Judgments of agency in schizophrenia: An impairment in autonoetic metacognition

We investigated judgments of agency in participants with schizophrenia and healthy controls. Participants engaged in a computer game in which they attempted to touch downward falling X's and avoid touching O's. On some trials participants were objectively in perfect control. On other trials they were objectively not in complete control because the movement of the cursor on the screen was distorted with respect to the position of the mouse by random noise (turbulence), or it was lagged by 250 or 500 ms. Participants made metacognitive judgments of agency as well as judgments of performance. Control participants' judgments of agency were affected by the turbulence and lag variables-indicating that they knew they were objectively not in control in those conditions. They were influenced by their assessments of performance. The patients also used their assessments of performance but neither turbulence nor lag affected their judgments of agency. This indicated an impairment in agency monitoring. The patients, unlike the healthy controls, used only publically available external cues about performance in making judgments of 'agency' and did not rely on any additional access to internal self-relevant cues that were diagnostic in indicating whether or not they were, in fact, in control.