Why do delusions persist?
Open accessAbstract
Delusions are bizarre and distressing beliefs that characterize certain mental illnesses. They arise without clear reasons and are remarkably persistent. Recent models of delusions, drawing on a neuroscientific understanding of learning, focus on how delusions might emerge from abnormal experience. We believe that these models can be extended to help us understand why delusions persist. We consider prediction error, the mismatch between expectancy and experience, to be central. Surprising events demand a change in our expectancies. This involves making what we have learned labile, updating and binding the memory anew: a process of memory reconsolidation. We argue that, under the influence of excessive prediction error, delusional beliefs are repeatedly reconsolidated, strengthening them so that they persist, apparently impervious to contradiction.
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Evidence from experiments using the NMDA receptor antagonist ketamine suggests a link between prediction error signaling and memory reconsolidation, which could strengthen delusional beliefs and foster their persistence.
“Evidence from experiments using the NMDA receptor antagonist ketamine, which has been previously shown to induce aberrant PE, suggests a link between PE signaling and memory reconsolidation, which could strengthen delusional beliefs and foster their persistence (103, 104).”
From The Predictive Coding Account of Psychosis (2018) · cites this paper as [103]
The Conclusion argues that aberrant prediction-error signals drive retrieval and reconsolidation-based strengthening of delusional beliefs, helping them persist. However, our copy does not present ketamine experiments as evidence for that reconsolidation link; ketamine appears in the titles of cited works in the References, while Box 1 discusses other NMDA-receptor manipulations. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWithin predictive coding, prediction error may lead to an updated belief or may be suppressed.
“This characteristic can be considered within the predictive coding framework, where prediction error might lead to an updated belief or might be suppressed.22”
From Computational psychiatry: a Rosetta Stone linking the brain to mental illness (2014) · cites this paper as [22]
The balance between extinction and reconsolidation of memories may be disrupted in people with psychosis, with less extinction learning and possible strengthening of beliefs during extinction trials.
“This balance between extinction and reconsolidation of memories might be disrupted in people with psychosis, such that there is reduced extinction learning and possibly even belief-strengthening on extinction trials.22”
From Computational psychiatry: a Rosetta Stone linking the brain to mental illness (2014) · cites this paper as [22]
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- Authors
- Corlett, P. R.
- Affiliations
- University of Cambridge (GB)
- Corresponding author
- Corlett, Philip R.
- ORCID
- Corlett, Philip R.
- Venue
- Frontiers in Human Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2009
- Volume
- 3
- Pages
- 12-12
- ISSN
- 1662-5161 (ISSN-L)
- PMC
- PMC2713737
- OpenAlex
- W2061637033
- Cited by
- 146
- References
- 88
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 11 · 2023: 6 · 2022: 12 · 2021: 12 · 2020: 9 · 2019: 3 · 2018: 6 · 2017: 12 · 2016: 15 · 2015: 8 · 2014: 10 · 2013: 10 · 2012: 10
- FWCI
- 70.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Human Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Bristol-Myers Squibb
- AstraZeneca
- National Alliance for Research on Schizophrenia and Depression
- Wellcome Trust (064351)
- University of Cambridge
- Shire
- National Institute on Alcohol Abuse and Alcoholism
- National Institute of Mental Health
- National Institute on Drug Abuse
- Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Life Sciences › Neuroscience › Cognitive Neuroscience › Embodied and Extended Cognition
- Keywords
- delusions, prediction error, memory reconsolidation, learning, belief updating
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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