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Cited by 40Mental Health and PsychiatrySchizophrenia research and treatmentPhilosophy and Theoretical Science

Thinking, believing, and hallucinating self in schizophrenia

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Humpston, Clara S, Broome, Matthew R·2020·The Lancet Psychiatry
DOI 10.1016/s2215-0366(20)30007-9
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Abstract

In this Personal View, we discuss the history and concept of self-disturbance in relation to the pathophysiology and subjective experience of schizophrenia in terms of three approaches: the perceptual anomalies approach of the early Heidelberg School of Psychiatry, the ipseity model, and the predictive coding framework. Despite the importance of these approaches, there has been a notable absence of efforts to compare them and consider how they might be integrated. This Personal View compares the three approaches and offers suggestions as to how they might work together, which represents a novel position. We view self-disturbances as transformations of self that form the inseparable background against which psychotic symptoms emerge. Integrating computational psychiatric approaches with those used by phenomenologists in the first two listed approaches, we argue that delusions and hallucinations are inferences produced under extraordinary conditions and are both statistically and experientially as real for patients as other mental events. Such inferences still approximate Bayes-optimality, given the personal, neurobiological, and environmental circumstances, and might be the only ones available to minimise prediction error. The added contribution we hope to make focuses on how the dialogue between neuroscience and phenomenology might improve clinical practice. We hope this Personal View will act as a timely primer and bridging point for the different approaches of computational psychiatry and phenomenological psychopathology for interested clinicians.

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  • According to the predictive coding framework, delusions and hallucinations in psychosis stem from imbalances between the precision of prior beliefs and the precision of sensory data.

    “According to the predictive coding framework, both these symptoms stem from imbalances between the precision of prior beliefs and the precision of sensory data, so that, for example, excessive expectations over sensory stimuli may lead to misattribute thoughts as false perceptions (Humpston and Broome, 2020; Horga and Abi-Dargham, 2019).”

    From Predictive coding in neuropsychiatric disorders: a systematic transdiagnostic review. (2025) · cites this paper as Humpston and Broome, 2020

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Authors
Humpston, C. S., & Broome, M. R.
Affiliations
University of Birmingham (GB)
Corresponding author
Humpston, Clara S
ORCID
Venue
The Lancet Psychiatry
Publisher
Elsevier BV
Published
2020-07
Volume
7
Issue
7
Pages
638-646
ISSN
2215-0366 (ISSN-L)
DOI
10.1016/s2215-0366(20)30007-9
OpenAlex
W3008759109
Cited by
40
References
11
Citations by year
2026: 4 · 2025: 6 · 2024: 3 · 2023: 9 · 2022: 8 · 2021: 8 · 2020: 2
FWCI
17.34
Type
journal article
Language
en
Open access
Licence
Locations
  • The Lancet Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc-nd)
Topics
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Philosophy and Theoretical Science
Keywords
schizophrenia, self-disturbance, self, hallucinations, delusions, predictive coding, perceptual anomalies, computational psychiatry, phenomenological psychopathology, Bayesian inference, prediction error
MeSH terms
Awareness, Hallucinations, Humans, Neurosciences, Psychiatry, Psychopathology, Schizophrenia, Schizophrenic Psychology, Self Concept, Theory of Mind

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