Cerebral energy supply is insufficient to support continuous neuronal processing of the plethora of time-constant objects that we are aware of. As a result, the brain is forced to limit processing resources to (the most relevant) cases ofchange. The neuronally generated world is thus temporally discontinuous. This parallels the fact that, in all relevant microscopic fundamental equations of nature, temporalchangeplays a dominant role. When a scientist calculates a “solution” to such an equation, integration over time is an essential step. The (...) present Hypothesis expresses that the step from neuronal activity to phenomenal content of consciousness is reflective of a (phenomenal) “solution:” the main source of the incomprehensibility of consciousness is proposed to result from the introduction of phenomenal time-constant entities. These are “filled-in”viaintegration, even though neuronal data only exists forchangesto these entities. In this way, a temporally continuous picture of the world phenomenally appears. Qualia are “initial conditions,” which are required for integration and cannot be deduced frompresentdata. Phenomenal “identity” (vs. “high similarity”) is related to qualia.Inattentivevisual perception, which is only rarely investigated, offers insights into these relationships. Introspectively, unattended vision appears rich because percepts are cumulated over long time spans, whereas attentive perception relies purely onpresentneuronal signals. The present Hypothesis is that a brief neuronal activity cansignifylong-lasting and constant phenomenal content of consciousness. Experimental support is presented that comes from discrepancies between neuronal activity and perception: transient neuronal responses to sustained stimuli, “filling-in,” change blindness, identity vs. close resemblance. (shrink)

For years, phenomenological psychiatry has proposed that distortions of the temporal structure of consciousness contribute to the abnormal experiences described before schizophrenia emerges, and may relate to basic disturbances in consciousness of the self. However, considering that temporality refers mainly to an implicit aspect of our relationship with the world, disturbances in the temporal structure of consciousness remain difficult to access. Nonetheless, previous studies have shown a correlation between self disorders and the automatic ability to expect an event in time, (...) suggesting timing is a key issue for the psychopathology of schizophrenia. Timing disorders may represent a target for cognitive remediation, but this requires that disorders can be demonstrated at an individual level. Since cognitive impairments in patients with schizophrenia are discrete, and there is no standardized timing exploration, we focused on timing impairments suggested to be related to self disorders. We present the case report of AF, a 22 year old man suffering from schizophrenia, with no antipsychotic intake. Although AF shows few positive and negative symptoms and has a normal neurocognitive assessment, he shows a high level of disturbance of Minimal Self Disorders (SDs) (assessed with the EASE scale). Moreover, AF has a rare ability to describe his self and time difficulties. An objective assessment of timing ability (variable foreperiod task) confirmed that AF had temporal impairments similar to those previously described in patients, i.e., a preserved ability to distinguish time intervals, but a difficulty to benefit from the passage of time to expect a visual stimulus. He presents additional difficulties in benefitting from temporal cues and adapting to changes in time delays. The impairments were ample enough to yield significant effects with analyses at the individual level. Although causal relationships between subjective and objective impairments cannot be established, the results show that exploring timing deficits at the individual level is possible in patients with schizophrenia. Besides, the results are consistent with hypotheses relating minimal self disorders (SDs) to timing difficulties. They suggest that both subjective and objective timing investigations should be developed further so that their use at an individual level can be generalized in clinical practice. (shrink)

Patients suffering from delusions of thought insertion (TI) report that external agents of different nature have placed thoughts into their minds. The symptom involves distressing feelings of intromission and exposition, loss of mental privacy, diminished ego boundaries, and a – often neglected – peculiar “physicality”. A dominant approach within cognitive sciences characterizes TI as involving alterations in the experience of being the author of certain thoughts. For the advocates of this so-called Standard Approach to TI, the absence of a sense (...) of agency for certain thoughts would lead to their externalization, this explaining the general structure of the clinical reports. In this paper, I problematize the phenomenological picture of everyday thoughts that the standard approach adopts when trying to make sense of TI. I claim that the standard approach neglects two more fundamental aspects of TI, namely the multimodal nature of thinking in psychosis and the deeply social dimension of the phenomenology of delusions in schizophrenia. After this, a broader descriptive phenomenological characterization of TI is provided. Finally, I establish some connections between the characterization of TI developed here and current research in social perception and clinical practice. (shrink)

Alterations in consciousness are among the most common transdiagnostic psychopathological symptoms. Therefore clinical practice would benefit from a clear conceptual framework that guides the recognition, comprehension, and treatment of consciousness disorders. However, contemporary psychopathology lacks such a framework. We describe how pathology of consciousness is currently being addressed in clinical psychology and psychiatry so far, and how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and International Classification of Diseases, Tenth Edition (ICD-10) refer to this subject. A (...) brief review of the literature on consciousness is then given. After describing psychological perspectives on consciousness and discussing theoretical issues involved in exploring consciousness, we offer a practical clinical working definition of consciousness and we illustrate its connections with a variety of diagnoses. Making use of Jean-Paul Sartre’s distinctions among: states, functions, qualities, and structure, provide a conceptual framework to understand consciousness, to refine diagnostics and to guide the development of therapeutic possibilities in clinical practice. (shrink)

Objective: Basic temporal dysfunctions have been described in patients with schizophrenia, which may impact their ability to connect and synchronize with the outer world. The present study was conducted with the aim to distinguish between interval timing and synchronization difficulties and more generally the spatial-temporal organization disturbances for voluntary actions. A new sensorimotor synchronization task was developed to test these abilities. Method: Twenty-four chronic schizophrenia patients matched with 27 controls performed a spatial-tapping task in which finger taps were to be (...) produced in synchrony with a regular metronome to six visual targets presented around a virtual circle on a tactile screen. Isochronous (time intervals of 500 ms) and non-isochronous auditory sequences (alternated time intervals of 300/600 ms) were presented. The capacity to produce time intervals accurately versus the ability to synchronize own actions (tap) with external events (tone) were measured. Results: Patients with schizophrenia were able to produce the tapping patterns of both isochronous and non-isochronous auditory sequences as accurately as controls producing inter-response intervals close to the expected interval of 500 and 900 ms, respectively. However, the synchronization performances revealed significantly more positive asynchrony means (but similar variances) in the patient group than in the control group for both types of auditory sequences. Conclusion: The patterns of results suggest that patients with schizophrenia are able to perceive and produce both simple and complex sequences of time intervals but are impaired in the ability to synchronize their actions with external events. These findings suggest a specific deficit in predictive timing, which may be at the core of early symptoms previously described in schizophrenia. (shrink)