietal control network and default mode network linking the metacognitive deficits with clinical symptoms in schizophrenia

Jia

Zhu

et al. 2019

Human Brain Mapping

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The metacognitive deficit in awareness of one's own mental states is a core feature of schizophrenia (SZ). The previous studies suggested that the metacognitive deficit associates with clinical symptoms. However, the neural mechanisms underlying the relationship remain largely unknown. We here investigated the neural activities associated with the metacognitive deficit and the neural signatures associated with clinical symptoms in 38 patients with SZ using functional magnetic resonance imaging with a perceptual decision‐making task accompanied with metacognition, in comparison to 38 age, gender, and education matched healthy control subjects. The metacognitive deficit in patients with SZ was associated with reduced regional activity in both the frontoparietal control network (FPCN) and the default mode network. Critically, the anticorrelational balance between the two disrupted networks was substantially altered during metacognition, and the extent of alteration positively scaled with negative symptoms. Conversely, decoupling between the two networks was impaired when metacognitive monitoring was not required, and the strength of excessive neural activity positively scaled with positive symptoms. Thus, disruptions of the FPCN and the default mode network underlie the metacognitive deficit, and alternations of network balance between the two networks correlate with clinical symptoms in SZ. These findings implicate that rebalancing these networks holds important clinical potential in developing more efficacious therapeutic treatments.

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Defective Relationship Between Subjective Experience and Behavior in Schizophrenia

Abstract: Patients were impaired in subjectively assessing the correctness of their knowledge, and their behavior was less determined by subjective experience than that of normal subjects. The patients' intact sensitivity to incentives has implications for cognitive remediation.

Cited by 61 publications

References 6 publications

Metacognition and Reflexivity in Patients with Schizophrenia

Metacognition and Reflexivity in Patients with Schizophrenia

Memory-Related Metacognition in Patients with Schizophrenia

Disruptions of frontoparietal control network and default mode network linking the metacognitive deficits with clinical symptoms in schizophrenia

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