Abstract
Dual-stream modulation failure (DSMF) proposes that dysfunctional regulation of logical and intuitive decision-making processes by conflict and emotional salience may be the underlying cognitive mechanism for the formation and maintenance of delusions in schizophrenia. The present study utilizes a combination of emotionally salient and neutral stimuli in conflict and non-conflict conditions in a sentence verification task to test specific hypotheses predicted by the model. Twenty-one patients with schizophrenia and 21 controls completed a sentence verification task with fMRI acquisition. The results are consistent with the predictions based on the conflict modulation component of the model, but do not support the emotional modulation component of the model.
Highlights
The Diagnostic and Statistical Manual of Mental Disorders [1] defines delusions as false beliefs based on incorrect inferences about external reality that are firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary
We proposed a dual-stream modulation failure (DSMF) model of delusions [16] that provides a potential mechanism that can account for the formation and maintenance of delusions, and the expression of cognitive biases such as JTC and BADE
Using a simple sentence verification paradigm that put content believability in agreement or in conflict with logical validity we found that the schizophrenia group showed a significantly greater decrease in performance for the conflict condition compared to the non-conflict condition compared to healthy controls
Summary
The Diagnostic and Statistical Manual of Mental Disorders [1] defines delusions as false beliefs based on incorrect inferences about external reality that are firmly sustained despite what almost everybody else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The rapid development of neuroimaging technologies and new models of human decision-making across the last decade have provided an opportunity to advance our understanding of the cognitive and neuropathophysiological basis for psychosis in general and delusions in particular. A number of cognitive models have been developed offering accounts of the emergence and subsequent persistence of delusions in schizophrenia and other psychiatric illnesses. Bentall has suggested that an attributional bias may act as a self-esteem defense mechanism contributing to the formation and maintenance of persecutory delusions [4, 5]. While the Theory of Mind and Attributional Bias accounts have good explanatory power for persecutory delusions, and provide an explanation for the content of these sorts of delusions, they are specific to persecutory delusions, rather than providing more general models of delusions
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