Nice read… Isn’t the advent of computational psychiatry exciting?
We recently had a lecture on delusions in which my friends and I discussed: What is the line with conspiracy theories?
One could certainly argue a level of aberrant salience network and affective processing; but except in this scenario, reinforced by a social and group dynamic. Heck, arguably certain groups actively seek to encourage this level of salience attribution.
Of course, the line itself is social functioning. If you are ostracised for your delusions, this is bad. If it helps you in a social group, it is good. But it’s interesting to think what happens to the social status quo if we had neurobiological markers of these paradigms. Still feels a ways away.
Right, there is some sort of reinforcing/positive feedback process that gets activated. That can be internal or external, I suppose. I had not thought of it that way. Interesting!
1) I'm sure that this is covered somewhere I missed or obvious but how is a delusion conceptually distinguished from a strong, hard to shift and OBVIOUSLY FALSE belief that's socially shared and not indicative of pathology (belief in deities, spirits and similar come to mind, as well as strongly held superstitions). Intuitively, there is a difference (and I'm not mocking) but I cannot put my finger on it however I squint apart from "belief in a god having spoken to the authors of a holy book seems non pathological in a way the belief in a god speaking to me through a podcast does not".
2) While I agree that "we all see non-existent patterns in noise, but some more than others" but I feel -- tho this is a free floating hypothesis rather than a hill I'm prepared to die on -- that developing a delusion requires more than just seeing patterns everywhere. It also, obviously, requires giving them credibility, taking them as valid, and persuasively, convincingly true? Both openness to weird hypothetical AND inability to reject them / entertain them as one of many alternatives? I know a lot of people prone to fantastic conjecture and able to entertain numerous conspiracy ideas for example, a mixture of schizoid, open to experience/bored and artsy, but not as "sticky" delusions. They take them on and discard fairly easily.
I didn't mention this directly, but the way we define delusions basically has a carve-out for culturally acceptable or widespread beliefs. Not ideal but it works in practice.
And I agree with your second point too. I think this is a weakness in the salience/dopamine centric explanations of delusions. It's not clear what explains the "fixity" of delusions vs regular beliefs or idle speculation. That's one reason I suggested that delusions tend to be linked to an affective system (an emotion) which makes it personal and important to the individual. But I did not really draw this point out enough, I think.
1. I know "fixed false belief" is not your definition but the key point about delusions is that they are unreasonable, both literally and culturally, as well being held with unshakeable conviction. They don't necessarily have to be wrong, e.g. a man who believes his wife is having an affair because the traffic light turned red may - by pure coincidence - be correct.
2. Delusions invariably hold some personal significance. It is hardly ever the case that someone who holds a delusional belief is otherwise ambivalent or disinterested in it and simply gets on with other more important things in their lives.
Both these characteristics need to be considered in any theories of mechanism.
Hi, yes! Good points. I did not develop this point enough. I think of the pairing with a given affective system (emotion) as what provides the personal significance and high importance to the individual. Otherwise, as you say, what distinguishes an incipient delusion from just something you find interesting?
I can't see manic delusions in this - even the idea of a status meter doesn't fit - I didn't feel superior with a grandiose delusion. More disconcerted. Especially when the delusions are part of manic delirium and the experience is one of disorientation and disconnection from consensual reality, and the patient is more of a passenger in the insanity.
You mentioned that delusions that were out of character "seemed" different from others... Were you endorsing or problematisizing the apparent difference?
I also struggle to see manic delusions in this... The sudden onset belief one is the Messiah... That disappears when mania settles. Grandiose delusions are just an obvious example of how manic delusions don't seem driven by misattributed salience.
It seems that we need some way to explain the distinction (which I think is useful) between e.g. paranoid personality or an extremely jealous individual, and someone who out of the blue develops Delusional Disorder, Jealous type. Long-standing cognitive biases can explain paranoid personality (that basically is the definition) but seems wholly inadequate to explain a new onset delusion, whatever the diagnosis.
Re mania, I allude to this in an earlier piece (Mental Disorders are About Things) that I imagine basically a "status system" in humans, which includes a "status-o-meter" that tracks where we rank compared to others. Narcissism is when the set point is too high, Avoidant PD is when the set point is too low, etc. Grandiose delusions are when this goes off the rails entirely. The religious themes are interesting, I have not fully thought that through.
Nice read… Isn’t the advent of computational psychiatry exciting?
We recently had a lecture on delusions in which my friends and I discussed: What is the line with conspiracy theories?
One could certainly argue a level of aberrant salience network and affective processing; but except in this scenario, reinforced by a social and group dynamic. Heck, arguably certain groups actively seek to encourage this level of salience attribution.
Of course, the line itself is social functioning. If you are ostracised for your delusions, this is bad. If it helps you in a social group, it is good. But it’s interesting to think what happens to the social status quo if we had neurobiological markers of these paradigms. Still feels a ways away.
Right, there is some sort of reinforcing/positive feedback process that gets activated. That can be internal or external, I suppose. I had not thought of it that way. Interesting!
1) I'm sure that this is covered somewhere I missed or obvious but how is a delusion conceptually distinguished from a strong, hard to shift and OBVIOUSLY FALSE belief that's socially shared and not indicative of pathology (belief in deities, spirits and similar come to mind, as well as strongly held superstitions). Intuitively, there is a difference (and I'm not mocking) but I cannot put my finger on it however I squint apart from "belief in a god having spoken to the authors of a holy book seems non pathological in a way the belief in a god speaking to me through a podcast does not".
2) While I agree that "we all see non-existent patterns in noise, but some more than others" but I feel -- tho this is a free floating hypothesis rather than a hill I'm prepared to die on -- that developing a delusion requires more than just seeing patterns everywhere. It also, obviously, requires giving them credibility, taking them as valid, and persuasively, convincingly true? Both openness to weird hypothetical AND inability to reject them / entertain them as one of many alternatives? I know a lot of people prone to fantastic conjecture and able to entertain numerous conspiracy ideas for example, a mixture of schizoid, open to experience/bored and artsy, but not as "sticky" delusions. They take them on and discard fairly easily.
I didn't mention this directly, but the way we define delusions basically has a carve-out for culturally acceptable or widespread beliefs. Not ideal but it works in practice.
And I agree with your second point too. I think this is a weakness in the salience/dopamine centric explanations of delusions. It's not clear what explains the "fixity" of delusions vs regular beliefs or idle speculation. That's one reason I suggested that delusions tend to be linked to an affective system (an emotion) which makes it personal and important to the individual. But I did not really draw this point out enough, I think.
Interesting! Couple of points I would make:
1. I know "fixed false belief" is not your definition but the key point about delusions is that they are unreasonable, both literally and culturally, as well being held with unshakeable conviction. They don't necessarily have to be wrong, e.g. a man who believes his wife is having an affair because the traffic light turned red may - by pure coincidence - be correct.
2. Delusions invariably hold some personal significance. It is hardly ever the case that someone who holds a delusional belief is otherwise ambivalent or disinterested in it and simply gets on with other more important things in their lives.
Both these characteristics need to be considered in any theories of mechanism.
Hi, yes! Good points. I did not develop this point enough. I think of the pairing with a given affective system (emotion) as what provides the personal significance and high importance to the individual. Otherwise, as you say, what distinguishes an incipient delusion from just something you find interesting?
I can't see manic delusions in this - even the idea of a status meter doesn't fit - I didn't feel superior with a grandiose delusion. More disconcerted. Especially when the delusions are part of manic delirium and the experience is one of disorientation and disconnection from consensual reality, and the patient is more of a passenger in the insanity.
You mentioned that delusions that were out of character "seemed" different from others... Were you endorsing or problematisizing the apparent difference?
I also struggle to see manic delusions in this... The sudden onset belief one is the Messiah... That disappears when mania settles. Grandiose delusions are just an obvious example of how manic delusions don't seem driven by misattributed salience.
It seems that we need some way to explain the distinction (which I think is useful) between e.g. paranoid personality or an extremely jealous individual, and someone who out of the blue develops Delusional Disorder, Jealous type. Long-standing cognitive biases can explain paranoid personality (that basically is the definition) but seems wholly inadequate to explain a new onset delusion, whatever the diagnosis.
Re mania, I allude to this in an earlier piece (Mental Disorders are About Things) that I imagine basically a "status system" in humans, which includes a "status-o-meter" that tracks where we rank compared to others. Narcissism is when the set point is too high, Avoidant PD is when the set point is too low, etc. Grandiose delusions are when this goes off the rails entirely. The religious themes are interesting, I have not fully thought that through.
Have you read SIMS symptoms in the mind? Great vocabulary for phenomenology
I haven't, thanks for the tip!