Impaired discrimination between imagined and performed actions in schizophrenia

II Department of Psychiatry, Medical University of Warsaw, Poland.
Psychiatry Research (Impact Factor: 2.47). 08/2011; 195(1-2):1-8. DOI: 10.1016/j.psychres.2011.07.035
Source: PubMed


The main aim of the present study was to investigate whether a specific type of source monitoring, namely self-monitoring for actions (differentiation between imagined and performed actions), is disrupted in schizophrenia. Persons diagnosed with schizophrenia (n=32) and healthy participants (n=32) were assessed with an action memory task. Simple actions were presented to the participants either verbally (short instructions) or nonverbally (icons). Some of the items required participants to physically perform the action whereas other actions had to be imagined. In the recognition phase of the study, participants were asked whether an action was previously displayed (verbally or nonverbally), whether it was a new action (not presented before), and if they had performed or imagined the action. In addition, participants were asked how confident they were in their decision. Participants in the group with schizophrenia significantly more often misattributed imagined actions as performed and vice versa and were more convinced about their wrong decision than participants in the control group. Patients revealed worse recognition for both verbal and nonverbal actions. In accordance with prior studies, we found that patients were less confident in their correct answers than healthy subjects. However, no enhanced confidence in incorrect answers was found. There was no observed significant relationship between source misattributions and the severity of psychopathological symptoms. Our findings suggest tentatively general source monitoring deficits in schizophrenia.


Available from: Łukasz Gawęda
  • Source
    • "Finally, the source monitoring-based model of psychotic symptoms was confirmed by meta-analysis from studies on auditory hallucinations in schizophrenia (Brookwell et al., 2013; Waters et al., 2012a, 2012b, 2012c). Moreover, patients do not only exhibit source-monitoring deficits , but also inappropriately evaluate subjective confidence regarding source-monitoring decisions (Moritz et al., 2005; Gaweda et al., 2012). Usually, false decisions are related to a lower level of subjective confidence in healthy subjects. "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study tested the influence of aging on source-monitoring and cognitive confidence deficits in schizophrenia. Younger (n=13) and older (n=10) schizophrenia patients were compared with younger (n=17) and older (n=10) healthy controls in the source-monitoring task. These preliminary results suggest that age negatively influences old/new item recognition, but not source monitoring, in both groups. Age has a negative impact on subjective confidence, but no interaction between group and age was found.
    Psychiatry Research 08/2015; 228:936-940. DOI:10.1016/j.psychres.2015.06.024 · 2.47 Impact Factor
  • Source
    • ". , 2003 ) in the formation and maintenance of psychosis . To summarize , a plethora of studies suggest that patients with schizophrenia are hastier in gathering information ( for reviews , see Garety and Freeman , 1999 , 2013 ; Fine et al . , 2007 ) and are more confident in erroneous responses pertaining to memory ( Moritz and Woodward , 2006a ; Gaweda et al . , 2012 ; Peters et al . , 2013 ) and social cognition ( Kother et al . , 2012 ; Moritz et al . , 2012b ) relative to non - clinical and psychiatric controls . Recent evidence suggests that this extends to perception ( Moritz et al . , 2014b ) . Both biases foster the formation of momentous false decisions that under some contextual factors may"
    [Show abstract] [Hide abstract]
    ABSTRACT: The majority of patients with schizophrenia display neurocognitive deficits (e.g. memory deficits) as well as inflated cognitive biases (e.g. jumping to conclusions). Both cognitive domains are implicated in the pathogenesis of the disorder and are known to compromise functional outcome. At present, there is a dearth of effective treatment options. A total of 90 patients with schizophrenia were recruited online (a diagnosis of schizophrenia had been confirmed in a large subgroup during a previous hospital admission). Subsequent to a baseline assessment encompassing psychopathology, self-reported cognition as well as objective memory and reasoning tests, patients were randomized to one of three conditions: standard cognitive remediation (mybraintraining), metacognition-augmented cognition remediation (CR) condition (variant of mybraintraining which encouraged patients to reduce speed of decision-making and attenuate response confidence when they made high-confidence judgements and hasty incorrect decisions) and a waitlist control group. Patients were retested after six weeks and again three months after the second assessment. Groups did not differ on psychopathology and neurocognitive parameters at any timepoint. However, at follow-up the metacognitive-augmented CR group displayed a significant reduction on jumping to conclusions and overconfidence. Treatment adherence correlated with a reduction of depression; gains in the training exercises from the standard mybraintraining condition were correlated with improved objective memory performance. The study suggests that metacognition-augmented CR may ameliorate cognitive biases but not neurocognition. The study ties in well with prior research showing that neurocognitive dysfunctions are rather resistant to change; the failure to detect significant improvement of CR or metacognition-augmented CR on psychopathology and neurocognition over time may partly be attributed to a number of methodological limitations of our s
    Frontiers in Psychology 07/2015; 6. DOI:10.3389/fpsyg.2015.01048 · 2.80 Impact Factor
  • Source
    • "Prior studies found support for a biased evaluation of memory performance in schizophrenia patients using these confidence level ratings (Danion et al., 2001; Moritz and Woodward, 2006b; Moritz et al., 2003, 2005; Peters et al., 2013). More recently, similar results have also been detected in studies regarding source monitoring (Gaweda et al., 2012, 2013) and social judgments (Köther et al., 2012; Moritz et al., 2012). A main bias seems to be an increased confidence in incorrect memories in addition to a decreased confidence in correct responses compared to healthy people and psychiatric controls (Moritz and Woodward, 2006b; Moritz et al., 2008; Peters et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Prior studies with schizophrenia patients described a reduced ability to discriminate between correct and false memories in terms of confidence compared to control groups. This metamemory bias has been associated with the emergence and maintenance of delusions. The relation to neuropsychological performance and other clinical dimensions is incompletely understood. In a cross-sectional study, metamemory functioning was explored in 32 schizophrenia patients and 25 healthy controls. Metamemory was assessed using a verbal recognition task combined with retrospective confidence level ratings. Associations of metamemory performance with six neuropsychological domains (executive functioning/problem solving, speed of processing, working memory, verbal and visual learning, and attention/vigilance) and psychopathological measures were analyzed. Results revealed a significantly smaller discrepancy between confidence ratings for correct and incorrect recognitions in the patient group. Furthermore, patients showed significantly lower recognition accuracy in the metamemory task and marked deficits in all neuropsychological domains. Across all participants, metamemory performance significantly correlated with executive functioning and working memory. No associations with delusions were found. This data confirms prior findings of metamemory biases in schizophrenia. Selective neuropsychological abilities seem to be modulating factors of metamemory functioning. Longitudinal studies in at risk mental state and first-episode patients are needed to reveal causal interrelations. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
    Psychiatry Research 12/2014; 225(3). DOI:10.1016/j.psychres.2014.11.040 · 2.47 Impact Factor
Show more