Deficits in access consciousness, integrative function, and consequent autonoetic thinking in schizophrenia.

In schizophrenia, disruptions in self-awareness and a loss of agency point to alterations in consciousness. Applying Ned Block's concept of access consciousness helps clarify deficits in reflective thought and autonoetic thinking. Theories such as Global Workspace Theory describe consciousness as recursive and integrative, functions that access consciousness contributes to. In schizophrenia, an integrative deficit prevents prior cognitive outputs from being incorporated into new working schemas. Disrupted cortical circuits related to integrative functions may cause subsequent cognitive dysfunction and symptoms. Constitutive failures to integrate information could block experiential unity and content management in autonoetic consciousness. Aberrant reasoning in schizophrenia, including problems with hierarchical relational reasoning and source monitoring, may also reflect alterations in access consciousness.

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Abstract

Alterations within consciousness in schizophrenia can be evidenced by impediments in self-awareness and loss of agency. Ned Block's definition of access consciousness is applied in order to further delineate cognitive deficits involving reflective thought and autonoetic thinking in persons with schizophrenia. Current theories on the nature and functioning of consciousness are discussed, which include Global Workspace Theory and metarepresentational characterizations. These describe a recursive, integrative quality to consciousness, contributed to by the functions of access consciousness, that is relevant in examining cognitive deficits in schizophrenia. The integrative deficit that is described as operating in conscious process involves a failure to incorporate prior outputs from a separate cognitive task and integrate these into a novel working schema. The alterations in access consciousness in persons with schizophrenia appear to be a consequence of disrupted integrative cognitive functions. An anteceding problem with cortical circuits involving integrative functions related to access consciousness is therefore hypothesized to manifest as subsequent cognitive dysfunction that leads to symptoms of schizophrenia. Constitutive failures to integrate information in schizophrenia could lead to an inability to create experiential unity and manage content in autonoetic consciousness. Some of the aberrant reasoning manifested by persons with schizophrenia, including problems with hierarchical relational reasoning, model-based-learning, J-con, ipseity, and source monitoring, could also reflect alterations in access consciousness, and their investigation offers additional approaches for scientific inquiry.