The fragmented self: imbalance between intrinsic and extrinsic self-networks in psychotic disorders

Sjoerd J. H. Ebisch*, Andre Aleman

*Corresponding author for this work

Research output: Contribution to journalEditorialAcademicpeer-review

23 Citations (Scopus)

Abstract

Self-disturbances are among the core features of schizophrenia and related psychotic disorders. The basic structure of the self could depend on the balance between intrinsic and extrinsic self-processing. We discuss studies on self-related processing in psychotic disorders that provide converging evidence for disrupted communication between neural networks subserving the so-called intrinsic self and extrinsic self. This disruption might be mainly caused by impaired integrity of key brain hubs. The intrinsic self has been associated with cortical midline structures involved in self-referential processing, autobiographical memory, and emotional evaluation. Additionally, we highlight central aspects of the extrinsic self in its interaction with the environment using sensorimotor networks, including self-experience in sensation and actions. A deficient relationship between these self-aspects because of disrupted between-network interactions offers a framework to explain core clinical features of psychotic disorders. In particular, we show how relative isolation and reduced modularity of networks subserving intrinsic and extrinsic self-processing might trigger the emergence of hallucinations and delusions, and why patients with psychosis typically have difficulties with self-other relationships and do not recognise mental problems.

Original languageEnglish
Pages (from-to)784-790
Number of pages7
JournalThe Lancet. Psychiatry
Volume3
Issue number8
DOIs
Publication statusPublished - Aug-2016

Keywords

  • AUDITORY VERBAL HALLUCINATIONS
  • CORTICAL MIDLINE STRUCTURES
  • DEFAULT-MODE NETWORK
  • SOCIAL COGNITION
  • 1ST-EPISODE SCHIZOPHRENIA
  • BRAIN CONNECTIVITY
  • ALIEN CONTROL
  • BODILY SELF
  • FMRI
  • SYMPTOMS

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