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Thinking, believing, and hallucinating self in schizophrenia.

Clara S Humpston1, Matthew R Broome1

  • 1Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK.

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Summary

This review integrates three models of schizophrenia self-disturbance: the Heidelberg School, ipseity, and predictive coding. It proposes that delusions and hallucinations are inferences, offering a novel framework for computational psychiatry and phenomenological psychopathology.

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Area of Science:

  • Psychiatry
  • Computational Neuroscience
  • Phenomenology

Background:

  • Self-disturbance is central to schizophrenia's pathophysiology and subjective experience.
  • Existing models (Heidelberg School, ipseity, predictive coding) lack integration.
  • Understanding self-disturbance is crucial for improving clinical practice.

Purpose of the Study:

  • To compare and integrate three distinct approaches to self-disturbance in schizophrenia.
  • To propose a novel framework for understanding delusions and hallucinations as inferences.
  • To bridge computational psychiatry and phenomenological psychopathology.

Main Methods:

  • Comparative analysis of historical and contemporary models of self-disturbance.
  • Integration of phenomenological and computational psychiatric perspectives.
  • Discussion of the role of inference in psychotic symptoms.

Main Results:

  • Self-disturbances are viewed as transformations of self, providing a background for psychotic symptoms.
  • Delusions and hallucinations are conceptualized as inferences under specific conditions.
  • These inferences may be optimal for minimizing prediction error in patients.

Conclusions:

  • Integrating computational and phenomenological approaches offers a novel perspective on schizophrenia.
  • Viewing psychotic symptoms as inferences can enhance understanding and clinical practice.
  • This work serves as a primer for dialogue between different psychiatric subfields.