4.4 Review

Derationalizing Delusions

Journal

CLINICAL PSYCHOLOGICAL SCIENCE
Volume 9, Issue 1, Pages 24-37

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/2167702620951553

Keywords

delusion; psychosis; schizophrenia; belief

Funding

  1. Wellcome Trust [200589/Z/16/Z]
  2. Royal Society University Research Fellowship award
  3. Wellcome Trust [200589/Z/16/Z] Funding Source: Wellcome Trust

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Traditional conceptualizations of delusions as irrational beliefs are not sufficient, as cognitive models fail to fully explain the social nature of delusions and their lack of sensitivity to social context. Therefore, delusion models need to include alterations to coalition cognition.
Because of the traditional conceptualization of delusion as irrational belief, cognitive models of delusions largely focus on impairments to domain-general reasoning. Nevertheless, current rationality-impairment models do not account for the fact that (a) equivalently irrational beliefs can be induced through adaptive social cognitive processes, reflecting social integration rather than impairment; (b) delusions are overwhelmingly socially themed; and (c) delusions show a reduced sensitivity to social context both in terms of how they are shaped and how they are communicated. Consequently, we argue that models of delusions need to include alteration to coalitional cognition-processes involved in affiliation, group perception, and the strategic management of relationships. This approach has the advantage of better accounting for both content (social themes) and form (fixity) of delusion. It is also supported by the established role of mesolimbic dopamine in both delusions and social organization and the ongoing reconceptualization of belief as serving a social organizational function.

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