Phenomenology<i>is</i>Bayesian in its application to delusions

Mishara, Aaron L.; Sterzer, Philipp

doi:10.1002/wps.20213

Cited by 11 publications

(5 citation statements)

References 10 publications

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“…It is a long‐standing notion in psychiatry, in fact, that delays in treating delusions might lead them to become more ‘crystallized’, that is, more tenaciously held by the patient. Bayesian models of delusional thinking seem particularly fit to further explore these hypotheses (Mishara & Sterzer, 2015; Williams, 2018). Alternatively, some authors have recently claimed that the detrimental effect of the DUP may be an artefact introduced by lead‐time bias, that is, a confounding effect due to assessing patients in different stages of the illness (Jonas et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

Murri

Bertelli²,

Carozza³

et al. 2020

Early Intervention Psych

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Aim To examine the incidence of with first‐episode psychosis (FEP) in the Integrated Department of Mental Health and Pathological Addictions in Ferrara, Italy, and to examine the association between the Duration of Untreated Psychosis (DUP) and the clinical course. Methods Participants recruited in 2013–2019 were assessed with the Health of the Nation Outcome Scale (HoNOS) every 6 months for 24 months. Hierarchical growth models analysed changes of global severity (HoNOS total scores) and symptom dimensions. Regression modelled factors associated with remission (HoNOS < 8) and clinical improvement (<12). Results The incidence of FEP was 21.5 (95%CI: 21.2–21.9) cases per 100 000 person year. Among participants (n = 86, mean age 23, 76% males), baseline HoNOS scores were higher for those with a longer DUP. More than half subjects reached clinical remission (61.6%) or improvement (82.6%), while very few (2.3%) were re‐hospitalized. HoNOS total scores decayed with a mixed linear/quadratic trend, with a slower decay among migrants. A longer DUP was associated with reduced improvements of positive symptoms and lower likelihood of clinical improvement (OR: 0.84; 95%CI: 0.73–0.96). Conclusions Patients from the FEP program of Ferrara reached good clinical outcomes. Nonetheless, individuals with a longer DUP may need additional clinical attention. Systematic monitoring of clinical outcomes may be an optimal strategy to improve the outcomes of FEP in the real world.

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Section: Discussionmentioning

confidence: 99%

First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

Murri

Bertelli²,

Carozza³

et al. 2020

Early Intervention Psych

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“…Computational modelling forces such concepts to be formalised mathematically, and likewise rival models can be formally compared. The predictive processing framework is one framework which explains symptoms of psychosis as an alteration in specific elements of information processing (86)(87)(88)(89)(90)(91). Predictive processing treats the brain as a Bayesian agent which makes inferences about the causes of its noisy and dynamic sensory inputs using an internal model of the world.…”

Section: Computational Accounts Of Psychosismentioning

confidence: 99%

Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis

Howes

Hird

Adams

et al. 2020

Biological Psychiatry

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Importantly, when conceiving of thoughts as being predicted by prior beliefs that are determined by context information, we make no principled assumption as to whether this context information is consciously accessible. In Bayesian inference, a prior belief is considered merely a probability distribution over some unknown state and may or may not be consciously accessible (Adams et al, 2013 ; Mishara and Sterzer, 2015 ). Importantly, current models of hierarchical predictive coding assume that prior beliefs are fundamentally embodied even at the lowest levels of sensory processing (Friston, 2005 ; Adams et al, 2013 ).…”

Section: Thought Insertion As a Consequence Of Reduced Precision Of Pmentioning

confidence: 99%

Thought Insertion as a Self-Disturbance: An Integration of Predictive Coding and Phenomenological Approaches

Sterzer

Mishara

Voss

et al. 2016

Front. Hum. Neurosci.

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Current theories in the framework of hierarchical predictive coding propose that positive symptoms of schizophrenia, such as delusions and hallucinations, arise from an alteration in Bayesian inference, the term inference referring to a process by which learned predictions are used to infer probable causes of sensory data. However, for one particularly striking and frequent symptom of schizophrenia, thought insertion, no plausible account has been proposed in terms of the predictive-coding framework. Here we propose that thought insertion is due to an altered experience of thoughts as coming from “nowhere”, as is already indicated by the early 20th century phenomenological accounts by the early Heidelberg School of psychiatry. These accounts identified thought insertion as one of the self-disturbances (from German: “Ichstörungen”) of schizophrenia and used mescaline as a model-psychosis in healthy individuals to explore the possible mechanisms. The early Heidelberg School (Gruhle, Mayer-Gross, Beringer) first named and defined the self-disturbances, and proposed that thought insertion involves a disruption of the inner connectedness of thoughts and experiences, and a “becoming sensory” of those thoughts experienced as inserted. This account offers a novel way to integrate the phenomenology of thought insertion with the predictive coding framework. We argue that the altered experience of thoughts may be caused by a reduced precision of context-dependent predictions, relative to sensory precision. According to the principles of Bayesian inference, this reduced precision leads to increased prediction-error signals evoked by the neural activity that encodes thoughts. Thus, in analogy with the prediction-error related aberrant salience of external events that has been proposed previously, “internal” events such as thoughts (including volitions, emotions and memories) can also be associated with increased prediction-error signaling and are thus imbued with aberrant salience. We suggest that the individual’s attempt to explain the aberrant salience of thoughts results in their interpretation as being inserted by an alien agent, similarly to the emergence of delusions in response to the aberrant salience of sensory stimuli.

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PhenomenologyisBayesian in its application to delusions

Cited by 11 publications

References 10 publications

First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

First‐episode psychosis in the Ferrara Mental Health Department: Incidence and clinical course within the first 2 years

Aberrant Salience, Information Processing, and Dopaminergic Signaling in People at Clinical High Risk for Psychosis

Thought Insertion as a Self-Disturbance: An Integration of Predictive Coding and Phenomenological Approaches

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