Studying Delusions Within Research Domain Criteria: The Challenge of Configural Traits When Building a Mechanistic Foundation for Abnormal Beliefs

MacDonald, Angus W.

doi:10.1093/schbul/sbw190

Cited by 5 publications

(5 citation statements)

References 23 publications

(18 reference statements)

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“…Thus, an attribution to the emotional domain of communication is possible for the emotional valence of delusions but not for the error of judgement per se. This view is consistent with the RDoC’s negative valence constructs for delusions, such as acute threat, potential threat, sustained threat, and frustrative nonreward [56], and empirical studies support the link of paranoid experience of threat and delusions of reference to abnormalities of the limbic system [57-60]. Furthermore, modern rating scales for delusions, such as the Psychotic Symptom Rating Scales (PSYRATS) [61] or the Delusions-Symptoms-States Inventory (DSSI) [62], focus on other aspects, particularly on the emotional content of delusions.…”

Section: Translational Psychopathology: Matching Psychotic Symptoms Wsupporting

confidence: 80%

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

et al. 2017

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Schizophrenia research has been in a deadlock for many decades. Despite important advances in clinical treatment, there are still major concerns regarding long-term psychosocial reintegration and disease management, biological heterogeneity, unsatisfactory predictors of individual course and treatment strategies, and a confusing variety of controversial theories about its etiology and pathophysiological mechanisms. In the present perspective on schizophrenia research, we first discuss a methodological pitfall in contemporary schizophrenia research inherent in the attempt to link mental phenomena with the brain: we claim that the time-honored phenomenological method of defining mental symptoms should not be contaminated with the naturalistic approach of modern neuroscience. We then describe our Systems Neuroscience of Psychosis (SyNoPsis) project, which aims to overcome this intrinsic problem of psychiatric research. Considering schizophrenia primarily as a disorder of interindividual communication, we developed a neurobiologically informed semiotics of psychotic disorders, as well as an operational clinical rating scale. The novel psychopathology allows disentangling the clinical manifestations of schizophrenia into behavioral domains matching the functions of three well-described higher-order corticobasal brain systems involved in interindividual human communication, namely, the limbic, associative, and motor loops, including their corticocortical sensorimotor connections. The results of several empirical studies support the hypothesis that the proposed three-dimensional symptom structure, segregated into the affective, the language, and the motor domain, can be specifically mapped onto structural and functional abnormalities of the respective brain systems. New pathophysiological hypotheses derived from this brain system-oriented approach have helped to develop and improve novel treatment strategies with noninvasive brain stimulation and practicable clinical parameters. In clinical practice, the novel psychopathology allows confining the communication deficits of the individual patient, shifting attention from the symptoms to the intact resources. We have studied this approach and observed important advantages for therapeutic alliances, personalized treatment, and de-escalation strategies. Future studies will further conjoin clinical definitions of psychotic symptoms with brain structures and functions, and disentangle structural and functional deficit patterns within these systems to identify neurobiologically distinct subsyndromes. Neurobiologically homogeneous patient groups may provide new momentum for treatment research. Finally, lessons learned from schizophrenia research may contribute to developing a comprehensive perspective on human experience and behavior that integrates methodologically distinct, but internally consistent, insights from humanities and neuroscience.

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Section: Translational Psychopathology: Matching Psychotic Symptoms Wsupporting

confidence: 80%

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

et al. 2017

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“…In our follow-up seed-based connectivity analysis, higher delusion severity was associated with the area negatively correlated with the PreCU cluster, although less robustly than the association for obsession. Symptoms that cause negative emotions, such as persecutory delusions, may be considered related to the negative valence constructs of the RDoC matrix; however, it is still insufficiently described by the RDoC matrix because, in an assessment of the severity of delusions, the P1 item on the PANSS encompasses a wide variety of delusions, such as grandiose or erotic delusions, which is difficult to define as negative emotion (MacDonald, 2017). These facets, also associated with manic mood, in part, may explain the weaker association reported for delusion in the seed-based analysis results.…”

Section: Discussionmentioning

confidence: 99%

Distinct neural networks associated with obsession and delusion: a connectome-wide association study

et al. 2020

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Background Obsession and delusion are theoretically distinct from each other in terms of reality testing. Despite such phenomenological distinction, no extant studies have examined the identification of common and distinct neural correlates of obsession and delusion by employing biologically grounded methods. Here, we investigated dimensional effects of obsession and delusion spanning across the traditional diagnostic boundaries reflected upon the resting-state functional connectivity (RSFC) using connectome-wide association studies (CWAS). Methods Our study sample comprised of 96 patients with obsessive–compulsive disorder, 75 patients with schizophrenia, and 65 healthy controls. A connectome-wide analysis was conducted to examine the relationship between obsession and delusion severity and RFSC using multivariate distance-based matrix regression. Results Obsession was associated with the supplementary motor area, precentral gyrus, and superior parietal lobule, while delusion was associated with the precuneus. Follow-up seed-based RSFC and modularity analyses revealed that obsession was related to aberrant inter-network connectivity strength. Additional inter-network analyses demonstrated the association between obsession severity and inter-network connectivity between the frontoparietal control network and the dorsal attention network. Conclusions Our CWAS study based on the Research Domain Criteria (RDoC) provides novel evidence for the circuit-level functional dysconnectivity associated with obsession and delusion severity across diagnostic boundaries. Further refinement and accumulation of biomarkers from studies embedded within the RDoC framework would provide useful information in treating individuals who have some obsession or delusion symptoms but cannot be identified by the category of clinical symptoms alone.

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“…They are a common symptom in psychotic disorders such as schizophrenia (APA, 2013). Studies have attempted to elucidate the cognitive mechanisms of these symptoms, but our understanding regarding them remains limited ( MacDonald, 2017 ). The dual-process model is a promising but underexplored framework for identifying the cognitive disruptions underlying delusions ( Bronstein et al, 2019 ;Ward & Garety, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Acquiescing to intuition in individuals prone to delusions: Alterations in dual processes and cognitive control

Liew¹,

Larsen²,

Katz³

et al. 2022

Preprint

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Delusions are aberrant beliefs that are maintained in the face of conflicting evidence. Promising mechanistic frameworks are suggested by cognitive control theory which delineates detection and resolution stages of conflict processing and an augmented dual-process framework which proposes acquiescence to intuitive beliefs despite awareness that they conflict with rationality. We measured intuitive processes using one-shot decision-making and analytic processes using cognitive reflection (CRT) and Stroop tasks. Higher intuitive strength and lower CRT/Stroop conflict resolution was associated with increased acquiescence. Importantly, those less prone to delusions were more likely to override a strong irrational intuition as their analytic strength (on CRT and Stroop) increased; however, in those high on delusion-proneness, analytic strength predicted an increased likelihood of acquiescing to intuition. These findings highlight an interactive role of intuitive and analytic processes such that those prone to delusions may tend to rally cognitive resources to rationalize their intuitions.

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Studying Delusions Within Research Domain Criteria: The Challenge of Configural Traits When Building a Mechanistic Foundation for Abnormal Beliefs

Cited by 5 publications

References 23 publications

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

Systems Neuroscience of Psychosis: Mapping Schizophrenia Symptoms onto Brain Systems

Distinct neural networks associated with obsession and delusion: a connectome-wide association study

Acquiescing to intuition in individuals prone to delusions: Alterations in dual processes and cognitive control

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