Social and neurocognitive research suggests that thinking about one’s own thinking and thinking about the thinking of others—termed ‘mindreading’, ‘metacognition’, ‘social cognition’ or ‘mentalizing’ are not identical activities. The ability though to think about thinking in the first person is nevertheless related to the ability to think about other’s thoughts in the third person. Unclear is how these phenomena influence one another. In this review, we explore how self-reflection and autobiographical memory influence the capacity to think about the thoughts and (...) emotions of others. We review studies suggesting that the more individuals are able to reflect on and retrieve episodes from their life narratives, the more they are likely to grasp others’ thoughts and emotions. We discuss evidence supporting this possibility including studies of the neurocognitive bases of empathy and self-awareness and how different aspects of self-reflection may impact on mindreading. We also draw from clinical reports how improved self-reflection may result in a more nuanced mindreading, namely persons suffering from schizophrenia and narcissistic personality disorder. We finally discuss the implications for research and practice and consider whether there are conditions in which the reverse is true, where self-reflection might impair mindreading or in which mindreading may facilitate self-reflection. (shrink)

With ever more detailed models of the neurobiological and social systems out of which schizophrenia is born, it is possible to overlook how suffering persons actually experience their symptoms.This book examines the experiences of persons who suffer from schizophrenia. It provides a highly readable and humane examination of this common condition.

Many with schizophrenia find social interactions a profound and terrifying threat to their sense of self. To better understand this we draw upon dialogical models of the self that suggest that those with schizophrenia have difficulty sustaining dialogues among diverse aspects of self. Because interpersonal exchanges solicit and evoke movement among diverse aspects of self, many with schizophrenia may consequently find those exchanges overwhelming, resulting in despair, the sensation of fusion with another, and/or self-dissolution. In short, compromised dialogical capacities may (...) be a contributing factor to social dysfunction in schizophrenia. (shrink)

Self-reflection plays a key role in healthy human adaptation. Self-reflection might involve different capacities which may be impaired to different degrees relatively independently of one another. Variation in abilities for different forms of self-reflection are commonly seen as key aspects of many adult mental disorders. Yet little has been written about whether there are different kinds of deficits in self-reflection found in mental illness, how those deficits should be distinguished from one another and how to characterize the extent to which (...) they are interrelated. We review clinical and experimental literature and suggest four different forms of deficits in self-reflection: sense of ownership of one’s own thoughts and actions, emotional awareness, distinction between fantasy and reality and the integration of a range of different views of oneself and others. We propose how these different impairments in self-reflection are linked with one another. (shrink)

While many with schizophrenia experience deficits in metacognition it is unclear whether those deficits are related to other features of illness. To explore this issue, the current study classified participants with schizophrenia as possessing a deficit in both awareness of their own emotions and those of others , aware of their own emotions but unaware of the emotions of others and aware of their own emotions and of other’s emotions . Groups were compared on assessments of neurocognitive function, symptoms, and (...) history of sexual trauma. ANCOVA controlling for education found that the group unaware of their own emotions and those of others demonstrated poorer verbal memory, processing speed, executive function, less emotional discomfort and higher levels of disorganization symptoms relative to the other groups. The group aware of their own emotions but not those of others had a significantly higher report of childhood sexual abuse. (shrink)

Awareness of illness in schizophrenia reflects complex storied understanding of the impact of the disorder upon one’s life. Individuals may be aware of their illness in different ways and this may be related to their functioning. A total of 76 adults with schizophrenia were assessed for their awareness of illness, neurocognition, social cognition, and social function concurrently and social function was also assessed at three later time points. A cluster analysis revealed 3 groups: generally full awareness, generally limited awareness, and (...) superficial awareness. Comparisons between these profiles revealed the superficial group had poorer executive function, emotion recognition ability, and capacity for social relationships than the full awareness group, yet had better verbal memory and more social contacts than the limited awareness group. These results suggest assessing the narrative qualities of awareness of illness may reveal unique links with cognition and function, and this may have implications for interventions. (shrink)

Theoretical models of schizophrenia have traditionally emphasized the biological social, and environmental forces that lead to the dysfunction that characterizes this disorder. However important these aspects may be, an understanding of schizophrenia is incomplete without attention to the first-person perspective of those who continue to struggle to find meaning and security in the midst of this disorder. Encouragingly, an interest has grown steadily in recent years in understanding subjective experience in schizophrenia, and can be found within a range of bodies (...) of research, including.. (shrink)

Current research suggests that stressful life experiences and situations create a substantive effect in the development of the initial manifestations of psychotic disorders and may influence temporo-limbic epileptic-like activity manifesting as cognitive and affective seizure-like symptoms in non-epileptic conditions. The current study assessed trauma history, hair cortisol levels, epileptic-like manifestations and other psychopathological symptoms in 56 drug naive adult young women experiencing their initial occurrence of psychosis. Hair cortisol levels among patients experiencing their initial episode of psychosis, were significantly correlated (...) with stress symptoms measured by Trauma Symptom Checklist-40, and complex partial seizure-like symptoms measured by the Complex Partial Seizure-Like Symptoms Inventory and LSCL-33. Hair cortisol levels were not found to be significantly correlated with symptoms of anxiety and depression measured by Beck depression Inventory and Zung Anxiety Scale. These findings suggest a significant relationship between epileptic-like symptoms and stress responses demonstrated by patients in their first psychotic episode. These findings may suggest the potential for research to explore usefulness of anticonvulsant treatment in patients who do not respond to usual psychotropic medication. (shrink)

In our original piece, we suggested that contemporary phenomenological models of schizophrenia such as the ipseity-disturbance model emphasize perceptual and cognitive elements of self-disturbances, potentially neglecting the presence and central importance of painful affect in the experience of schizophrenia. We concluded that integrating affect within developing phenomenological models would offer not only a theoretical advance but also a possible path to more effective recovery-oriented treatment. In response, Phillips agrees there is incontrovertible evidence of painful affect central to the experience of (...) schizophrenia. He expresses concerns though about a danger in falsely reducing.. (shrink)

In general, current biomedical models of schizophrenia focus on distinguishing discrete elements that, on their own or in combination with others, might lead to some form of disability. These different and potentially autonomous aspects of the disorder that might disrupt daily activities include positive and negative symptoms as well as disturbances in neurocognitive and psychobiological processes. Such disturbances include genetic vulnerabilities that increase the risk of abnormalities in brain development, and resultant neurocognitive deficits which interfere with the ability to carry (...) out specific tasks.These approaches to schizophrenia, which have... (shrink)