PubMed · 15835434
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Stephen Wright. Humility heals.. https://doi.org/10.7748/ns.19.30.34.s31
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Imbalanced plasticity of neural networks in the brain is proposed to underlie deficits in the integration of efferent and afferent processes in schizophrenia. These deficits affect the priming of the behavior implementing systems by prior knowledge, and thus impair both controlled regulation and automatic activation of mental and motor processes. The sense of self as a distinct entity can consequently be undermined. In predominantly reality-distorting patients, hypo-plasticity of neural connectivity may cause the emergence of highly focused but inflexible patterns of activation in their representation and response systems. This may lead to dominance of prepotent patterns of activity in these systems and a relative inability of higher control systems to bias lower level activity towards congruence with the ongoing cognitive and motor context. By contrast, predominantly disorganized patients are characterized by hyper-plastic connectivity. This leads to a weakening of prepotent response tendencies but also, as in reality-distorting patients, to less effective top-down contextual constraining.
Passivity experiences in schizophrenia are thought to be due to a failure in a neurocognitive action self-monitoring system (NASS). Drawing on the assumption that inner speech is a form of action, a recent model of auditory verbal hallucinations (AVHs) has proposed that AVHs can be explained by a failure in the NASS. In this article, we offer an alternative application of the NASS to AVHs, with separate mechanisms creating the emotion of self-as-agent and other-as-agent. We defend the assumption that inner speech can be considered as a form of action, and show how a number of previous criticisms of applying the NASS to AVHs can be refuted. This is achieved in part through taking a Vygotskian developmental perspective on inner speech. It is suggested that more research into the nature and development of inner speech is needed to further our understanding of AVHs.