Autonoetic Awareness, Executive Social Skills, and the Appreciation of Intention: Figurative Reasoning in Amnesia, Confabulation, and Schizophrenia

Abstract

This paper presents a cognitive neuropsychological model of the appreciation of unfamiliar abstract speech. The model elaborates upon the proposals of Bottini et al. (1994) by suggesting that we come to appreciate unfamiliar metaphorical speech in the autonoetically aware state. The specific executive skills of (1) an "as if" processor (2) a shared relevance seeker and monitor are harnessed to retrieval of information from personal long-term memory or imagination. The same cognitive system is assumed to handle other forms of indirect speech which need disambiguation as well as situations in which the intention or belief state of another has to be inferred. Predictions concerning the behavioural consequences of malfunctions occurring at different stages within the system are set out. Method: To illustrate the behavioural consequences of differential system dysfunction, data collected from four case studies are presented. Each case performed two tasks. These entailed the appreciation of true/false functional sentences and unfamiliar metaphors. The sentences both required the need to reason analogically and were matched for syntactic complexity and number of words. Results: Clear similarities were seen in the performance of the new metaphors test between a patient with Korsakoff syndrome and consequent amnesia and one with negative feature schizophrenia. The same test also highlights similar processing deficits in a case of Korsakoff syndrome with amnesia and confabulation and a schizophrenic patient with formal thought disorder. By proposing different loci for system malfunctions within and across diagnoses the characteristic clinical and/or cognitive features of the illnesses or syndromes are addressed. The importance of recognising the implications of specific cognitive dysfunctions across diagnoses for understanding the cognitive profiles of individual cases and the clinical aspects of the illness/syndrome is stressed. Finally, the utility of the model for explaining how we process other situations that require an appreciation of others' intentions, thoughts, and beliefs is discussed.