Monitoring of Action in Schizophrenia

In the present chapter, we review evidence that potentially bridges cognitive mechanisms that are readily mapped onto single neurons in the primate brain with the phenomenology of agency. Disturbances in the subjective sense of agency over action are common in schizophrenia. From the perspective of neuroscience, this subjective sense of agency requires that action plans be monitored online. One prevailing model indicates that copies of motor commands are transmitted to sensory processing regions, allowing the prediction of future sensory states before that action has been completed. Consequently, a match between the predicted and actual sensory consequences of an action contributes to the sense of agency regarding the action. In this contribution, we review evidence from primate neurophysiology, human electrophysiology, and cognitive psychology supporting rapid action monitoring and summarize evidence for altered action monitoring in individuals with schizophrenia as well as presenting a case study to provide a qualitative viewpoint. We conclude by suggesting that these altered sensorimotor processes contribute to the profound self-disturbances experienced by individuals with schizophrenia as they navigate the complexities of the external world.