This paper contrasts an interactionist account of delusional misidentification with more traditional one- and two-stage models. Unlike the unidirectional nature of these more traditional models, in which the aetiology of the disorder is said to progress from a neurological disruption via an anomalous experience to a delusional belief, the interactionist account posits the interaction of top-down and bottom-up processes to better explain the maintenance of the delusional belief. In addition, it places a greater emphasis on the patient’s underlying phenomenal experience (...) in accounting for the specificity of the delusional content. The role played by patient phenomenology is examined in light of Ratcliffe’s recent phenomenological account. Similarities and differences are discussed. The paper concludes that a purely phenomenological account is unable to differentiate between non-delusional patient groups, who have what appear to be equivalent phenomenal experiences to patients suffering from delusional misidentification but without the delusional belief, and delusional groups, something the interactionist model is able to do. (shrink)

Stanford Encyclopedia Entry on Delusions.

This monograph discusses the question of what it is to be a reason – mainly in practical ethics – and proposes an original contribution to metaethics.It critically examines theories of metaethical realism, constructivism and error theory and identifies several misunderstandings or unclarities in contemporary debates. Based on this examination, the book suggests a distinction between a conceptual question, that can be answered by pure first-personal thinking, and a material question, that targets responses to reasons as a natural phenomenon in space (...) and time and that can be answered by help of the sciences. While this book defends a sharp distinction between these approaches, it also argues that the insights gained by the distinct approaches can be fruitfully integrated into a comprehensive picture.The comprehensive picture promoted in this book, based on both philosophical analysis and resources from psychology and cognitive science, is a picture of reasons as items in a collective archive of mind – reconfiguring the “domain of reasons” as a collectively established and socially cultivated fund of considerations with normative weight. The developed Collective Archive View combines Reasons Fundamentalism as an answer to the conceptual question, with a social ontological proposal, similar to Haslanger’s critical realism, as an answer to the material question.Thereby, it introduces central ideas from the field of social metaphysics into metaethics. At the same time, it offers a way of settling some controversies within metaethics, going on between proponents of Reasons Fundamentalism and Constitutivism, realism and constructivism, as well as proponents of mind-dependence and mind-independence of normative facts. Finally, the proposal enables us to envision and conceptualize genuine normative change within a metaethical theory. (shrink)

RESUMEN En este artículo se plantea una discusión con el enfoque doxástico de los delirios. A pesar de que esta línea de análisis ha hecho importantes aportes a la comprensión del fenómeno, tiene dificultades importantes a la hora de aportar un marco explicativo completo de los delirios, porque deja por fuera el aspecto total de la experiencia y sigue basándose implícitamente en la idea de que podemos estudiar de manera separada e independiente los aspectos físicos, cognitivos y experienciales de un (...) fenómeno tan complejo. El artículo propone que, más allá de la decisión acerca de si se debe considerar a los delirios como creencias irracionales o no, o de si se puede concebirlos como creencias en absoluto, es necesario tener en cuenta la drástica transformación del mundo entero de la experiencia que se da en el sujeto delirante, tal como lo plantea la fenomenología. ABSTRACT This article discusses the doxastic approach to delusions. Although this analytic approach has made important contributions to our understanding of the phenomenon, it faces serious difficulties when it comes to providing a complete explanatory framework of delusions, as it leaves out the experiential aspect. This analytic approach continues to be implicitly based on the idea that the physical, cognitive and experiential aspects of such a complex phenomenon can be studied separately. The article suggests that, in addition to merely considering whether or not delusions ought to be taken as irrational beliefs, or even as beliefs at all, it is necessary to take into account the drastic transformation of the entire experiential world of the delusional subject, as suggested by the phenomenological approach. (shrink)

After describing the disorder of psychopathy, I examine the theories and the evidence concerning the psychopaths’ deficient moral capacities. I first examine whether or not psychopaths can pass tests of moral knowledge. Most of the evidence suggests that they can. If there is a lack of moral understanding, then it has to be due to an incapacity that affects not their declarative knowledge of moral norms, but their deeper understanding of them. I then examine two suggestions: it is their deficient (...) practical reason or their stunted emotions that are at fault. The evidence supports both explanations. I conclude with an overview of the debate concerning whether they are morally or legally responsible for their actions. (shrink)

The centenary of Karl Jaspers' General Psychopathology was recognised in 2013 with the publication of a volume of essays dedicated to his work. Leading phenomenological-psychopathologists and philosophers of psychiatry examined Jaspers notion of empathic understanding and his declaration that certain schizophrenic phenomena are ‘un-understandable’. The consensus reached by the authors was that Jaspers operated with a narrow conception of phenomenology and empathy and that schizophrenic phenomena can be understood through what they variously called second-order and radical empathy. This article offers (...) a critical examination of the second-order empathic stance along phenomenological and ethical lines. It asks: Is second-order empathy possible? Is the second-order empathic stance an ethically acceptable attitude towards persons diagnosed with schizophrenia? I argue that second-order empathy is an incoherent method that cannot be realised. Further, the attitude promoted by this method is ethically problematic insofar as the emphasis placed on radical otherness disinvests persons diagnosed with schizophrenia from a fair chance to participate in the public construction of their identity and, hence, to redress traditional symbolic injustices. (shrink)

Explanations of Capgras delusion and prosopagnosia typically incorporate a dual-route approach to facial recognition in which a deficit in overt or covert processing in one condition is mirror-reversed in the other. Despite this double dissociation, experiences of either patient-group are often reported in the same way – as lacking a sense of familiarity toward familiar faces. In this paper, deficits in the facial processing of these patients are compared to other facial recognition pathologies, and their experiential characteristics mapped onto the (...) dual-route model in order to provide a less ambiguous link between facial processing and experiential content. The paper concludes that the experiential states of Capgras delusion, prosopagnosia, and related facial pathologies are quite distinct, and that this descriptive distinctiveness finds explanatory equivalence at the level of anatomical and functional disruption within the face recognition system. The role of skin conductance response as a measure of ‘familiarity’ is also clarified. (shrink)

Young and colleagues . Betwixt life and death: case studies of the Cotard delusion. In P. W. Halligan & J. C. Marshall , Method in madness: Case studies in cognitive neuropsychiatry. Mahway, NJ: Lawrence Erlbaum Associates.) have suggested that cases of the Cotard delusion result when a particular perceptual anomaly occurs in the context of an internalising attributional style. This hypothesis has not previously been tested directly. We report here an investigation of attributional style in a 24-year-old woman with Cotard (...) delusion . LU’s attributional style was assessed using the Internal, Personal and Situational Attributions Questionnaire . A new measure of causal locus: the internal, personal and situational attributions questionnaire. Personality and Individual Differences, 20, 261–264.). LU showed a significantly greater proportion of internalising attributions than the control group, both overall and for negative events specifically. The results obtained thus support an association of Cotard delusion with an internalising attributional style, and are therefore consistent with the account of Young and colleagues. The potential brain basis of Cotard delusion is discussed. (shrink)

One of the tasks that recent philosophy of psychiatry has taken upon itself is to extend the range of understanding to some of those aspects of psychopathology that Jaspers deemed beyond its limits. Given the fundamental difficulties of offering a literal interpretation of the contents of primary delusions, a number of alternative strategies have been put forward including regarding them as abnormal versions of framework propositions described by Wittgenstein in On Certainty. But although framework propositions share some of the apparent (...) epistemic features of primary delusions, their role in partially constituting the sense of inquiry rules out their role in helping to understand delusions. (shrink)

Delusions are often thought of as the hallmark of irrationality. Accepted definitions of delusion are cast in terms of epistemic features that reflect irrationality: impossibility or falsity of con...

This thesis is set out as a collection of self-standing essays. Throughout these essays, I try to illuminate a number of controversies surrounding the way in which delusions are formed, and relatedly, their nature and epistemic standing. In Chapter 2, after an introductory chapter, I flesh out a new ‘endorsement’ approach to the Capgras delusion, the main idea being that the delusion is formed by endorsing the content of a metaphorical-perceptual state in which a loved one is represented metaphorically as (...) an imposter. In Chapter 3, I take issue with the idea, prevalent in the literature, that Bayesian accounts of inference in delusions are best characterised as versions of ‘explanationism’. Taking one such influential account as a test case, I argue that it is no more or less compatible with the endorsement alternative, which says delusions are acquired non-inferentially from experience. In Chapter 4, I examine a recent critique of predictive processing theories of delusions, according to which such theories suffer two limitations: they fail to explain why an agent believes something delusional as opposed to nothing at all or something else; they fail to explain how delusional hypotheses are generated in the first place. I suggest ways in which these concerns might be addressed. In Chapter 5, I consider how the Spinozan theory of belief fixation can improve the prospects of doxasticism about delusions. Doxasticism has been criticised on the grounds that delusions typically do not abide by rational standards which we expect beliefs to conform to. If belief fixation is Spinozan, I argue, these deviations from rationality are not just compatible with, but supportive of, their status as beliefs. In Chapter 6, I ask whether misidentification delusions formed via endorsement processes have any measure of perceptual justification. To give the best chance of getting a ‘yes’ answer, I address the question from the perspective of perceptual dogmatism, as this appears the best option if we are to grant at least defeasible justifiedness to MDs. I argue that, even so, MDs are completely unjustified. (shrink)

An examination of alien abduction belief can inform how we ought to approach constructing explanations of monothematic delusion formation. I argue that the formation and maintenance of alien abduction beliefs can be explained by a one-factor account, and that this explanatory power generalizes to (other) cases of monothematic delusions. There are no differences between alien abduction beliefs and monothematic delusions which indicate the need for additional explanatory factors in cases of the latter. I make the additional point that whilst alien (...) abduction beliefs can be readily explained using a one-factor framework, the two-factor framework requires adjustment to accommodate them. I conclude that theorists interested in delusion formation have much to learn from the case of alien abduction belief. (shrink)

ABSTRACTEmpiricists about monothematic delusion formation agree that anomalous experience is a factor in the formation of these attitudes, but disagree markedly on which further factors need to be specified. I argue that epistemic innocence may be a unifying feature of monothematic delusions, insofar as a judgment of epistemic innocence to this class of attitudes is one that opposing empiricist accounts can make. The notion of epistemic innocence allows us to tell a richer story when investigating the epistemic status of monothematic (...) delusions, one which resists the trade-off view of pragmatic benefits and epistemic costs. Though monothematic delusions are often characterized by appeal to their epistemic costs, they can play a positive epistemic role, and this is a surprising conclusion on which, so I argue, all empiricists can agree. Thus, I show that all empiricists have the notion of epistemic innocence at their disposal. (shrink)

Experiences of thought-insertion are a first-rank, diagnostically central symptom of schizophrenia. Schizophrenic patients who undergo such delusional mental states report being first-personally aware of an occurrent conscious thought which is not theirs, but which belongs to an external cognitive agent. Patients seem to be right about what they are thinking but mistaken about who is doing the thinking. It is notoriously difficult to make sense of such delusions. One general approach to explaining the etiology of monothematic delusions has come to (...) be known as the endorsement model. This model claims that the patient holds her delusional belief because she simply trusts her bizarre experience and takes it at face value. The content of the bizarre experience thus plays a central role in the etiology of delusions. Despite being widely discussed with respect to delusions like Capgras and Cotard, an endorsement model of thought-insertion has not yet been formulated. This article seeks to fill this void by fleshing out and defending the endorsement approach to delusions of inserted thoughts. It aims to show that such an approach can be defended against objections that have been raised in the literature. In particular, it will be argued that there is nothing wrong with the idea of being first-personally aware of a thought which is presented in consciousness as being someone else's. The upshot is that with respect to delusions of thought-insertion, the endorsement model turns out to be a viable account of why patients come to believe that someone else is inserting thoughts into their minds. (shrink)

Jennifer Radden has drawn attention to two features of delusion, ambivalence and subjectivity, which are problematic for theories of delusion that treat delusions as empirical beliefs. She argues for an ‘attitude’ theory of delusion. I argue that once the cognitive architecture of delusion formation is properly described the debate between doxastic and attitude theorists loses its edge. That architecture suggests that delusions are produced by activity in the ‘default mode network’ unsupervised by networks required for decontextualized processing. The cognitive properties (...) of these networks explain the features of delusion which generate the debate between doxastic and attitude theorists. (shrink)

In this paper I discuss the role played by disturbed phenomenology in accounting for the formation and maintenance of the Capgras delusion. Whilst endorsing a two-stage model to explain the condition, I nevertheless argue that traditional accounts prioritise the role played by some form of second-stage cognitive disruption at the expense of the significant contribution made by the patient’s disturbed phenomenology, which is often reduced to such uninformative descriptions as “anomalous” or “strange”. By advocating an interactionist model, I argue that (...) the delusional belief constitutes an attempt on the part of the patient to explain his/her initially odd and somewhat disturbed phenomenal content and, moreover, that the delusion then structures the patient’s experience such that what he/she perceives is an impostor. This fact is used to explain the delusional belief’s maintenance and resistance to revision. Thus, whilst accepting that second-stage cognitive disruption has a part to play in explaining the Capgras delusion, the emphasis here is placed on the role played by the patient’s changing phenomenal content and its congruence with the delusional belief. Unlike traditional two-stage models, which posit a unidirectional progression from experience to belief, the interactionist model advocates a two-way interaction between bottom-up and top-down processes. The application of this model to other delusional beliefs is also considered. (shrink)

This paper explores the phenomenology of the Capgras and Cotard delusions. The former is generally characterised as the belief that relatives or friends have been replaced by impostors, and the latter as the conviction that one is dead or has ceased to exist. A commonly reported feature of these delusions is an experienced ''defamiliarisation'' or even ''derealisation'' of things, which is associated with an absence or distortion of affect. I suggest that the importance attributed to affect by current explanations of (...) delusional experience can serve to make explicit the manner in which we ordinarily experience the world under a taken-for-granted aspect of affective familiarity. This implicit feeling is, I argue, partly constitutive of our sense of reality. However, so-called ''folk psychology,'' which is generally adopted by philosophers as an initial interpretive backdrop for delusional beliefs and for beliefs more generally, fails to accommodate it. As a consequence, some pervasive philosophical assumptions concerning the manner in which we experience and understand the world, ourselves, and each other are called into question. (shrink)

The impact of our desires and preferences upon our ordinary, everyday beliefs is well-documented [Gilovich, T. . How we know what isn’t so: The fallibility of human reason in everyday life. New York: The Free Press.]. The influence of such motivational factors on delusions, which are instances of pathological misbelief, has tended however to be neglected by certain prevailing models of delusion formation and maintenance. This paper explores a distinction between two general classes of theoretical explanation for delusions; the motivational (...) and the deficit. Motivational approaches view delusions as extreme instances of self-deception; as defensive attempts to relieve pain and distress. Deficit approaches, in contrast, view delusions as the consequence of defects in the normal functioning of belief mechanisms, underpinned by neuroanatomical or neurophysiological abnormalities. It is argued that although there are good reasons to be sceptical of motivational theories , recent experiments confirm that motives are important causal forces where delusions are concerned. It is therefore concluded that the most comprehensive account of delusions will involve a theoretical unification of both motivational and deficit approaches. (shrink)

This paper draws on studies of the Capgras delusion in order to illuminate the phenomenological role of affect in interpersonal recognition. People with this delusion maintain that familiars, such as spouses, have been replaced by impostors. It is generally agreed that the delusion involves an anomalous experience, arising due to loss of affect. However, quite what this experience consists of remains unclear. I argue that recent accounts of the Capgras delusion incorporate an impoverished conception of experience, which fails to accommodate (...) the role played by ‘affective relatedness’ in constituting (a) a sense of who a particular person is and (b) a sense of others as people rather than impersonal objects. I draw on the phenomenological concept of horizon to offer an interpretation of the Capgras experience that shows how the content ‘this entity is not my spouse but an impostor’ can be part of the experience, rather than something that is inferred from a strange experience. (shrink)

On one influential view, the problems that should attract medical attention involve a disorder, because the goals of medical practice are to prevent and treat disorders. Based on this view, if there are no mental disorders then the status of psychiatry as a medical field is challenged. In this paper, I observe that it is often difficult to establish whether the problems that attract medical attention involve a disorder, and argue that none of the notions of disorder proposed so far (...) offers a successful demarcation criterion between medical and non-medical problems. As an illustration, I consider why delusions are considered pathological and whether they attract medical attention in virtue of being pathological, where ‘pathological’ stands for ‘being caused by a disorder’. Although there are several promising answers to what makes delusions pathological, available accounts of the pathological nature of delusions fail to distinguish delusions from other irrational beliefs that are not typically thought of as pathological; and cannot explain why delusions typically attract medical attention whereas other irrational beliefs do not. (shrink)

Complex systems are to be seen as typically having multiple levels of organization. For instance, in the behavioural and cognitive sciences, there has been a long lasting trend, promoted by the seminal work of David Marr, putting focus on three distinct levels of analysis: the computational level, accounting for the What and Why issues, the algorithmic and the implementational levels specifying the How problem. However, the tremendous developments in neuroscience knowledge about processes at different scales of organization together with the (...) complexity of today cognitive theories suggest that there will hardly be only three levels of explanation. Instead, there will be many different degrees of commitments corresponding to the different granularities—from high-level (behavioural) models to low-level (neural and molecular) models of the cognitive research program. For instance, Bayesian approaches, that are usually advocated for formalizing Marr’s computational level and rational behaviour, have even been adopted to model synaptic plasticity and axon guidance by molecular gradients. As a result, we can consider the behavioural scientist as dealing with models at a multiplicity of levels. The purpose of this Research Topic in Frontiers in Theoretical and Philosophical Psychology is to promote an approach to the role of the levels and explanation and models which is of interest for cognitive scientists, neuroscientists, psychologists, behavioural scientists, and philosophers of science. (shrink)

En este artículo se plantea una discusión con el enfoque doxástico de los delirios. A pesar de que esta línea de análisis ha hecho importantes aportes a la comprensión del fenómeno, tiene dificultades importantes a la hora de aportar un marco explicativo completo de los delirios, porque deja por fuera el aspecto total de la experiencia y sigue basándose implícitamente en la idea de que podemos estudiar de manera separada e independiente los aspectos físicos, cognitivos y experienciales de un fenómeno (...) tan complejo. El artículo propone que, más allá de la decisión acerca de si se debe considerar a los delirios como creencias irracionales o no, o de si se puede concebirlos como creencias en absoluto, es necesario tener en cuenta la drástica transformación del mundo entero de la experiencia que se da en el sujeto delirante, tal como lo plantea la fenomenología. (shrink)

Celem tego tekstu jest rekonstrukcja i analiza argumentów przedstawianych za Psychologiczną Zasadą Niesprzeczności, stwierdzającą, że żaden podmiot nie może mieć sprzecznych przekonań lub być opisany jako posiadający sprzeczne przekonania. Poprzez rozróżnienie dwóch możliwych interpretacji PZN, deskryptywnej i normatywnej, oraz dokładne zbadanie argumentacji przedstawionej dla każdej z nich z osobna, wskazuję zawarte w nich błędy oraz problemy związane z uzgodnieniem ich z wynikami badań prowadzonych w psychologii poznawczej i klinicznej. Uzasadniam, dlaczego PZN nie może być wyprowadzona z żadnego ze stanowisk metafizycznych (...) dotyczących nastawień sądzeniowych i że posiadanie sprzecznych przekonań powinno być uznane za możliwe. Następnie piszę, dlaczego zinterpretowanie niektórych podmiotów jako posiadających sprzeczne przekonania może być bardziej efektywne w wyjaśnianiu przypadków nieracjonalnego zachowania niż rozwiązania zgodne z PZN. (shrink)

The text concerns the role of emotions in delusion formation. Provided are definitions from DSM-V and DSM-IV-R and the problems found in those definitions. One of them, the problem of delusion formation, is described when providing cognitive theories of delusions. The core of the paper is a presentation of the emotional and affective disorders in delusions, especially Capgras delusion and Cotard delusion. The author provides a comparison of the kinds of delusions and the conclusions taken from neuroimaging studies. As a (...) result of the fact that an explanation of delusion formation focusing on emotional problems turns out to be insufficient, the author provides examples of the reasoning impairments which coexist with them. At the end of the article, some hypotheses are proposed concerning the role of emotions and reasoning in delusion formation and the relation between belief disorders and emotional disorders. (shrink)

This paper provides a concise description and discussion of bottom–up and top–down approaches to misattribution of agency in schizophrenia. It explores if first-person accounts of passivity phenomena can provide support for one of these approaches. The focus is on excerpts in which the writers specifically examine their experiences of external influence. None of the accounts provides arguments that fit easily with only one of the possible approaches, which is in line with current attempts to theoretical integration.

This book provides the first full-length treatment of disjunctivism about visual experiences in the service of defending a naive realist theory of veridical visual perception. It includes detailed theories of hallucination and illusion that show how such states can be indistinguishable from veridical experiences without sharing any common character.

ABSTRACTThis article intends to reconsider the epistemological status of delusional beliefs on the basis of Wittgenstein’s conception of certainty. Several works over the last two decades have compared delusional beliefs with so-called hinge propositions, which – according to Wittgenstein – function as expressions of objective certainty. This gives rise to a paradox. On the one hand, delusions are compatible to Wittgensteinian certainties in some respects; on the other hand, they contradict beliefs shared by other members of the community, which makes (...) them different from ‘normal’ certainties. In order to address this issue, I use Moyal-Sharrock’s taxonomy of hinge propositions. This taxonomy allows one to distinguish between different types of hinge propositions; all types share the same features, but these features are manifested in a variety of ways. Thus, delusional beliefs might also be regarded as constituting a specific type of hinge propositions. This move makes it possible to resolve the paradox and to identify the special epistemic features of delusional beliefs. (shrink)