Allen Paul P, Johns Louise C, Fu Cynthia H Y, Broome Matthew R, Vythelingum Goparlen N, McGuire Philip K
Section of Neuroimaging, Division of Psychological Medicine, Institute of Psychiatry, P.O. Box 67, Denmark Hill, London SE5 8AF, UK.
Schizophr Res. 2004 Aug 1;69(2-3):277-87. doi: 10.1016/j.schres.2003.09.008.
One of the main cognitive models of positive symptoms in schizophrenia proposes that they arise through impaired self-monitoring. This is supported by evidence of behavioural deficits on tasks designed to engage self-monitoring, but these deficits could also result from an externalising response bias. We examined whether patients with hallucinations and delusions would demonstrate an externalising bias on a task that did not involve cognitive self-monitoring.
Participants passively listened (without speaking) to recordings of single adjectives spoken in their own and another person's voice, and made self/nonself judgements about their source. The acoustic quality of recorded speech was experimentally manipulated by altering the pitch. Fifteen patients with schizophrenia who were currently experiencing hallucinations and delusions, 13 patients with schizophrenia not experiencing current hallucinations and delusions and 15 healthy controls were compared.
When listening to distorted words, patients with hallucinations and delusions were more likely than both the group with no hallucinations and delusions and the control group to misidentify their own speech as alien (i.e. spoken by someone else). Across the combined patient groups, the tendency to misidentify self-generated speech as alien was positively correlated with current severity of hallucinations but not with ratings of delusions or positive symptoms in general.
These findings indicate that patients with hallucinations and delusions are prone to misidentifying their own verbal material as alien in a task which does not involve cognitive self-monitoring. This suggests that these symptoms are related to an externalising bias in the processing of sensory material, and not solely a function of defective self-monitoring.
精神分裂症阳性症状的主要认知模型之一提出，这些症状是通过自我监测受损而产生的。旨在进行自我监测的任务中行为缺陷的证据支持了这一点，但这些缺陷也可能源于外化反应偏差。我们研究了有幻觉和妄想的患者在一项不涉及认知自我监测的任务中是否会表现出外化偏差。
参与者被动聆听（不说话）以自己和他人声音说出的单个形容词的录音，并对其来源做出自我/非自我判断。通过改变音高对录制语音的声学质量进行实验性操纵。比较了15名目前有幻觉和妄想的精神分裂症患者、13名目前没有幻觉和妄想的精神分裂症患者以及15名健康对照者。
在聆听失真的单词时，有幻觉和妄想的患者比既无幻觉也无妄想的组以及对照组更有可能将自己的语音错误识别为他人的（即由其他人说出）。在合并的患者组中，将自我产生的语音错误识别为他人的倾向与当前幻觉的严重程度呈正相关，但与妄想或一般阳性症状的评分无关。
这些发现表明，有幻觉和妄想的患者在一项不涉及认知自我监测的任务中容易将自己的言语材料错误识别为他人的。这表明这些症状与感觉材料处理中的外化偏差有关，而不仅仅是自我监测缺陷的作用。
