Confabulation and delusion: A common monitoring framework

Abstract

Confabulations and delusions both involve the production of false claims. Although they may have different types of content, they share several characteristics. For example, they are often held with considerable conviction and are resistant to counter evidence, they may be acted upon, and they may be accompanied by a lack of concern about the false claim or its implications. Confabulations and delusions may initially arise from failures in different systems (e.g., mnemonic vs. perceptual or affective). However, their shared characteristics raise the possibility that the monitoring deficits involved might be the same, resulting in failure to reject the confabulatory or delusional ideas. In this paper we will focus on the nature of these common monitoring deficits. Critically, we argue that monitoring in confabulation and delusion involves both unconscious and conscious processes. We propose that an unconscious process is responsible for tagging suspect content which needs to be checked for veracity by a separate set of conscious evaluative processes. Failure of these monitoring processes would allow ideas which ought to be checked and rejected to instead be uncritically accepted: This would result in the production of confabulations or delusions. Importantly, inclusion of both unconscious and conscious monitoring stages allows the model to account for both "endorsement" and "explanation" delusions, and both "primary" and "secondary" confabulations. Our hope is that this model may provide a theoretical framework to guide empirical investigation of the commonalities and differences between the conditions.

The network substrate of confabulatory tendencies in Alzheimer's disease

“…These latter hypotheses seem to be a more realistic reflection of the kind of brain function disruption that might be expected in early AD. The mechanisms of confabulation share important theoretical commonalities with the processes behind the generation of delusions (Turner & Coltheart, 2010). In fact, the presence of delusional (and aggression) symptoms influenced the presence of confabulations during cognitive tasks (Lee, Akanuma, Meguro, Ishii, Yamaguchi & Meguro, 2007).…”

Confabulation: A Beginner’s Guide for legal professionals

“…However, a major difference lies in the strength of their commitment to the belief or memory. Delusions are defined as the firm, false beliefs that can be maintained even in the face of contradicting arguments or evidence [32]. Conversely, confabulations are defined as inaccurate memories and can be altered in the presence of high pressure or convincing alternatives.…”

“…Despite the facade of confidence and accuracy, individuals may confabulate entirely false memories of imagined details or events [2,32,36]. It is important to note that in some instances, confabulation can be based on partially true information grounded in a kernel of truth.…”

Loved Ones Near and Far: Feinberg’s Personal Significance Theory

“…One reason for postulating a second factor-malfunction of prefrontal executive processes-is that it is intended to explain why the patients do not notice the absurdity and implausibility of their claims (Coltheart, 2007;Turner & Coltheart, 2009). Instead of this second factor, Feinberg says that "there is a disturbance in a firm and stable sense of personal identity and a perturbation in ego boundaries."…”