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Hypothesis & Theory ARTICLE

Why do delusions persist?

Philip R. Corlett^1,2*, John H. Krystal¹, Jane R. Taylor¹ and Paul C. Fletcher²

Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, USA

Brain Mapping Unit, Department of Psychiatry, Behavioural and Clinical Neurosciences Institute, School of Clinical Medicine, University of Cambridge, Cambridge, UK

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.

Keywords:

salience, delusions, prediction error, extinction, habit, reconsolidation

Citation:

Corlett PR, Krystal JH, Taylor JR and Fletcher PC (2009). Why do delusions persist? Front. Hum. Neurosci. 3:12. doi: 10.3389/neuro.09.012.2009

Received:

01 April 2009;

Paper pending published:

17 May 2009;

Accepted:

16 June 2009;

Published online:

10 July 2009.

Edited by:

Neal J. Cohen, University of Illinois, USA

Reviewed by:

Anthony Wagner, Stanford University, USA
Stephan Heckers, Vanderbilt University, USA

© 2009 Corlett, Krystal, Taylor and Fletcher. This is an open-access article subject to an exclusive license agreement between the authors and the Frontiers Research Foundation, which permits unrestricted use, distribution, and reproduction in any medium, provided the original authors and source are credited.

*Correspondence:

Philip R. Corlett, Department of Psychiatry, Abraham Ribicoff Research Facility, Connecticut Mental Health Centre, Yale University School of Medicine, 34 Park Street, New Haven, CT 06519, USA. e-mail: philip.corlett@yale.edu