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Cited by 655Schizophrenia research and treatmentFree Will and AgencyMental Health and Psychiatry

The positive and negative symptoms of schizophrenia reflect impairments in the perception and initiation of action

Frith, C. D.·1987·Psychological Medicine
DOI 10.1017/s0033291700025873
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Abstract

The CNS maintains a fundamental distinction between actions elicited by external stimuli and actions elicited by internal goals (acts of will). As a result the intact organism can monitor centrally three aspects of its own actions: (1) the action appropriate to current external stimulation (stimulus intention or meaning); (2) the action appropriate to current goals (willed intention); and (3) the action which was actually selected (corollary discharge). In Type I (acute) schizophrenic patients, intentions of will lead to actions, but these willed intentions are not monitored correctly. This apparent discrepancy between will and action gives rise to experiential (1st rank) positive symptoms (e.g. delusions of control and passivity). In Type II (chronic) patients, intentions of will are no longer properly formed and so actions are rarely elicited via this route. This gives rise to behavioural negative signs (e.g. poverty of speech). The behaviour of Type II schizophrenics has surface similarities to that shown by patients with Parkinson's disease and patients with frontal lobe lesions in that all three types of patient show a relative deficit of actions elicited by willed intentions. Dopamine blocking drugs reduce positive symptoms in Type I patients precisely because they induce Parkinsonism, i.e. reduce the likelihood of actions being initiated by willed intentions. This in turn reduces the likelihood that actions will occur for which the patient had no awareness of his intention to act.

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  • Predictive coding models have previously been applied to the sense of agency.

    “Predictive coding models have previously been applied to the sense of agency”

    From An Interoceptive Predictive Coding Model of Conscious Presence (2012) · cites this paper as Frith, 1987

  • Disturbances of sensed agency, for example in schizophrenia, arise from imprecise predictions about the sensory consequences of actions.

    “Such models propose that disturbances of sensed agency, for example in schizophrenia, arise from imprecise predictions about the sensory consequences of actions”

    From An Interoceptive Predictive Coding Model of Conscious Presence (2012) · cites this paper as Frith, 1987

  • Behavioral experiments have confirmed corollary discharge dysfunction in schizophrenia.

    “Frith expanded this concept (Frith, 1987) and prompted a series of behavioral experiments confirming corollary discharge dysfunction in schizophrenia (Brebion, et al., 2000; Frith, Blakemore, & Wolpert, 2000; Lindner, Thier, Kircher, Haarmeier, & Leube, 2005; Shergill, Samson, Bays, Frith, & Wolpert, 2005; Stirling, Hellewell, & Quraishi, 1998; Turken, Vuilleumier, Mathalon, Swick, & Ford, 2003).”

    From Anticipating the future: Automatic prediction failures in schizophrenia (2012) · cites this paper as Frith, 1987

  • There is evidence supporting the theory that voice-hearing results from inner speech being misattributed to an external source, that is, a problem of source monitoring.

    “There is evidence supporting the theory that voice-hearing results from inner speech being misattributed to an external source, that is, a problem of source monitoring. 23-25”

    From Towards an Integrative Account of Potential Mechanisms Mediating the Path From Sleep Dysfunction to Hallucinations (2025) · cites this paper as [24]

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Authors
Frith, C. D.
Affiliations
Northwick Park Hospital (GB)
Corresponding author
Frith, C. D.
ORCID
Frith, C. D.
Venue
Psychological Medicine
Publisher
Cambridge University Press (CUP)
Published
1987-08
Volume
17
Issue
3
Pages
631-648
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
DOI
10.1017/s0033291700025873
OpenAlex
W1979445479
Cited by
655
References
85
Citations by year
2026: 4 · 2025: 8 · 2024: 11 · 2023: 12 · 2022: 9 · 2021: 18 · 2020: 10 · 2019: 12 · 2018: 12 · 2017: 18 · 2016: 14 · 2015: 11 · 2014: 9 · 2013: 21 · 2012: 25
FWCI
6.29
Type
journal article
Language
en
Open access
closed
Licence
www.cambridge.org/core/terms (unspecified, 8013 d)
Locations
  • Psychological Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Free Will and Agency
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
Keywords
schizophrenia, positive symptoms, negative symptoms, first-rank symptoms, delusions of control, poverty of speech, corollary discharge, action monitoring, parkinsonism, dopamine antagonists, Parkinson's disease, frontal lobe lesions, action initiation
MeSH terms
Animals, Disease Models, Animal, Eye Movements, Humans, Models, Psychological, Parkinson Disease, Perception, Schizophrenia, Schizophrenic Psychology, Volition

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