A Delusion of Control - What happens to a sense of Agency in Schizophrenic patients?
The sense of agency is known to be disrupted in Schizophrenia. This article explores the transition from the comparator model to the two-step model of agency, in order to review the paper ‘In and out of control: brain mechanisms linking fluency of action selection to self-agency in patients with Schizophrenia’1. A sense of agency involves using retrospective cues to make causal inferences, but this paper also introduces a new, prospective aspect. This paper shows that subliminal priming, a prospective cue, increases the reported sense of agency over a subsequent action outcome. It also shows that in schizophrenic patients, retrospective cues had more of an influence on their reported sense of agency, while conversely, prospective cues had less influence. This may reflect a greater reliance on retrospective cues in schizophrenia, which could be one of the underlying factors for some of the delusions seen in schizophrenia. Using fMRI measurements during the task, results suggest that angular gyrus activation reflects the experience of non-agency. In healthy controls, they saw altered connectivity between frontal areas and the angular gyrus associated with priming. In schizophrenic patients, there was no effect of priming on activation of the angular gyrus, or frontoparietal connectivity. In our review, we have introduced a putative schema that suggests that the action selection signals from the frontal lobes into the angular gyrus represent the prospective aspect of agency. This connection is disrupted In schizophrenia, and that may be why prospective agency is impaired.