Institute of Psychiatry, Department of Psychosis Studies, King's College London, London, United Kingdom.
Neuropsychology. 2011 May;25(3):295-305. doi: 10.1037/a0021747.
The Cortical Midline Structures (CMS) play a critical role in self-reflection, together with the insula. Abnormalities in self-referential processing and its neural underpinnings have been reported in schizophrenia and at-risk populations, suggesting they might be markers of psychotic vulnerability. Psychometric measures of schizotypal traits may be used to index psychosis proneness (PP) in nonclinical samples. It remains an unresolved question whether differences in self-reflective processing are associated with PP.
Six hundred students completed the Community Assessment of Psychic Experiences Questionnaire, positive subscale. Two groups were formed from the extremes of the distribution (total N = 36). fMRI was used to examine CMS/insula function during a self-reflection task. Participants judged personality trait sentences about self and about an acquaintance.
High PP subjects attributed less positive traits to others (i.e., acquaintances) than subjects with low PP. Across groups, the contrasts self > semantic and self > other induced activation in CMS and insula, whereas other > semantic did not produce insula activation. Other > self induced posterior cingulate cortex activation in low PP but not in high PP. In addition, high PP subjects showed stronger activation than low PP in left insula during self > semantic. Examining valence effects revealed that high PP individuals showed increased activation in left insula, right dMPFC, and left vMPFC for positive self-related traits, and in bilateral insula, ACC, and right dMPFC for negative self-related traits.
The findings suggest that aspects of self-referential processing and underlying brain mechanisms are similar in clinical and subclinical (high PP) forms of psychosis, suggesting that these may be associated with vulnerability to psychosis.
皮质中线结构（CMS）与脑岛一起在自我反思中起着关键作用。精神分裂症和高危人群的自我参照处理及其神经基础异常的报道表明，它们可能是精神病易感性的标志物。精神分裂症特质的心理测量指标可用于索引非临床样本中的精神病倾向（PP）。自我反思处理的差异是否与 PP 相关，这仍然是一个悬而未决的问题。
600 名学生完成了《社区心理体验评估问卷》的积极量表。从分布的极端（总 N=36）形成两组。使用 fMRI 检查自我反思任务期间 CMS/脑岛的功能。参与者判断关于自我和熟人的人格特质句子。
高 PP 组比低 PP 组对他人（即熟人）赋予的积极特质较少。在两组中，自我>语义和自我>他人的对比在 CMS 和脑岛中引起激活，而他人>语义则不会引起脑岛激活。其他>自我在低 PP 中引起后扣带皮层激活，但在高 PP 中则没有。此外，高 PP 组在自我>语义时比低 PP 组在左侧脑岛显示出更强的激活。检查效价效应表明，高 PP 个体在左侧脑岛、右侧 dmPFC 和左侧 vmPFC 对积极的自我相关特质表现出更强的激活，而在双侧脑岛、ACC 和右侧 dmPFC 对消极的自我相关特质表现出更强的激活。
研究结果表明，自我参照处理的各个方面及其潜在的大脑机制在临床和亚临床（高 PP）形式的精神病中是相似的，这表明这些可能与精神病易感性有关。
