Disruption of Conscious Access in Schizophrenia

Schizophrenia is a severe and complex psychiatric disorder resulting in delusions, hallucinations, and cognitive impairments. Across a variety of paradigms, an elevated threshold for conscious perception has been repeatedly observed in persons with schizophrenia. Remarkably, even subtle measures of subliminal processing appear to be preserved. We argue here that the dissociation between impaired conscious access and intact unconscious processing may be due to a specific disruption of top-down attentional amplification. This proposal is compatible with the neurophysiological disturbances observed in schizophrenia, including dysconnectivity, abnormal neural oscillations, and glutamatergic and cholinergic dysregulation. Therefore, placing impaired conscious access as a central feature of schizophrenia can help researchers develop a coherent and parsimonious pathophysiological framework of the disease.