Confabulation, delusion, and anosognosia: Motivational factors and false claims

Abstract

False claims are a key feature of confabulation, delusion, and anosognosia. In this paper we consider the role of motivational factors in such claims. We review motivational accounts of each symptom and consider the evidence adduced in support of these accounts. In our view the evidence is strongly suggestive of a role for motivational factors in each domain. Before concluding, we widen the focus by outlining a tentative general taxonomy of false claims, including false claims that occur in clinical settings as well as more garden-variety false claims, and incorporating both motivational and nonmotivational approaches to explaining such claims.

Keywords:

• Anosognosia
• Confabulation
• Delusion
• Motivational processes

Acknowledgements

RM was supported by a research fellowship as part of a large collaborative project coordinated from the Centre for Anthropology and Mind (http://www.cam.ox.ac.uk) at the University of Oxford and funded by the European Commission's Sixth Framework Programme (“Explaining Religion”). Thanks to Katerina Fotopoulou for valuable discussions, and to those who organised and participated in the Delusions and Confabulations workshop, held at Macquarie University in July 2007. We also acknowledge the helpful comments of two anonymous reviewers.

Notes

¹What do we mean by “unduly”? An example may serve to clarify. Imagine that a scientist, motivated by a desire for certainty (see later), conducts an experiment to investigate which of two theories best explains a given phenomenon. She runs the experiment, but sadly the results she obtains are utterly equivocal. However, her desire for certainty is sufficiently strong that her consideration of her evidence is motivationally biased: instead of admitting that her data are completely inconclusive, she concludes that the evidence favours one theory over the other. This conclusion (a thetic representation) has stemmed from her desire for certainty (a telic factor: specifically a telic metarepresentation), both in the sense that this factor provided the original impetus for conducting the experiment and in the sense that this factor biased her handling of the evidence. It is only in the second sense, however, that the telic factor has figured unduly in the formation of the thetic representation.

²Italicisation of relatively here denotes the “weaker” formulation of the Bentall et al. account (Garety & Freeman, 1999), whereby explicit self-esteem is high relative to implicit self-esteem (in the “stronger” formulation explicit self-esteem is high—and implicit self-esteem low—relative to that of healthy individuals). The weaker formulation provides for scenarios where persecutory delusions only partially fulfil their putative defensive function, and explicit self-esteem is not fully preserved.

³Single Category Implicit Association Test (Karpinski & Steinman, 2006). Because the SC-IAT uses only a single attitude category (e.g., self) rather than pairs of complementary attitude categories (e.g., self vs. other), some of the ambiguity in test score interpretation is eliminated.

⁴The ideas outlined here have been developed collaboratively with Katerina Fotopoulou.