Pathological prediction: a top-down cause of organic disease

Abstract

Though predictive processing (PP) approaches to the mind were originally applied to exteroceptive perception, i.e., vision and action, recent work has started to explore the role of interoceptive perception, i.e., emotion and affect (Barrett, 2017; Barrett and Simmons, 2015; Miller and Clark, 2018; Seth, 2013; Van de Cruys, 2017; Wilkinson et al., 2019). This article builds on this work by extending PP beyond emotion to the construction of emotional dispositions. I employ principles from dynamical systems theory and PP to provide a model of how dispositional anger (also known as ‘hostile attribution bias’ or HAB) can develop in response to early experiences of psychosocial stress. The model is then deployed to explain the established link between psychosocial stress in early life and the appearance of certain organic disease phenotypes (such as cardiovascular disease) in later life. This phenomenon can appear mysterious when viewed through the standard biomedical explanatory lens, which has difficulty accounting for the causal influence of subjective perceptions and evaluations of the social and material environment on the development of organic disease processes. The model provided presents such cases as instances of developmental mismatch. They occur when an organism develops an emotional disposition that leads them to make habitually-biased appraisals of what the social environment affords. The model provides a novel explanation of certain organic disease phenotypes with top-down and developmental causes, and demystifies one class of cases involving apparently spooky ‘mind-to-matter’ causation.