Are clinical delusions adaptive?

Abstract

Delusions are symptoms of psychiatric disorders such as schizophrenia and dementia. By and large, delusions are characterized by their behavioral manifestations and defined as irrational beliefs that compromise good functioning. In this overview paper, we ask whether delusions can be adaptive notwithstanding their negative features. Can they be a response to a crisis rather than the source of the crisis? Can they be the beginning of a solution rather than the problem? Some of the psychological, psychiatric, and philosophical literature has recently suggested that they can. We consider different types of delusions and different ways in which they can be considered as adaptive: psychologically (e.g., by increasing wellbeing, purpose in life, intrapsychic coherence, or good functioning) and biologically (e.g., by enhancing genetic fitness). Although further research is needed to map the costs and benefits of adopting and maintaining delusional beliefs, a more nuanced picture of the role of delusions in people's lives has started to emerge.This article is categorized under: Philosophy > RepresentationPhilosophy > Knowledge and BeliefNeuroscience > Cognition

Explaining Ideology: Mechanisms and Metaphysics

“…For instance, attribution biases are systematic and resilient in paranoid ideation. Also, clinical delusions perform a defensive function in protecting subjects from forming beliefs that would cause more distress (Lancellotta and Bortolotti 2019). Still, patients tend to lose confidence in their delusions when faced repeatedly with counter-evidence and positive effects are limited in time (Gunn and Bortolotti 2018).…”

Delusions in the two-factor theory

“…Beliefs are usually called 'adaptive' if they enhance a person's wellbeing, purpose in life, or good functioning (psychological adaptiveness); or if they enhance an individual's chances of survival and reproduction (biological adaptiveness). It has been shown that arguments for the biological adaptiveness of delusions are less common and overall less persuasive than claims about their psychological adaptiveness (McKay and Dennett 2009;Lancellotta and Bortolotti 2019) and when some delusions are presented as psychologically adaptive, their contribution to wellbeing or good functioning is often regarded as partial or temporary. We will spend more time on the psychological adaptiveness claim simply because the biological adaptiveness thesis has been defended (to our knowledge) only within the predictive-processing account of delusion formation (Fineberg and Corlett 2016) and not within the two-factor theory.…”

“…In this section, we ask whether the claim that delusions are adaptive is compatible with the Coltheart model and the McKay model. In the philosophical, psychological, and psychiatric literature there have been recent explorations of the idea that some delusions may be adaptive in some sense (Lancellotta and Bortolotti 2019), psychologically (McKay and Dennett 2009), biologically (Fineberg and Corlett 2016), even epistemically (Bortolotti 2015;.…”

Mental Health First Aid Training: A Study of Community Members’ Pre and Post-training Responses to a 17-Item Questionnaire

“…The trainees correct (A, 17S) and wrong (D) responses increased insignificantly (>0.05) and DNK responses decreased insignificantly (>0.05) post-test evaluation. Research evidenced that mostly delusions linked with reasoning bias or deficit have social themes that cause tremendous distress to delusional persons and arguing/reasoning with them often lead to hostile behavior [74,75]. Overall, the bottom-line is that community participants' three types of responses (A-D-DNK to S1-S17) before and after training course were variable possibly attributable to a bit difficult questionnaire and their meager knowledge, perceptions, attitude and practice of mental health problems and crisis situations.…”