The 33rd Sir Frederick Bartlett Lecture Cognitive neuropsychiatry and delusional belief

Abstract

Cognitive neuropsychiatry is a new field of cognitive psychology which seeks to learn more about the normal operation of high-level aspects of cognition such as belief formation, reasoning, decision making, theory of mind, and pragmatics by studying people in whom such processes are abnormal. So far, the high-level cognitive process most widely studied in cognitive neuropsychiatry has been belief formation, investigated by examining people with delusional beliefs. This paper describes some of the forms of delusional belief that have been examined from this perspective and offers a general two-deficit cognitive-neuropsychiatric account of delusional belief.

Models and Neural Bases of the Believing Process

“…In psychology and cognitive neuroscience, believing is an act of generating and maintaining a mental construct as real or true based on previously stored information. There is an increasing interest in understanding this mental act in terms of adaptive significance, cognitive processes, and their neural implementation in the human brain [13]- [22]. Through interdisciplinary interrogation, it has become evident the necessity of sharing the following three notions on the nature of the believing process among the relevant academic fields.…”

“…He suggested that the belief evaluation component is accommodated in the right LPFC based on the finding of a reduced activity in this region in delusional patients [13] [16] and on the response of this region in the face of knowledge-violating information in healthy subjects [15] [18] [22]. Considering the potential relevance of the belief evaluating process to the stability of the belief, this brain area may correspond to the stabilizer function.…”

“…On the one hand, Coltheart [13] [14] developed the two-component model of bizarre delusion [20] by incor- porating neuroimaging findings on patients with delusional belief and relevant activation studies with normal subjects. He suggested that the belief evaluation component is accommodated in the right LPFC based on the finding of a reduced activity in this region in delusional patients [13] [16] and on the response of this region in the face of knowledge-violating information in healthy subjects [15] [18] [22].…”

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."…”

The Cognitive Approach to Delusions: Opportunities and Perspectives

“…В случае бреда система нару-шается, и появившаяся для объяснения перцептивной аномалии бредовая концепция, встречаясь с многочисленными опровержениями, остается устойчивой по отношению к ним. Также были получены свидетельства в пользу того, что наличию второго фактора сопутствуют повреждения лате-ральной части префронтальной коры в правом полушарии [Coltheart 2007;Coltheart at al. 2010;Coltheart et al 2007;Langdon et al 2008].…”