We provide a battery of examples of delusions against which theoretical accounts can be tested. Then, we identify neuropsychological anomalies that could produce the unusual experiences that may lead, in turn, to the delusions in our battery. However, we argue against Maher’s view that delusions are false beliefs that arise as normal responses to anomalous experiences. We propose, instead, that a second factor is required to account for the transition from unusual experience to delusional belief. The second factor in the (...) aetiology of delusions can be described superficially as a loss of the ability to reject a candidate for belief on the grounds of its implausibility and its inconsistency with everything else that the patient knows. But we point out some problems that confront any attempt to say more about the nature of this second factor. (shrink)

Article copyright 2002. We provide a battery of examples of delusions against which theoretical accounts can be tested. Then we identify neuropsychological anomalies that could produce the unusual experiences that may lead, in turn, to the delusions in our battery. However, we argue against Maher's view that delusions are false beliefs that arise as normal responses to anomalous experiences. We propose, instead, that a second factor is required to account for the transition from unusual experience to delusional belief. The second (...) factor in the etiology of delusions can be described superficially as a loss of the ability to reject a candidate for belief on the grounds of its implausibility and its inconsistency with everything else that the patient knows, but we point out some problems that confront any attempt to say more about the nature of this second factor. (shrink)

In folie à deux, a ‘primary’ patient transmits a delusional belief to one or more ‘secondary’ patients who then adopt and share the belief. This paper applies the two‐factor theory of delusion to retrospectively analyse published cases of folie à deux. Lessons from this retrospective analysis include, firstly, that two‐factor theorists need to shift their focus from endogenous processes to consider the exogenous source of delusional content in most secondaries. Secondly, secondaries who come to share the belief via normal processes (...) of social contagion only qualify as delusional by virtue of the abnormal persistence of their belief, albeit a temporary persistence in those secondaries who abandon their belief soon after separation from the primary. Underpinning this abnormal persistence may be a form of inhibitory failure—a difficulty with inhibiting a belief to allow reasoning for and against it being true. (shrink)

The impact of our desires and preferences upon our ordinary, everyday beliefs is well-documented [Gilovich, T. . How we know what isn’t so: The fallibility of human reason in everyday life. New York: The Free Press.]. The influence of such motivational factors on delusions, which are instances of pathological misbelief, has tended however to be neglected by certain prevailing models of delusion formation and maintenance. This paper explores a distinction between two general classes of theoretical explanation for delusions; the motivational (...) and the deficit. Motivational approaches view delusions as extreme instances of self-deception; as defensive attempts to relieve pain and distress. Deficit approaches, in contrast, view delusions as the consequence of defects in the normal functioning of belief mechanisms, underpinned by neuroanatomical or neurophysiological abnormalities. It is argued that although there are good reasons to be sceptical of motivational theories , recent experiments confirm that motives are important causal forces where delusions are concerned. It is therefore concluded that the most comprehensive account of delusions will involve a theoretical unification of both motivational and deficit approaches. (shrink)

Cognitive neuropsychology is that branch of cognitive psychology that investi- gates people with acquired or developmental disorders of cognition. The aim is to learn more about how cognitive systems normally operate or about how they are normally acquired by studying selective patterns of cognitive break- down after brain damage or selective dif?culties in acquiring particular cogni- tive abilities. In the early days of modern cognitive neuropsychology, research focused on rather basic cognitive abilities such as speech comprehension or production at the (...) single-word level, reading and spelling, object and face recognition, and short-term memory. More recently the cognitive-neuro- psychological approach has been applied to the study of rather more complex domains of cognition such as belief ?xation (e.g. Coltheart and Davies, 2000; Langdon and Coltheart, 2000) and pragmatic aspects of communication (e.g. McDonald and Van Sommers, 1993). Our paper concerns the investigation of pragmatic disorders in one clinical group in which such disorders are common, patients with schizophrenia, and what the study of such people can tell us about the normal processes of communication. (shrink)

Fregoli delusion is the mistaken belief that some person currently present in the deluded person's environment is a familiar person in disguise. The stranger is believed to be psychologically identical to this known person even though the deluded person perceives the physical appearance of the stranger as being different from the known person's typical appearance. To gain a deeper understanding of this contradictory error in the normal system for tracking and identifying known persons, we conducted a detailed survey of all (...) the Fregoli cases reported in the literature since the seminal Courbon and Fail paper. Our preliminary reading of these cases revealed a notable lack of definitional clarity. So, we first formulated a classification scheme of different person misidentification delusions so as to identify those cases that qualified as instances of Fregoli according to the above characterization: the mistaken belief that a known person is present in the environment in a different guise to his or her typical appearance. We identified 38 clear cases of this type and set out to answer a series of questions motivated by current hypotheses about the origin of the Fregoli delusion. We asked whether the patients misidentified particular strangers, made reference to the misidentified known persons using wigs or plastic surgery , misidentified many different strangers or only one, showed other symptoms , and made inferences about the motives of the known persons in disguise. We conclude by discussing the implications of our findings for current hypotheses concerning the origin of the Fregoli delusion. (shrink)

Mirrored-self misidentification is the delusional belief that one's own reflection in the mirror is a stranger. In two experiments, we tested the ability of hypnotic suggestion to model this condition. In Experiment 1, we compared two suggestions based on either the delusion's surface features (seeing a stranger in the mirror) or underlying processes (impaired face processing). Fifty-two high hypnotisable participants received one of these suggestions either with hypnosis or without in a wake control. In Experiment 2, we examined the extent (...) to which social cues and role-playing could account for participants' behaviour by comparing the responses of 14 hypnotised participants to the suggestion for impaired face processing (reals) with those of 14 nonhypnotised participants instructed to fake their responses (simulators). Overall, results from both experiments confirm that we can use hypnotic suggestion to produce a compelling analogue of mirrored-self misidentification that cannot simply be attributed to social cues or role-playing. (shrink)

This article contrasts the cognitive neuropsychiatric approach with the traditional psychiatric approaches to delusions to develop testable cognitive theories of delusions so as to render the generation of delusions psychologically understandable. It illustrates how cognitive neuropsychiatrists use the Bruce and Young model of face processing to explain the generation of misidentification delusions. The study of facial expression highlights that future cognitive neuropsychiatric study of self and non-self face processing using different representational media in patients with mirrored-self misidentification delusions will likely (...) be informative with regard to advancing scientific understanding of the putative differences between self and non-self recognition. It reviews cognitive neuropsychiatric research into the Capgras delusion and shows the distinction between overt face recognition and person identity authentication, and suggests the need for further modification of Bruce and Young's model to remove direct pathways between the person's identity module and the affective response system and to incorporate a separate integrative device. (shrink)

In their pursuit of adaptively biased misbelief-making systems, McKay & Dennett (M&D) describe a putative doxastic shear-pin system which enables misbeliefs to form in situations of extreme psychological stress. Rather than discussing their argument, I consider how this shear-pin system might combine with both pathological belief-making ( breakdowns caused by neuropathy) and normal belief-making to explain a spectrum of delusions.

Much attention has been paid recently to the role of anomalous experiences in the aetiology of certain types of psychopathology, e.g. in the formation of delusions. We examine, instead, the top-down influence of pre-existing beliefs and affective factors in shaping an individual’s characterisation of anomalous sensory experiences. Specifically we investigated the effects of paranormal beliefs and alexithymia in determining the intensity and quality of an altered state of consciousness . Fifty five participants took part in a sweat lodge ceremony, a (...) traditional shamanic ritual which was unfamiliar to them. Participants reported significant alterations in their state of consciousness, quantified using the ‘APZ’ questionnaire, a standardized measure of ASC experience. Participants endorsing paranormal beliefs compatible with shamanic mythology, and those showing difficulty identifying feelings scored higher on positive dimensions of ASC experience. Our findings demonstrate that variation in an individual’s characterisation of anomalous experiences is nuanced by pre-existing beliefs and affective factors. (shrink)

Dehaene et al. (2003) showed an absence of conscious, but not masked, conflict effects when patients with schizophrenia performed a number-categorisation priming task. We aimed to replicate these influential results using a different word-categorisation priming task. Counter to Dehaene et al.'s findings, 21 patients and 20 healthy controls showed similar congruence effects for both masked and visible primes. Within patients, a reduced congruence effect for visible primes associated with longer duration of illness and more severe behavioural disorganisation. Patients, unlike controls, (...) were no slower to respond to targets that followed visible compared to masked primes. Conscious conflict effects on priming tasks are not universally reduced in schizophrenia but may associate with chronicity and behavioural disorganisation. That patients were no slower when the preceding primes were clearly visible accords with evidence elsewhere that information processing in schizophrenia is driven more by immediate conscious experience and constrained less by prior events. (shrink)

By conceiving of autism and psychosis as diametrically opposite phenotypes of underactive and overactive mentalizing, respectively, Crespi & Badcock (C&B) commit themselves to a continuum view of intercorrelated mentalizing functions. This view fails to acknowledge dissociations between mentalizing functions and that psychotic people show a mixture of both hypo- and hyper-mentalizing.