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Despite the historically consolidated psychopathological perspective, on the one hand, contemporary organicistic psychiatry often highlights abnormalities in neurotransmitter systems like dysregulation of dopamine transmission, neural circuitry, and genetic factors as key contributors to schizophrenia. Neuroscience, on the other, has so far almost entirely neglected the first-person experiential dimension of this syndrome, mainly focusing on high-order cognitive functions, such as executive function, working memory, theory of mind, and the like. An alternative view posits that schizophrenia is a self-disorder characterized by anomalous self-experience and awareness. This view may not only shed new light on the psychopathological features of psychosis but also inspire empirical research targeting the bodily and neurobiological changes underpinning this disorder. Cognitive neuroscience can today address classic topics of phenomenological psychopathology by adding a new level of description, finally enabling the correlation between the first-person experiential aspects of psychiatric diseases and their neurobiological roots. Recent empirical evidence on the neurobiological basis of a minimal notion of the self, the bodily self, is presented. The relationship between the body, its motor potentialities and the notion of minimal self is illustrated. Evidence on the neural mechanisms underpinning the bodily self, its plasticity, and the blurring of self-other distinction in schizophrenic patients is introduced and discussed. It is concluded that brain-body function anomalies of multisensory integration, differential processing of self- and other-related bodily information mediating self-experience, might be at the basis of the disruption of the self disorders characterizing schizophrenia., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Objective: Embodied emotions arise from interoceptive and somatosensory processes, and are essential to the development of a stable sense of self. Emotional embodiment is therefore inherently interwoven with our sense of bodily self-awareness, and allows us to navigate complex social situations. Given that the core feature of schizophrenia (SZ) is characterized by the presence of bodily self-disturbances and social-emotional deficits, we hypothesized that embodiment of emotion would be disrupted in SZ., Method: Twenty-six medicated individuals with SZ and 26 demographically matched controls used a computerized topographical mapping tool ("EmBODY") to indicate on a body outline where they felt bodily sensations while experiencing an emotion. There were 13 different emotions plus a neutral state. The resulting bodily maps of emotions were quantitatively compared between groups using linear discriminant analysis and similarity scores., Results: Bodily maps of emotions were anomalous in SZ as indicated by indistinguishable maps across different emotions. Relative to the control group, patients reported less discrete and less clear bodily sensations across emotions. In particular, bodily maps for low-arousal emotions were atypical in comparison with healthy controls., Conclusions: Anomalous and undifferentiated mapping of embodied emotions in SZ could lead to deficits in linking bodily sensations to conceptual categories of emotions. Disrupted emotional embodiment could also contribute to poor social functioning. Abnormal bodily sensations of emotions might therefore be a promising target for future psychosocial interventions., (© The Author(s) 2018. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Anomalous or weakened sense of self was central to early theories of schizophrenia. Recent studies have also documented disturbances in body ownership and increased susceptibility for dissociative experiences, such as the out-of-body experience in individuals with schizophrenia, but further research is necessary to clarify components of bodily self-disturbances in the schizophrenia spectrum, and the stability of these experiences over time. With respect to methodology, self-disturbances research in schizophrenia tends to rely exclusively on verbal self-report questionnaires and interviews. Given that individuals with schizophrenia suffer from language and communication difficulties, verbal self-report measures may be insufficient. To bridge this gap, we have developed a new picture-based instrument, the Benson et al. Body Disturbances Inventory (B-BODI), designed to quantify bodily self-disturbances with respect to the frequency and vividness of these experiences, as well as the degree of distress associated with them. Drawings that depicted different aspects of aberrant bodily self-experiences were presented with accompanying captions. Participants were asked to indicate the frequency, vividness, and distressfulness of the experience captured by the picture using a 5-point scale. Individuals with schizophrenia, older healthy controls, and college students participated in two alternative versions of the B-BODI. Participants were also asked to complete a battery of established questionnaires that probed psychosis proneness and a range of self, body, and perceptual aberrations. The results suggest that the B-BODI is a useful tool that accurately captures bodily self-disturbances and has the potential to predict psychosis risk in healthy young individuals. Furthermore, anomalous self-disturbances seem to be relatively stable across time in individuals with chronic schizophrenia., (© 2019 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.)

Schizophrenia is associated with self-disturbances and anomalous embodiment of emotion such that the distinct patterns of bodily sensations that typically accompany specific emotions are disrupted. Previous evidence indicated that cultural factors might shape the embodiment of emotion and therefore influence the subjective experience of schizophrenia.We investigated embodiment of emotion in individuals with schizophrenia (SZ) and matched control participants (CO) from Korea (26 ​K-SZ and 26 ​K–CO) and the USA (26 US-SZ and US-26 CO), using a topographical mapping task that requires participants to indicate the locations of bodily sensations that accompany 14 distinct emotions. We found that emotion-related bodily sensations, especially for low-arousal emotions, were diminished in SZ compared to CO in both cultures. Cultural differences emerged in the embodiment of sadness, shame and disgust such that the patterns of bodily sensations associated with these emotions were more similar between SZ and CO in the Korean sample than in the US sample.These findings suggest that emotional embodiment anomalies are present in SZ regardless of culture, supporting the universality of bodily self-disturbances in this population. However, there are culture-specific features of embodied emotional experiences that may be important to consider for future research and treatment.

Background and Hypothesis A primary disruption of the bodily self is considered a core feature of schizophrenia (SCZ). The "disembodied" self might be underpinned by inefficient body-related multisensory integration processes, normally occurring in the peripersonal space (PPS), a plastic sector of space surrounding the body whose extent is altered in SCZ. Although PPS is a malleable interface marking the perceptual border between self and others, no study has addressed the potential alteration of its plasticity in SCZ. We investigated the plasticity of PPS in SCZ patients after a motor training with a tool in the far space. Study Design Twenty-seven SCZ patients and 32 healthy controls (HC) underwent an audio-tactile task to estimate PPS boundary before (Session 1) and after (Session 3) the tool-use. Parameters of PPS, including the size and the slope of the psychometric function describing audio-tactile RTs as a function of the audio-tactile distances, were estimated. Study Results Results confirm a narrow PPS extent in SCZ. Surprisingly, we found PPS expansion in both groups, thus showing for the first time a preserved PPS plasticity in SCZ. Patients experienced a weaker differentiation from others, as indicated by a shallower PPS slope at Session 1 that correlated positively with negative symptoms. However, at Session 3, patients marked their bodily boundary in a steeper way, suggesting a sharper demarcation of PPS boundaries after the action with the tool. Conclusions These findings highlight the importance of investigating the multisensory and motor roots of self-disorders, paving the way for future body-centred rehabilitation interventions that could improve patients' altered body boundary. [ABSTRACT FROM AUTHOR]

Some people diagnosed with "schizophrenia" showed a fundamental alteration of the sense of self. From a psychodynamic perspective, it has been hypothesized that patients diagnosed as schizophrenic have disorders of the embodied self and its boundaries. Phenomenologically, it has been observed a self-disorder, at an implicit and pre-reflective level of bodily awareness. Neuroscientific evidence seems to confirm the aforementioned aspects. The mean levels of Interoceptive Accuracy (IA), which is an objective empirical measure of interoception, namely a measure of basic awareness distinct from subjective measures, are significantly lower in patients with a diagnosis of schizophrenia than among healthy controls. Affiliative touch is crucial for constructing a basic sense of self and its boundaries, and it affects interoception. In order to reduce the disturbance of the sense of self, Angelo participated for three years in an experimental intervention plan including Amniotic Therapy (AT) and individual psychodynamic psychotherapy. AT is a group-therapy based on sensory-motor interactions, especially affiliative touch, similar to those involved in "holding". Results showed an increase in the Angelo's IA and global functioning, as well as a significant decrease in positive symptoms. In Angelo, AT seems to strengthen a basic sense of self, reducing self-disorder. [ABSTRACT FROM AUTHOR]

The present study focuses on the multifaceted concept of self-disturbance in schizophrenia, adding knowledge about a not yet investigated aspect, which is the interoceptive accuracy. Starting from the assumption that interoceptive accuracy requires an intact sense of self, which otherwise was proved to be altered in schizophrenia, the aim of the present study was to explore interoceptive accuracy in a group of schizophrenia patients, compared to healthy controls. Furthermore, the possible association between interoceptive accuracy and patients’ positive and negative symptomatology was assessed. To pursue these goals, a group of 23 schizophrenia patients and a group of 23 healthy controls performed a heartbeat perception task. Patients’ symptomatology was assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results demonstrated significantly lower interoceptive accuracy in schizophrenia patients compared to healthy controls. This difference was not accounted for participants’ age, BMI, anxiety levels and heart rate. Furthermore, patients’ illness severity, attention and pharmacological treatment did not influence their interoceptive accuracy levels. Interestingly, a strong positive relation between interoceptive accuracy and positive symptoms severity, especially Grandiosity, was found. The present results demonstrate for the first time that interoceptive accuracy is altered in schizophrenia. Furthermore, they prove a specific association between interoceptive accuracy and positive symptomatology, suggesting that the symptom Grandiosity might be protective against an altered basic sense of self in patients characterized by higher sensibility to their inner bodily sensations.

The present study focuses on the multifaceted concept of self-disturbance in schizophrenia, adding knowledge about a not yet investigated aspect, which is the interoceptive accuracy. Starting from the assumption that interoceptive accuracy requires an intact sense of self, which otherwise was proved to be altered in schizophrenia, the aim of the present study was to explore interoceptive accuracy in a group of schizophrenia patients, compared to healthy controls. Furthermore, the possible association between interoceptive accuracy and patients' positive and negative symptomatology was assessed. To pursue these goals, a group of 23 schizophrenia patients and a group of 23 healthy controls performed a heartbeat perception task. Patients' symptomatology was assessed by means of the Positive and Negative Syndrome Scale (PANSS). Results demonstrated significantly lower interoceptive accuracy in schizophrenia patients compared to healthy controls. This difference was not accounted for participants' age, BMI, anxiety levels, and heart rate. Furthermore, patients' illness severity, attention and pharmacological treatment did not influence their interoceptive accuracy levels. Interestingly, a strong positive relation between interoceptive accuracy and positive symptoms severity, especially Grandiosity, was found. The present results demonstrate for the first time that interoceptive accuracy is altered in schizophrenia. Furthermore, they prove a specific association between interoceptive accuracy and positive symptomatology, suggesting that the symptom Grandiosity might be protective against an altered basic sense of self in patients characterized by higher sensibility to their inner bodily sensations. [ABSTRACT FROM AUTHOR]

In the present paper, we review the recent empirical evidence on the neurobiological basis of a minimal notion of the self, the bodily self. We show the relationship between the body, its motor potentialities and the notion of minimal self. We argue that this approach can shed new light onto self-disturbances and social deficits characterizing schizophrenia. We discuss our approach with other views on the neural correlates of self-disturbances in schizophrenia and propose that cognitive neuroscience can today address the classical topics of psychopathology by adding a new level of description, finally enabling the correlation between the first-person experiential aspects of psychiatric diseases and their neurobiological roots. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]