The doxastic shear pin: delusions as errors of learning and memory

Cogn Neuropsychiatry. 2016;21(1):73-89. doi: 10.1080/13546805.2015.1136206. Epub 2016 Feb 15.

Abstract

We reconsider delusions in terms of a "doxastic shear pin", a mechanism that errs so as to prevent the destruction of the machine (brain) and permit continued function (in an attenuated capacity). Delusions may disable flexible (but energetically expensive) inference. With each recall, delusions may be reinforced further and rendered resistant to contradiction. We aim to respond to deficit accounts of delusions - that delusions are only a problem without any benefit - by considering delusion formation and maintenance in terms of predictive coding. We posit that brains conform to a simple computational principle: to minimize prediction error (the mismatch between prior top-down expectation and current bottom-up input) across hierarchies of brain regions and psychological representation. Recent data suggest that delusions may form in the absence of constraining top-down expectations. Then, once formed, they become new priors that motivate other beliefs, perceptions, and actions by providing strong (sometimes overriding) top-down expectation. We argue that delusions form when the shear-pin breaks, permitting continued engagement with an overwhelming world, and ongoing function in the face of paralyzing difficulty. This crucial role should not be ignored when we treat delusions: we need to consider how a person will function in the world without them..

Keywords: Belief; delusion; epistemic benefit; prediction error; schizophrenia.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Association Learning
  • Brain / physiopathology*
  • Capgras Syndrome / physiopathology
  • Capgras Syndrome / psychology*
  • Delusions / physiopathology
  • Delusions / psychology*
  • Humans
  • Knowledge
  • Learning*
  • Memory*
  • Mental Recall
  • Motivation
  • Psychological Theory