Influence of prior beliefs on perception in early psychosis: Effects of illness stage and hierarchical level of belief.
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Abstract
Alterations in the balance between prior expectations and sensory evidence may account for faulty perceptions and inferences leading to psychosis. However, uncertainties remain about the nature of altered prior expectations and the degree to which they vary with the emergence of psychosis. We explored how expectations arising at two different levels-cognitive and perceptual-influenced processing of sensory information and whether relative influences of higher- and lower-level priors differed across people with prodromal symptoms and those with psychotic illness. In two complementary auditory perception experiments, 91 participants (30 with first-episode psychosis, 29 at clinical risk for psychosis, and 32 controls) were required to decipher a phoneme within ambiguous auditory input. Expectations were generated in two ways: an accompanying visual input of lip movements observed during auditory presentation or through written presentation of a phoneme provided prior to auditory presentation. We determined how these different types of information shaped auditory perceptual experience, how this was altered across the prodromal and established phases of psychosis, and how this relates to cingulate glutamate levels assessed by magnetic resonance spectroscopy. The psychosis group relied more on high-level cognitive priors compared to both healthy controls and those at clinical risk for psychosis and relied more on low-level perceptual priors than the clinical risk group. The risk group was marginally less reliant on low-level perceptual priors than controls. The results are consistent with previous theory that influences of prior expectations in perceptions in psychosis differ according to level of prior and illness phase. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Hierarchical predictive coding suggests that hallucinations arise from disrupted balance between top-down expectations and bottom-up sensory inputs, with a stronger influence of expectations in people with hallucinations.
“hierarchical predictive coding, a cognitive model of psychosis, suggests that hallucinations arise from disrupted balance between top-down expectations and bottom-up sensory inputs, with a stronger influence of expectations observed in people with hallucinations11–13”
From Deviations in effective connectivity explain different hallucination subtypes in Parkinson's disease psychosis (2026) · cites this paper as [13]
The Discussion (page unavailable) says predictive coding links abnormal perception to a shifted balance between prior expectations and sensory input. The paper also reports that an expectation-driven auditory omission effect is stronger in people with hallucinations, but it limits that observation to learned cognitive expectations and cautions that expectations are not stronger across all levels or stages of psychosis. (LLM, conf=0.84)
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- Authors
- Haarsma, J., Knolle, F., Griffin, J. D., Taverne, H., Mada, M., Goodyer, I. M., The NSPN Consortium, Fletcher, P. C., & Murray, G. K.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Murray, Graham K.
- ORCID
- Venue
- Journal of Abnormal Psychology
- Published
- 2020-08
- Volume
- 129
- Issue
- 6
- Pages
- 581-598
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- PMC
- PMC7409392
- OpenAlex
- W3048182146
- Cited by
- 60
- References
- 64
- Citations by year
- 2026: 10 · 2025: 14 · 2024: 11 · 2023: 9 · 2022: 3 · 2021: 7 · 2020: 5 · 2019: 1
- FWCI
- 4.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Abnormal Psychology (publishedVersion, cc-by)
- bioRxiv (Cold Spring Harbor Laboratory) (acceptedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Apollo (University of Cambridge) (submittedVersion)
- Apollo
- Funders
- Neuroscience in Psychiatry Network
- Wellcome Trust (095844/Z/11/Z, 093270)
- Bernard Wolfe Health Neuroscience Fund
- Cambridge NIHR Biomedical Research Centre
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- early psychosis, prior expectations, perceptual priors, auditory perception, phoneme identification, lip reading, prodromal psychosis, first-episode psychosis, disease stage, hierarchical priors, sensory evidence
- MeSH terms
- Acoustic Stimulation, Adolescent, Adult, Auditory Perception, Female, Humans, Male, Psychotic Disorders, Young Adult
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