Metacognitive control over false memories: A key determinant of delusional thinking

Abstract

This article reviews the current literature on false memories in schizophrenia. Increasing evidence suggests that neither memory impairment in general nor false memories in particular can reliably differentiate patients with schizophrenia or delusions from psychiatric controls. In contrast, it is proposed that a reduced metacognitive awareness of one's own fallibility, and overconfidence in errors, may predispose a person to fixed, false beliefs (ie, delusions). Congruent with this position, a number of recent investigations suggest that the memory of patients with schizophrenia, as well as healthy subjects scoring high on delusional ideation, is corrupted by an increased number of incorrect memories held with high confidence, possibly relating to a jumping-to-conclusions or liberal acceptance bias in schizophrenia spectrum disorders. A new training approach is described that is intended to sharpen patients' awareness of such errors and reduce confidence in fallible memories. Some empirical gaps and directions for further research are outlined.

The Relationship of Metacognition with Jumping to Conclusions among Persons with Schizophrenia Spectrum Disorders

“…These findings are consistent with the assertions [10,11] that difficulties in thinking about thinking may underpin a tendency to liberally accept a conclusion and arrive at a firm decision without sufficient information [27], as well as with emerging models that deficits in metacognition play a role in the development of psychosocial dysfunction in schizophrenia [28,29]. While the nature of this study precludes drawing causal conclusions, results point to possibilities which could direct future research.…”

“…While we use metacognition as an umbrella term, we recognize that it is closely related to a range of other terms including mentalization [10], and partially with theory of mind, though the latter largely pertains to the recognition part of mental state attribution, whereas metacognition explicitly entails one’s ability to detect, reason upon, integrate and actively use mentalistic information from one’s own and others’ mental processes for problem-solving [9]. Reviewing false memories and schizophrenia, Moritz and Woodward [11] propose that a ‘reduced metacognitive awareness of one’s own fallibility, and overconfidence in errors may predispose a person to fixed, false beliefs (i.e. delusions)’ (p. 184).…”

Emotion recognition in depression: An investigation of performance and response confidence in adult female patients with depression

“…False judgements that are made with high confidence may be associated with more severe behavioural consequences than those made with some doubt (Moritz and Van Quaquebeke, 2014;Moritz and Woodward, 2006). In everyday life, it is often impossible to correctly decide the emotional state of one's counterpart based on FEE alone.…”

Metamemory in schizophrenia: Retrospective confidence ratings interact with neurocognitive deficits

“…Overconfidence in memory errors may represent a risk factor for delusions and hallucinations (Moritz and Woodward, 2006a;Gaweda et al, 2013). It might be a consequence of a liability to accept false hypotheses as true and evaluate them on the basis of too little information-a liberal acceptance-which in turn results in wrong and delusional interpretations of situations (Moritz et al, 2005(Moritz et al, , 2008, comparable to the "jumping to conclusion" bias (Fine et al, 2007).…”