Abstract
This paper examines the evidence that delusions can be explained within the framework of a neurocognitive
model of how the brain assesses certainty. Here, ‘certainty’ refers to both low-level interpretations of one's en- vironment and high-level (conscious) appraisals of one's beliefs and experiences. A model is proposed explain- ing how the brain systems responsible for assigning certainty might dysfunction, contributing to the cause and maintenance of delusional beliefs. It is suggested that delusions arise through a combination of perturbed striatal dopamine and aberrant salience as well as cognitive biases such as the tendency to jump to conclusions (JTC) and hypersalience of evidence-hypothesis matches. The role of emotion, stress, trauma and sociocultural factors in forming and modifying delusions is also considered. Understanding the mechanisms involved in forming and maintaining delusions has important clinical implications, as interventions that improve cognitive flexibility (e.g. cognitive remediation therapy and mindfulness training) could potentially attenuate neurocognitive processes.
© 2017, Elsevier Ltd. The attached document (embargoed until 18/03/2019) is an author produced version of a paper published in Clinical Psychology Review, uploaded in accordance with the publisher’s self- archiving policy. The final published version (version of record) is available online at https://doi.org/10.1016/j.cpr.2017.04.006. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
model of how the brain assesses certainty. Here, ‘certainty’ refers to both low-level interpretations of one's en- vironment and high-level (conscious) appraisals of one's beliefs and experiences. A model is proposed explain- ing how the brain systems responsible for assigning certainty might dysfunction, contributing to the cause and maintenance of delusional beliefs. It is suggested that delusions arise through a combination of perturbed striatal dopamine and aberrant salience as well as cognitive biases such as the tendency to jump to conclusions (JTC) and hypersalience of evidence-hypothesis matches. The role of emotion, stress, trauma and sociocultural factors in forming and modifying delusions is also considered. Understanding the mechanisms involved in forming and maintaining delusions has important clinical implications, as interventions that improve cognitive flexibility (e.g. cognitive remediation therapy and mindfulness training) could potentially attenuate neurocognitive processes.
© 2017, Elsevier Ltd. The attached document (embargoed until 18/03/2019) is an author produced version of a paper published in Clinical Psychology Review, uploaded in accordance with the publisher’s self- archiving policy. The final published version (version of record) is available online at https://doi.org/10.1016/j.cpr.2017.04.006. Some minor differences between this version and the final published version may remain. We suggest you refer to the final published version should you wish to cite from it.
| Original language | English |
|---|---|
| Journal | CLINICAL PSYCHOLOGY REVIEW |
| DOIs | |
| Publication status | Published - 18 Apr 2017 |