Abnormalities in the establishment of feeling of self-agency in schizophrenia

Background: People usually feel they cause their own actions and the consequences of those actions, i.e., they attribute behavior to the proper agent. Research suggests that there are two routes to the experience of self-agency: 1) an explicit route, where one has the intention to obtain a goal (if it occurs, I must have done it) and 2) an implicit route, where information about the goal is unconsciously available and increases the feeling of self-agency. Schizophrenia patients typically experience no behavioral control and exhibit difficulties in distinguishing one's own actions from those of others. The present study investigates differences in both routes to self-agency experiences between schizophrenia patients and controls. Methods: Twenty-three schizophrenia patients and 23 controls performed a task where they performed an action (button press) and subsequently indicated whether or not they were the agent of the consequence of this action (the outcome) on a 9-point scale. The task can be manipulated to measure both the explicit and implicit route (by using priming) to the experience of self-agency. Results: In the explicit condition (participants intended to produce a specific outcome, and this outcome matched their goal), both groups experienced enhanced self-agency. In the implicit condition (the outcome matched the primed outcome), healthy controls showed increased self-agency over the outcome, while patients did not. Potential differences in task motivation and attention did not explain these findings. Conclusions: These findings provide new evidence for the idea that implicit processes leading to feelings of self-agency may be disturbed in schizophrenia.