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Schizophrenia Bulletin Advance Access published online on August 27, 2008
Schizophrenia Bulletin, doi:10.1093/schbul/sbn112
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© The Author 2008. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

First-Rank Symptoms in Schizophrenia: Reexamining Mechanisms of Self-recognition

Flavie A.V. Waters* and Johanna C. Badcock
Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, Australia
School of Psychiatry and Clinical Neurosciences, The University of Western Australia, Perth

* Corresponding author: Dr Flavie Waters, Centre for Clinical Research in Neuropsychiatry, Graylands Hospital, Mail Bag No 1, Claremont, Perth, 6910, Australia. tel: +61 8 9347 6429, fax: +61 8 9384 5128 (Flavie{at}ccrn.uwa.edu.au)

Disturbances of self are a common feature of schizophrenic psychopathology, with patients reporting that their thoughts and actions are controlled by external forces, as shown in first-rank symptoms (FRS). One widely accepted explanatory model of FRS suggests a deficiency in the internal forward model system. Recent studies in the field of cognitive sciences, however, have generated new insights into how complex sensory and motor systems contribute to the sense of self-recognition, and it is becoming clear that the forward model conceptualization does not have unique access to representations about the self. We briefly evaluate the forward model explanation of FRS, reassess the distinction made between the sense of agency and body ownership, and outline recent developments in 4 domains of sensory-motor control that have supplemented our understanding of the processes underlying the sense of self-recognition. The application of these findings to FRS will open up new research directions into the processes underlying these symptoms.

Keywords: psychosis / self / agency / body ownership / internal forward model / sensory-motor


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