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Powers A, Angelos PA, Bond A, Farina E, Fredericks C, Gandhi J, Greenwald M, Hernandez-Busot G, Hosein G, Kelley M, Mourgues C, Palmer W, Rodriguez-Sanchez J, Seabury R, Toribio S, Vin R, Weleff J, Woods S, Benrimoh D. A computational account of the development and evolution of psychotic symptoms. Biol Psychiatry 2024:S0006-3223(24)01584-1. [PMID: 39260466 DOI: 10.1016/j.biopsych.2024.08.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 09/13/2024]
Abstract
The mechanisms of psychotic symptoms like hallucinations and delusions are often investigated in fully-formed illness, well after symptoms emerge. These investigations have yielded key insights, but are not well-positioned to reveal the dynamic forces underlying symptom formation itself. Understanding symptom development over time would allow us to identify steps in the pathophysiological process leading to psychosis, shifting the focus of psychiatric intervention from symptom alleviation to prevention. We propose a model for understanding the emergence of psychotic symptoms within the context of an adaptive, developing neural system. We will make the case for a pathophysiological process that begins with cortical hyperexcitability and bottom-up noise transmission, which engenders inappropriate belief formation via aberrant prediction error signaling. We will argue that this bottom-up noise drives learning about the (im)precision of new incoming sensory information because of diminished signal-to-noise ratio, causing a compensatory relative over-reliance on prior beliefs. This over-reliance on priors predisposes to hallucinations and covaries with hallucination severity. An over-reliance on priors may also lead to increased conviction in the beliefs generated by bottom-up noise and drive movement toward conversion to psychosis. We will identify predictions of our model at each stage, examine evidence to support or refute those predictions, and propose experiments that could falsify or help select between alternative elements of the overall model. Nesting computational abnormalities within longitudinal development allows us to account for hidden dynamics among the mechanisms driving symptom formation and to view established symptomatology as a point of equilibrium among competing biological forces.
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Affiliation(s)
- Albert Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA.
| | - P A Angelos
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Alexandria Bond
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Emily Farina
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Carolyn Fredericks
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Jay Gandhi
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Maximillian Greenwald
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | | | - Gabriel Hosein
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Megan Kelley
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Catalina Mourgues
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - William Palmer
- Yale University Department of Psychology, New Haven, CT, USA
| | | | - Rashina Seabury
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Silmilly Toribio
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Raina Vin
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Jeremy Weleff
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - Scott Woods
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, USA
| | - David Benrimoh
- Department of Psychiatry, McGill University, Montreal, Canada
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2
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Mikus N, Lamm C, Mathys C. Computational phenotyping of aberrant belief updating in individuals with schizotypal traits and schizophrenia. Biol Psychiatry 2024:S0006-3223(24)01554-3. [PMID: 39218138 DOI: 10.1016/j.biopsych.2024.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 08/10/2024] [Accepted: 08/13/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Psychotic experiences are thought to emerge from various interrelated patterns of disrupted belief updating, such as overestimating the reliability of sensory information and misjudging task volatility. Yet, these substrates have never been jointly addressed under one computational framework and it is not clear to what degree they reflect trait-like computational patterns. METHODS We introduced a novel hierarchical Bayesian model that describes how individuals simultaneously update their beliefs about the task volatility and noise in observation. We applied this model to data from a modified Predictive inference task in a test-retest study with healthy volunteers (N=45, 4 sessions) and examined the relationship between model parameters and schizotypal traits in a larger online sample (N = 437) and in a cohort of patients with schizophrenia (N = 100). RESULTS The interclass correlations were moderate to high for model parameters and excellent for averaged belief trajectories and precision-weighted learning rates estimated through hierarchical Bayesian inference. We found that uncertainty about the task volatility was related to schizotypal traits and to positive symptoms in patients, when learning to gain rewards. In contrast, negative symptoms in patients were associated with more rigid beliefs about observational noise, when learning to avoid losses. CONCLUSION These findings suggest that individuals with schizotypal traits across the psychosis continuum are less likely to learn or utilize higher-order statistical regularities of the environment and showcase the potential of clinically relevant computational phenotypes for differentiating symptom groups in a transdiagnostic manner.
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Affiliation(s)
- Nace Mikus
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Austria; Interacting Minds Centre, Aarhus University, Denmark.
| | - Claus Lamm
- Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Austria
| | - Christoph Mathys
- Interacting Minds Centre, Aarhus University, Denmark; Translational Neuromodeling Unit, University of Zurich and ETH Zurich, Zurich, Switzerland;; Scuola Internazionale Superiore di Studi Avanzati (SISSA), Trieste, Italy
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3
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Barnby JM, Haslbeck JMB, Rosen C, Sharma R, Harrow M. Modelling the longitudinal dynamics of paranoia in psychosis: A temporal network analysis over 20 years. Schizophr Res 2024; 270:465-475. [PMID: 38996524 DOI: 10.1016/j.schres.2024.06.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 07/14/2024]
Abstract
BACKGROUND Paranoia is a key feature of psychosis that can be highly debilitating. Theories of paranoia mostly interface with short-scale or cross-sectional data models, leaving the longitudinal course of paranoia underspecified. METHODS We develop an empirical characterisation of two aspects of paranoia - persecutory and referential delusions - in individuals with psychosis over 20 years. We examine delusional dynamics by applying a Graphical Vector Autoregression Model to data collected from the Chicago Follow-up Study (n = 135 with a range of psychosis-spectrum diagnoses). We adjusted for age, sex, IQ, and antipsychotic use. RESULTS We found that referential and persecutory delusions are central themes, supported by other primary delusions, and are strongly autoregressive - the presence of referential and persecutory delusions is predictive of their future occurrence. In a second analysis we demonstrate that social factors influence the severity of referential, but not persecutory, delusions. IMPLICATIONS We suggest that persecutory delusions represent central, resistant states in the cognitive landscape, whereas referential beliefs are more flexible, offering an important window of opportunity for intervention. Our data models can be collated with prior biological, computational, and social work to contribute toward a more complete theory of paranoia and provide more time-dependent evidence for optimal treatment targets.
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Affiliation(s)
- J M Barnby
- Social Computation and Representation Lab, Department of Psychology, Royal Holloway, University of London, London, UK; Cultural and Social Neuroscience Group, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, University of London, London, UK.
| | - J M B Haslbeck
- Department of Clinical Psychological Science, Maastricht University, the Netherlands; Department of Psychological Methods, University of Amsterdam, the Netherlands
| | - C Rosen
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - R Sharma
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - M Harrow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
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4
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Griffin JD, Diederen KMJ, Haarsma J, Jarratt Barnham IC, Cook BRH, Fernandez-Egea E, Williamson S, van Sprang ED, Gaillard R, Vinckier F, Goodyer IM, Murray GK, Fletcher PC. Distinct alterations in probabilistic reversal learning across at-risk mental state, first episode psychosis and persistent schizophrenia. Sci Rep 2024; 14:17614. [PMID: 39080434 PMCID: PMC11289106 DOI: 10.1038/s41598-024-68004-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 07/17/2024] [Indexed: 08/02/2024] Open
Abstract
We used a probabilistic reversal learning task to examine prediction error-driven belief updating in three clinical groups with psychosis or psychosis-like symptoms. Study 1 compared people with at-risk mental state and first episode psychosis (FEP) to matched controls. Study 2 compared people diagnosed with treatment-resistant schizophrenia (TRS) to matched controls. The design replicated our previous work showing ketamine-related perturbations in how meta-level confidence maintained behavioural policy. We applied the same computational modelling analysis here, in order to compare the pharmacological model to three groups at different stages of psychosis. Accuracy was reduced in FEP, reflecting increased tendencies to shift strategy following probabilistic errors. The TRS group also showed a greater tendency to shift choice strategies though accuracy levels were not significantly reduced. Applying the previously-used computational modelling approach, we observed that only the TRS group showed altered confidence-based modulation of responding, previously observed under ketamine administration. Overall, our behavioural findings demonstrated resemblance between clinical groups (FEP and TRS) and ketamine in terms of a reduction in stabilisation of responding in a noisy environment. The computational analysis suggested that TRS, but not FEP, replicates ketamine effects but we consider the computational findings preliminary given limitations in performance of the model.
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Affiliation(s)
- J D Griffin
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK.
| | - K M J Diederen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - J Haarsma
- Wellcome Centre for Human Neuroimaging, Queen Square, UCL, London, UK
| | - I C Jarratt Barnham
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK
- Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - B R H Cook
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK
| | - E Fernandez-Egea
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK
- Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - S Williamson
- Coventry and Warwickshire NHS Partnership Trust, Warwick, UK
| | - E D van Sprang
- Amsterdam University Medical Centres (UMC), Amsterdam, The Netherlands
| | - R Gaillard
- Paris Descartes University, Paris, France
| | - F Vinckier
- Service Hospitalo-Universitaire, GHU Paris Psychiatrie & Neurosciences, F-75014, Paris, France
- Motivation, Brain & Behavior (MBB) lab, Institut du Cerveau et de la Moelle épinière (ICM), F-75013, Paris, France
- Université Paris Cité, F-75006, Paris, France
| | - I M Goodyer
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK
- Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - G K Murray
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK
- Cambridgeshire and Peterborough NHS Trust, Cambridge, UK
| | - P C Fletcher
- Department of Psychiatry, University of Cambridge, Addenbrookes Hospital, Cambridge, CB2 0QQ, UK.
- Cambridgeshire and Peterborough NHS Trust, Cambridge, UK.
- Wellcome Trust MRC Institute of Metabolic Science, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK.
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Foley JA, Chen C, Paget A, Cipolotti L. A Bayesian predictive processing account of Othello syndrome in Parkinson's disease. Cogn Neuropsychiatry 2023; 28:269-284. [PMID: 37366042 DOI: 10.1080/13546805.2023.2229080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 03/24/2023] [Indexed: 06/28/2023]
Abstract
Introduction: Although delusions in Parkinson's disease (PD) are rare, when they occur they frequently take the form of "Othello syndrome": the irrational belief that a spouse or partner is being unfaithful. Hitherto dismissed as either a by-product of dopamine therapy or cognitive impairment, there are still no convincing theoretical accounts to explain why only some patients fall prey to this delusion, or why it persists despite clear disconfirmatory evidence.Methods: We discuss the limitations of existing explanations of this delusion, namely hyperdopaminergia-induced anomalous perceptual experiences and cognitive impairment, before describing how Bayesian predictive processing accounts can provide a more comprehensive explanation by foregrounding the importance of prior experience and its impact upon computation of probability. We illustrate this new conceptualisation with three case vignettes.Results: We suggest that in those with prior experience of romantic betrayal, hyperdominergic-induced aberrant prediction errors enable anomalous perceptual experiences to accrue greater prominence, which is then maintained through Bayes-optimal inferencing to confirm cognitive distortions, eliciting and shaping this dangerous delusion.Conclusions: We propose the first comprehensive mechanistic account of Othello syndrome in PD and discuss implications for clinical interventions.
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Affiliation(s)
- Jennifer A Foley
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
- UCL Queen Square Institute of Neurology, London, UK
| | - Cliff Chen
- Department of Clinical Neuropsychology, Salford Royal NHS Foundation Trust, Salford, UK
| | - Andrew Paget
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Lisa Cipolotti
- Department of Neuropsychology, National Hospital for Neurology and Neurosurgery, London, UK
- UCL Queen Square Institute of Neurology, London, UK
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Tandon R. Computational psychiatry and the psychopathology of psychosis: Promising leads and blind alleys. Schizophr Res 2023; 254:143-145. [PMID: 36889180 DOI: 10.1016/j.schres.2023.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 03/10/2023]
Affiliation(s)
- Rajiv Tandon
- Department of Psychiatry, WMU Homer Stryker School of Medicine, Kalamazoo, MI, United States of America.
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Adams RA, Vincent P, Benrimoh D, Friston KJ, Parr T. Everything is connected: Inference and attractors in delusions. Schizophr Res 2022; 245:5-22. [PMID: 34384664 PMCID: PMC9241990 DOI: 10.1016/j.schres.2021.07.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 02/06/2023]
Abstract
Delusions are, by popular definition, false beliefs that are held with certainty and resistant to contradictory evidence. They seem at odds with the notion that the brain at least approximates Bayesian inference. This is especially the case in schizophrenia, a disorder thought to relate to decreased - rather than increased - certainty in the brain's model of the world. We use an active inference Markov decision process model (a Bayes-optimal decision-making agent) to perform a simple task involving social and non-social inferences. We show that even moderate changes in some model parameters - decreasing confidence in sensory input and increasing confidence in states implied by its own (especially habitual) actions - can lead to delusions as defined above. Incorporating affect in the model increases delusions, specifically in the social domain. The model also reproduces some classic psychological effects, including choice-induced preference change, and an optimism bias in inferences about oneself. A key observation is that no change in a single parameter is both necessary and sufficient for delusions; rather, delusions arise due to conditional dependencies that create 'basins of attraction' which trap Bayesian beliefs. Simulating the effects of antidopaminergic antipsychotics - by reducing the model's confidence in its actions - demonstrates that the model can escape from these attractors, through this synthetic pharmacotherapy.
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Affiliation(s)
- Rick A Adams
- Centre for Medical Image Computing, Dept of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK.
| | - Peter Vincent
- Sainsbury Wellcome Centre, University College London, 25 Howland St, London W1T 4JG, UK
| | - David Benrimoh
- Department of Psychiatry, McGill University, H3G 1A4 QC, Canada
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
| | - Thomas Parr
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
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Wiese W, Friston KJ. AI ethics in computational psychiatry: From the neuroscience of consciousness to the ethics of consciousness. Behav Brain Res 2022; 420:113704. [PMID: 34871706 PMCID: PMC9125160 DOI: 10.1016/j.bbr.2021.113704] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022]
Abstract
Methods used in artificial intelligence (AI) overlap with methods used in computational psychiatry (CP). Hence, considerations from AI ethics are also relevant to ethical discussions of CP. Ethical issues include, among others, fairness and data ownership and protection. Apart from this, morally relevant issues also include potential transformative effects of applications of AI-for instance, with respect to how we conceive of autonomy and privacy. Similarly, successful applications of CP may have transformative effects on how we categorise and classify mental disorders and mental health. Since many mental disorders go along with disturbed conscious experiences, it is desirable that successful applications of CP improve our understanding of disorders involving disruptions in conscious experience. Here, we discuss prospects and pitfalls of transformative effects that CP may have on our understanding of mental disorders. In particular, we examine the concern that even successful applications of CP may fail to take all aspects of disordered conscious experiences into account.
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Affiliation(s)
- Wanja Wiese
- Institute of Philosophy II, Ruhr University Bochum, Universitätsstraße 150, 44780 Bochum, Germany.
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
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Fisher VL, Ortiz LS, Powers AR. A computational lens on menopause-associated psychosis. Front Psychiatry 2022; 13:906796. [PMID: 35990063 PMCID: PMC9381820 DOI: 10.3389/fpsyt.2022.906796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/07/2022] [Indexed: 11/21/2022] Open
Abstract
Psychotic episodes are debilitating disease states that can cause extreme distress and impair functioning. There are sex differences that drive the onset of these episodes. One difference is that, in addition to a risk period in adolescence and early adulthood, women approaching the menopause transition experience a second period of risk for new-onset psychosis. One leading hypothesis explaining this menopause-associated psychosis (MAP) is that estrogen decline in menopause removes a protective factor against processes that contribute to psychotic symptoms. However, the neural mechanisms connecting estrogen decline to these symptoms are still not well understood. Using the tools of computational psychiatry, links have been proposed between symptom presentation and potential algorithmic and biological correlates. These models connect changes in signaling with symptom formation by evaluating changes in information processing that are not easily observable (latent states). In this manuscript, we contextualize the observed effects of estrogen (decline) on neural pathways implicated in psychosis. We then propose how estrogen could drive changes in latent states giving rise to cognitive and psychotic symptoms associated with psychosis. Using computational frameworks to inform research in MAP may provide a systematic method for identifying patient-specific pathways driving symptoms and simultaneously refine models describing the pathogenesis of psychosis across all age groups.
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Affiliation(s)
- Victoria L Fisher
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Liara S Ortiz
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
| | - Albert R Powers
- Yale University School of Medicine and the Connecticut Mental Health Center, New Haven, CT, United States
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Rigoli F, Martinelli C, Pezzulo G. I want to believe: delusion, motivated reasoning, and Bayesian decision theory. Cogn Neuropsychiatry 2021; 26:408-420. [PMID: 34558392 DOI: 10.1080/13546805.2021.1982686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Introduction: Several arguments suggest that motivated reasoning (occurring when beliefs are not solely shaped by accuracy, but also by other motives such as promoting self-esteem or self-protection) is important in delusions. However, classical theories of delusion disregard the role of motivated reasoning. Thus, this role remains poorly understood.Methods: To explore the role of motivated reasoning in delusions, here we propose a computational model of delusion based on a Bayesian decision framework. This proposes that beliefs are not only evaluated based on their accuracy (as in classical theories), but also based on the cost (in terms of reward and punishment) of rejecting them.Results: The model proposes that, when the values at stake are high (as often it is the case in the context of delusion), a belief might be endorsed because rejecting it is evaluated as too costly, even if the belief is less accurate. This process might contribute to the genesis of delusions.Conclusions: Our account offers an interpretation of how motivated reasoning might shape delusions. This can inspire research on the affective and motivational processes supporting delusions in clinical conditions such as in psychosis, neurological disorders, and delusional disorder.
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Affiliation(s)
- Francesco Rigoli
- Department of Psychology, City, University of London, Northampton Square, London, UK
| | - Cristina Martinelli
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Department of Psychology, Kingston University, Surrey, UK
| | - Giovanni Pezzulo
- Institute of Cognitive Sciences and Technologies, National Research Council of Italy, Rome, Italy
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