Explaining delusions of control: The comparator model 20 years on

doi:10.1016/j.concog.2011.06.010

Consciousness and Cognition

Volume 21, Issue 1, March 2012, Pages 52-54

https://doi.org/10.1016/j.concog.2011.06.010 Get rights and content

Abstract

Over the last 20 years the comparator model for delusions of control has received considerable support in terms of empirical studies. However, the original version clearly needs to be replaced by a model with a much greater degree of sophistication and specificity. Future developments are likely to involve the specification of the role of dopamine in the model and a generalisation of its explanatory power to the whole range of positive symptoms. However, we will still need to explain why symptoms can be so variable and we still do not understand the origin of the most mysterious symptom of all: thought insertion.

Highlights

► Delusions of control are associated with problems in predicting the consequences of action. ► Similar failures of prediction might explain other positive symptoms of schizophrenia. ► There is a role for dopamine in the response to prediction errors. ► New paradigms are needed so that we can study thoughts as well as actions.

References (20)

E.C. Johnstone et al.
Mechanism of the antipsychotic effect in the treatment of acute schizophrenia
Lancet
(1978)
A. Lindner et al.
Disorders of agency in schizophrenia correlate with an inability to compensate for the sensory consequences of actions
Current Biology
(2005)
R.C. Miall et al.
Forward models for physiological motor control
Neural Networks
(1996)
J.W. Moore et al.
Feelings of control: Contingency determines experience of action
Cognition
(2009)
M. Synofzik et al.
Beyond the comparator model: A multifactorial two-step account of agency
Consciousness and Cognition
(2008)
S.J. Blakemore et al.
The perception of self-produced sensory stimuli in patients with auditory hallucinations and passivity experiences: Evidence for a breakdown in self-monitoring
Psychological Medicine
(2000)
M. Davies et al.
Monothematic delusions: Towards a two-factor account
Philosophy, Psychiatry & Psychology
(2001)
Y. Delevoye-Turrell et al.
A deficit in the adjustment of grip force responses in schizophrenia
Neuroreport
(2002)
I. Feinberg
Efference copy and corollary discharge: Implications for thinking and its disorders
Schizophrenia Bulletin
(1978)
P.C. Fletcher et al.
Perceiving is believing: A Bayesian approach to explaining the positive symptoms of schizophrenia
Nature Reviews Neuroscience
(2009)

There are more references available in the full text version of this article.

Cited by (129)

Disentangling the neural correlates of agency, ownership and multisensory processing
2023, NeuroImage
The experience of the self as an embodied agent in the world is an essential aspect of human consciousness. This experience arises from the feeling of control over one's bodily actions, termed the Sense of Agency, and the feeling that the body belongs to the self, Body Ownership. Despite longstanding philosophical and scientific interest in the relationship between the body and brain, the neural systems involved in Body Ownership and Sense of Agency, and especially their interactions, are not yet understood. In this preregistered study using the Moving Rubber Hand Illusion inside an MR-scanner, we aimed to uncover the relationship between Body Ownership and Sense of Agency in the human brain. Importantly, by using both visuomotor and visuotactile stimulations and measuring online trial-by-trial fluctuations in the illusion magnitude, we were able to disentangle brain systems related to objective sensory stimulation and subjective judgments of the bodily-self. Our results indicate that at both the behavioral and neural levels, Body Ownership and Sense of Agency are strongly interrelated. Multisensory regions in the occipital and fronto-parietal regions encoded convergence of sensory stimulation conditions. The subjective judgments of the bodily-self were related to BOLD fluctuations in the Somatosensory cortex and in regions not activated by the sensory conditions, such as the insular cortex and precuneus. Our results highlight the convergence of multisensory processing in specific neural systems for both Body Ownership and Sense of Agency with partially dissociable regions for subjective judgments in regions of the Default Mode Network.
Delusions and the dilemmas of life: A systematic review and meta-analyses of the global literature on the prevalence of delusional themes in clinical groups
2023, Clinical Psychology Review
We investigated the prevalence of persecutory, grandiose, reference, control, and religious delusions in adult clinical populations worldwide and whether they differed according to country characteristics or age, gender, or year of publication. 123 studies met inclusion criteria, across 30 countries; 102 (115 samples, n = 20,979) were included in the main random-effects meta-analysis of studies measuring multiple delusional themes (21 in a separate analysis of studies in recording a single theme). Persecutory delusions were most common (pooled point estimate: 64.5%, CI = 60.6–68.3, k = 106, followed by reference (39.7%, CI 34.5–45.3, k = 65), grandiose (28.2, CI 24.8–31.9, k = 100), control 21.6%, CI 17.8–26.0, k = 53), and religious delusions 18.3%, CI 15.4–21.6, k = 50). Data from studies recording one theme were broadly consistent with these findings. There were no effects for study quality or publication date. Prevalences were higher in samples exclusively with psychotic patients but did not differ between developed and developing countries, or by country individualism, power distance, or prevalence of atheism. Religious and control delusions were more prevalent in countries with higher income inequality. We hypothesize that these delusional themes reflect universal human dilemmas and existential challenges.
Cognitive load decreases the sense of agency during continuous action
2023, Acta Psychologica
The sense of agency that normally accompanies voluntary actions depends on a combination of sensory predictions and other inferences. For example, when people manipulate moving objects and rate their degree of control, control ratings are influenced by proximal correlations between motor commands and visual feedback as well as the overall success or failure of the action. The relative importance of sensory predictions vs. post hoc feedback may depend on the availability and perceived reliability of those cues, which is context dependent. The present study investigated how increasing cognitive load during a visuomotor tracking task influences the sense of agency, and whether cognitive load influences the extent to which control ratings depend on sensory predictions vs. post hoc feedback. In Experiments 1 and 2, participants performed a dual task that involved tracking a moving target using a joystick while rehearsing 3, 5, or 7 digits. Control ratings decreased as memory set size increased, even though set size had no significant effect on objective tracking error. Experiment 3 replicated this finding while also manipulating the favorability of feedback presented after each trial. Control ratings were correlated with post hoc feedback, but there was no significant interaction between feedback and cognitive load. These results suggest that sensorimotor predictions, performance feedback, and availability of working memory resources can all influence sense of agency. The hypothesis that people rely more on post hoc feedback to rate control when they are distracted was not supported.
The sense of agency for brain disorders: A comprehensive review and proposed framework
2022, Neuroscience and Biobehavioral Reviews
Citation Excerpt :
The authors speculated that this “hyper-binding” effect in schizophrenia was due to impairments in predicting the consequences of self-initiated actions. Indeed, future work supported this claim, describing either an impaired or absent forward model of motor control (Frith, 2012). Accordingly, one study found significant cortical thinning in the SMA of schizophrenic patients (Massey et al., 2017).
Sense of Agency (SoA) refers to the feeling of control over voluntary actions and the outcomes of those actions. Several brain disorders are characterized by an abnormal SoA. To date, there is no robust treatment for aberrant agency across disorders; this is, in large part, due to gaps in our understanding of the cognitive mechanisms and neural correlates of the SoA. This apparent gap stems from a lack of synthesis in established findings. As such, the current review reconciles previously established findings into a novel neurocognitive framework for future investigations of the SoA in brain disorders, which we term the Agency in Brain Disorders Framework (ABDF). In doing so, we highlight key top-down and bottom-up cues that contribute to agency prospectively (i.e., prior to action execution) and retrospectively (i.e., after action execution). We then examine brain disorders, including schizophrenia, autism spectrum disorders (ASD), obsessive-compulsive disorders (OCD), and cortico-basal syndrome (CBS), within the ABDF, to demonstrate its potential utility in investigating neurocognitive mechanisms underlying phenotypically variable presentations of the SoA in brain disorders.
Reduced TMS-evoked fast oscillations in the motor cortex predict the severity of positive symptoms in first-episode psychosis
2021, Progress in Neuro-Psychopharmacology and Biological Psychiatry
Citation Excerpt :
CDs represent the putative neural mechanism responsible for distinguishing between environmental and self-generated stimuli (so-called “self-monitoring”) (Ford and Mathalon, 2019). In psychosis, disturbances in CDs are hypothesized to underlie the false attribution to the outer world of internally generated percepts and thoughts, which could explain symptoms, including hallucinations, delusions (Feinberg, 1978; Frith, 1987; Frith, 2012), and self-disorders (Nelson et al., 2014). Intriguingly, in our patients' group, we reported an association between the reduced intrinsic ability of the motor area to generate beta-2 frontal oscillations, assessed by TMS-EEG, and the severity of positive symptoms (Fig. 3).
Accumulating evidence points to neurophysiological abnormalities of the motor cortex in Schizophrenia (SCZ). However, whether these abnormalities represent a core biological feature of psychosis rather than a superimposed neurodegenerative process is yet to be defined, as it is their putative relationship with clinical symptoms. in this study, we used Transcranial Magnetic Stimulation coupled with electroencephalography (TMS-EEG) to probe the intrinsic oscillatory properties of motor (Brodmann Area 4, BA4) and non-motor (posterior parietal, BA7) cortical areas in twenty-three first-episode psychosis (FEP) patients and thirteen age and gender-matched healthy comparison (HC) subjects. Patients underwent clinical evaluation at baseline and six-months after the TMS-EEG session. We found that FEP patients had reduced EEG activity evoked by TMS of the motor cortex in the beta-2 (25-34 Hz) frequency band in a cluster of electrodes overlying BA4, relative to HC participants. Beta-2 deficits in the TMS-evoked EEG response correlated with worse positive psychotic symptoms at baseline and also predicted positive symptoms severity at six-month follow-up assessments. Altogether, these findings indicate that reduced TMS-evoked fast oscillatory activity in the motor cortex is an early neural abnormality that: 1) is present at illness onset; 2) may represent a state marker of psychosis; and 3) could play a role in the development of new tools of outcome prediction in psychotic patients.
Nigrostriatal dopamine signals sequence-specific action-outcome prediction errors
2021, Current Biology
Dopamine has been suggested to encode cue-reward prediction errors during Pavlovian conditioning, signaling discrepancies between actual versus expected reward predicted by the cues.1, 2, 3, 4, 5 While this theory has been widely applied to reinforcement learning concerning instrumental actions, whether dopamine represents action-outcome prediction errors and how it controls sequential behavior remain largely unknown. The vast majority of previous studies examining dopamine responses primarily have used discrete reward-predictive stimuli,1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15 whether Pavlovian conditioned stimuli for which no action is required to earn reward or explicit discriminative stimuli that essentially instruct an animal how and when to respond for reward. Here, by training mice to perform optogenetic intracranial self-stimulation, we examined how self-initiated goal-directed behavior influences nigrostriatal dopamine transmission during single and sequential instrumental actions, in behavioral contexts with minimal overt changes in the animal’s external environment. We found that dopamine release evoked by direct optogenetic stimulation was dramatically reduced when delivered as the consequence of the animal’s own action, relative to non-contingent passive stimulation. This dopamine suppression generalized to food rewards was specific to the reinforced action, was temporally restricted to counteract the expected outcome, and exhibited sequence-selectivity consistent with hierarchical control of sequential behavior. These findings demonstrate that nigrostriatal dopamine signals sequence-specific prediction errors in action-outcome associations, with fundamental implications for reinforcement learning and instrumental behavior in health and disease.

View all citing articles on Scopus

^☆: This article is part of a special issue of this journal on Beyond the Comparator Model.

View full text

Explaining delusions of control: The comparator model 20 years on☆

Abstract

Highlights

Lancet

Current Biology

Neural Networks

Cognition

Consciousness and Cognition

The perception of self-produced sensory stimuli in patients with auditory hallucinations and passivity experiences: Evidence for a breakdown in self-monitoring

Psychological Medicine

Monothematic delusions: Towards a two-factor account

Philosophy, Psychiatry & Psychology

A deficit in the adjustment of grip force responses in schizophrenia

Neuroreport

Efference copy and corollary discharge: Implications for thinking and its disorders

Schizophrenia Bulletin

Perceiving is believing: A Bayesian approach to explaining the positive symptoms of schizophrenia

Nature Reviews Neuroscience