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Delusional Unreality and Predictive Processing.

Santiago Castiello1, Rosa Rossi-Goldthorpe1, Siyan Fan1

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Summary
This summary is machine-generated.

This study shows how predictive processing may explain the sense of unreality in people with delusions. Aberrant prediction error processing is linked to unreality experiences in both clinical and nonclinical beliefs.

Keywords:
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Area of Science:

  • Cognitive neuroscience
  • Psychopathology
  • Computational psychiatry

Background:

  • Phenomenological psychopathologists note delusions involve experiencing multiple realities, a phenomenon not easily explained by predictive processing.
  • This study explores how predictive processing mechanisms might account for a pervasive sense of dual reality.

Purpose of the Study:

  • To investigate the role of predictive processing in explaining the sense of unreality associated with delusions.
  • To examine differences in prediction error processing between individuals with schizophrenia, those with elevated esoteric beliefs, and healthy controls.

Main Methods:

  • A cross-sectional study involving patients with schizophrenia (n=42), healthy participants with elevated esoteric beliefs (n=31), and healthy controls (n=62).
  • Utilized a Kamin blocking causal learning task with extinction to examine belief formation.
  • Assessed unreality experiences using the Peters Delusion Inventory and clinical symptoms via structured interviews.

Main Results:

  • Unreality experiences were reported by some patients with schizophrenia and some individuals with elevated esoteric beliefs, but not healthy controls.
  • Different types of aberrant prediction error processing were associated with unreality experiences in clinical delusions versus nonclinical beliefs.
  • Not all individuals with schizophrenia reported a sense of unreality.

Conclusions:

  • Predictive processing can potentially explain the sense of unreality experienced by individuals with delusions.
  • Dysfunctions in prediction error signaling are linked to delusions with varying content.
  • The study addresses how psychosis impacts beliefs and experiences of reality using a predictive processing framework.