ABSTRACT

Over the last decade or so, several researchers have considered the predictive processing framework (PPF) to be a useful perspective from which to shed some much-needed light on the mechanisms behind psychosis. Most approaches to psychosis within PPF come down to the idea of the “atypical” brain generating inaccurate hypotheses that the “typical” brain does not generate, either due to a systematic top-down processing bias or more general precision weighting breakdown. Strong at explaining common individual symptoms of psychosis, such approaches face some issues when we look at a more general clinical picture. In this paper, we propose an update on the current accounts of psychosis based on the realization that a neurotypical brain constantly generates non-actual, de-coupled, counterfactual hypotheses as part of healthy cognition. We suggest that what is going on in psychosis, at least in some cases, is not so much a generation of erroneous hypotheses, but rather an inability to correctly use the counterfactual ones. This updated view casts “accurate” cognition as more fragile and delicate, but also closes the gap between psychosis and typical cognition.

摘要

在过去十年左右的时间里，一些研究人员认为预测处理框架 (PPF) 是一个有用的视角，可以从中阐明精神病背后的机制。PPF 中精神病的大多数方法都归结为“非典型”大脑产生“典型”大脑不会产生的不准确假设的想法，这要么是由于系统的自上而下的处理偏差，要么是由于更普遍的精度加权分解。这种方法擅长解释精神病的常见个体症状，但当我们查看更一般的临床情况时，这些方法会面临一些问题。在这篇论文中，我们基于这样一种认识，即神经典型大脑不断产生非实际的、去耦合的、反事实的假设作为健康认知的一部分，提出了对精神病的当前描述的更新。我们认为，至少在某些情况下，精神病正在发生的与其说是错误假设的产生，不如说是无法正确使用反事实假设。这种更新的观点将“准确”认知视为更加脆弱和微妙，但也缩小了精神病与典型认知之间的差距。