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A Bayesian account of 'hysteria'
Mark J Edwards1, Rick A Adams, Harriet Brown
1Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square House, Queen Square, London WC1N 3BG, UK. m.j.edwards@ucl.ac.uk
Brain : a Journal of Neurology
|May 30, 2012
Summary
This study explains functional motor and sensory symptoms using a neurobiological model of Bayesian inference. It details how attention and beliefs influence these symptoms through altered brain processes.
Area of Science:
- Neurobiology
- Cognitive Neuroscience
- Psychiatry
Background:
- Functional motor and sensory symptoms, previously termed 'hysterical' or 'psychogenic', lack clear organic explanations.
- Understanding the neurobiological underpinnings of these symptoms is crucial for effective diagnosis and treatment.
Purpose of the Study:
- To provide a neurobiological account of functional motor and sensory symptoms.
- To explain these symptoms using a model of hierarchical Bayesian inference in the brain.
- To elucidate the roles of attention, prior beliefs, and sensory evidence in symptom manifestation.
Main Methods:
- Utilized a neurobiologically informed model of hierarchical Bayesian inference.
- Examined the interplay between prior beliefs and sensory evidence, modulated by attention and expectations.
- Analyzed symptom formation at neuromodulatory, cognitive-experiential, and computational levels.
Main Results:
- Proposed that functional symptoms arise from primary and secondary failures of inference.
- Identified a primary failure where beliefs are held with undue certainty due to attentional modulation.
- Described a secondary failure where perceptions are misattributed as symptoms, explaining prediction errors.
Conclusions:
- The Bayesian inference model successfully explains key features of functional symptoms, including their link to attention and beliefs.
- The model accommodates the induction, maintenance, and modification of symptoms by psychological factors.
- This framework offers a unified neurobiological explanation for 'medically unexplained' motor and sensory disturbances.
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