Skip to main content
SpringerLink
Log in

Impaired semantic memory in the formation and maintenance of delusions post-traumatic brain injury: a new cognitive model of delusions

  • Original Paper
  • Published:
European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

This paper proposes a new cognitive model to explain the aetiology of delusions irrespective of diagnosis and/or phenomenology. The model hypothesises the influence of two processes in the formation and maintenance of delusions; (i) impaired perceptual abilities, particularly affect perception, which fosters the encoding of (ii) idiosyncratic semantic memories, especially those with an affective/self-referential valence. Previous research has established that schizophrenia patients with delusions have impaired semantic memory function. In the current paper we sought to provide evidence for (ii) abnormal semantic processing in persons with delusions with an alternative aetiology. Performance of four cases with a significant delusion post a traumatic brain injury was examined on a broad range of semantic memory tests. Overall semantic processing was impaired in the four cases relative to a normative healthy control sample. Cases performed better on tasks which required categorical identification, relative to the novel production of semantic information, which was poor in all four of the cases. These data offer preliminary evidence for our hypothesis of impaired semantic processing in persons with delusions. Findings will need to be empirically verified in larger sample groups and in those with alternative aetiologies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Abe N, Ishii H, Fujii T, Ueno A, Lee E, Ishioka T, Mori E (2007) Selective impairment in the retrieval of family relationships in person identification: a case study of delusional misidentification. Neuropsychologia 45(13):2902–2909

    Article  PubMed  Google Scholar 

  2. Allen HA, Frith CD (1983) Selective retrieval and free emission of category exemplars in schizophrenia. Br J Psychol 74:481–490

    PubMed  Google Scholar 

  3. Andreasen NC, Olsen S (1982) Negative versus positive schizophrenia. Definition and validation. Arch Gen Psychiatry 39:789–794

    CAS  PubMed  Google Scholar 

  4. Bassiony MB, Lyketsos CG (2003) Delusions and hallucinations in Alzheimer’s disease: review of the brain decade. Psychosomatics 44:388–401

    Article  PubMed  Google Scholar 

  5. Battig WF, Montague WE (1969) Category norms of verbal items in 56 categories: A replication and extension of the Connecticut category norms. J Exp Psychol 80(3, Pt. 2):1–46

    Article  Google Scholar 

  6. Birchwood M (1999) Commentary of Garety & Freeman I: ‘cognitive approaches to delusions—a critical review of theories and evidence’. Br J Clin Psychol 38:315–318

    Article  PubMed  Google Scholar 

  7. Brebion G, David AS, Bressan RA, Pilowsky LS (2005) Word frequency effects of free recall and recognition in patients with schizophrenia. J Psychiatr Res 39:215–222

    Article  PubMed  Google Scholar 

  8. Chadwick P, Trower P (1996) Cognitive therapy for punishment paranoia: A single case experiment. Behav Res Ther 34:351–356

    Article  CAS  PubMed  Google Scholar 

  9. Chapman LJ, Chapman JP (1988) The genesis of delusions. In: Oltman TF, Maher BA (eds) Delusional beliefs. Wiley, New York

    Google Scholar 

  10. Chen EY, Wilkins AJ, McKenna PJ (1994) Semantic memory is both impaired and anomalous in schizophrenia. Psychol Med 24:193–202

    Article  CAS  PubMed  Google Scholar 

  11. Corcoran R, Mercer G, Frith CD (1995) Schizophrenia, symptomatology and social inference: investigating “theory of mind” in people with schizophrenia. Schizophr Res 17:5–13

    Article  CAS  PubMed  Google Scholar 

  12. Cummings JL (1985) Organic delusions: phenomenology, anatomical correlations, and review. Br J Psychiatry 146:184–197

    Article  CAS  PubMed  Google Scholar 

  13. Davies M, Coltheart M, Langdon R, Breen N (2001) Monothematic delusions: towards a two-factor account. Philos Psychiatry Psychol 8:133–158

    Article  Google Scholar 

  14. Dudley RE, John CH, Young AW, Over DE (1997) Normal and abnormal reasoning in people with delusions. Br J Clin Psychol 36:243–258

    PubMed  Google Scholar 

  15. Edelstyn NM, Oyebode F (1999) A review of the phenomenology and cognitive neuropsychological origins of the Capgras syndrome. Int J Geriatr Psychiatry 14:48–59

    Article  CAS  PubMed  Google Scholar 

  16. Feinberg TE, Eaton LA, Roane DM, Giacino JT (1999) Multiple Fregoli delusions after traumatic brain injury. Cortex 35:373–387

    Article  CAS  PubMed  Google Scholar 

  17. Frith C (1999) Commentary on Garety and Freeman II: “cognitive approaches to delusions—a critical review of theories and evidence”. Br J Clin Psychol 38:319–321

    Article  PubMed  Google Scholar 

  18. Frith C (1992) The cognitive neuropsychology of schizophrenia. Lawrence Erlbaum Associates, London

    Google Scholar 

  19. Garety PA, Freeman D (1999) Cognitive approaches to delusions: a critical review of theories and evidence. Br J Clin Psychol 38:113–154

    Article  PubMed  Google Scholar 

  20. Garety PA, Hemsley DR, Wessely S (1991) Reasoning in deluded schizophrenic and paranoid patients. Biases in performance on a probabilistic inference task. J Nerv Ment Dis 179:194–201

    Article  CAS  PubMed  Google Scholar 

  21. Hampton JA, Gardiner MM (1983) Measures of internal category structure: a correlational analysis of normative data. Br J Psychol 74(4):491–516

    Google Scholar 

  22. Henik A, Nissimov E, Priel B, Umansky R (1995) Effects of cognitive load on semantic priming in patients with schizophrenia. J Abnorm Psychol 104:576–584

    Article  CAS  PubMed  Google Scholar 

  23. Howard D, Patterson K (1992) Pyramids and palm trees. Pearson Assessments, London

    Google Scholar 

  24. Huq SF, Garety PA, Hemsley DR (1988) Probabilistic judgements in deluded and non-deluded subjects. Q J Exp Psychol A: Hum Exp Psychol 40:801–812

    CAS  Google Scholar 

  25. Jaspers J (1913) General psychopathology (translated 1959). Manchester University Press

  26. Kay J, Lesser R, Coltheart M (1992) Psycholinguistic assessment of language processing in Aphasia. Lawrence Erlbaum, London

    Google Scholar 

  27. Kemp R, Chua S, McKenna P, David A (1997) Reasoning and delusions. Br J Psychiatry 170:398–405

    Article  CAS  PubMed  Google Scholar 

  28. Kiang M, Kutas M, Light GA, Braff DL (2008) An event-related brain potential study of direct and indirect semantic priming in schizophrenia. Am J Psychiatry 165(1):74–81

    Article  PubMed  Google Scholar 

  29. Kinderman P, Kaney S, Morley S, Bentall RP (1992) Paranoia and the defensive attributional style: deluded and depressed patients’ attributions about their own attributions. Br J Med Psychol 65:371–383

    PubMed  Google Scholar 

  30. Knobel A, Heinz A, Voss M (2008) Imaging the deluded brain. Eur Arch Psychiatry Clin Neurosci 258(Suppl 5):76–80

    Article  PubMed  Google Scholar 

  31. Kucera H, Francis WN (1967) Computational analysis of present-day American English. Brown University Press, Providence

    Google Scholar 

  32. Langdon R, Coltheart M (2001) Visual perspective-taking and schizotypy: Evidence for a simulation-based account of mentalizing in normal adults. Cognition 2001(82):1–26

    Article  Google Scholar 

  33. Langdon R, Coltheart M, Ward PB, Catts SV (2002) Disturbed communication in schizophrenia: the role of poor pragmatics and poor mind-reading. Psychol Med 2002(32):1273–1284

    Google Scholar 

  34. Maher BA (1988) Anomalous experience and delusional thinking: the logic of explanations. In: Oltmanns T, Maher B (eds) Delusional beliefs. Wiley Interscience, New York

    Google Scholar 

  35. McKay AP, McKenna PJ, Bentham P, Mortimer AM, Holbery A, Hodges JR (1996) Semantic memory is impaired in schizophrenia. Biol Psychiatry 39:929–937

    Article  CAS  PubMed  Google Scholar 

  36. McKenna PJ (1991) Memory, knowledge and delusions. Br J Psychiatry 159(Suppl 14):36–41

    Google Scholar 

  37. Overall JE, Gorham DR (1988) The Brief Psychiatric Rating Scale (BPRS): recent developments in ascertainment and scaling. Psychopharmacol Bull 24(1):97–99

    Google Scholar 

  38. Paulsen JS, Romero R, Chan A, Davis AV, Heaton RK, Jeste DV (1996) Impairment of the semantic network in schizophrenia. Psychiatry Res 63:109–121

    Article  CAS  PubMed  Google Scholar 

  39. Rossell SL (2006) Category fluency performance in patients with schizophrenia and bipolar disorder: the influence of affective categories. Schizophr Res 82:135–138

    Article  PubMed  Google Scholar 

  40. Rossell SL, David AS (2006) Are semantic processing deficits in schizophrenia an access or storage problem? Schizophr Res 2006(82):121–134

    Article  Google Scholar 

  41. Rossell SL, Rabe-Hesketh S, Shapleske J, David AS (1999) Is semantic fluency differentially impaired in schizophrenic patients with delusions? J Clin Exp Neuropsychol 21(5):629–642

    Article  CAS  PubMed  Google Scholar 

  42. Rossell SL, Shapleske J, David AS (1998) Sentence verification and delusions: a content-specific deficit. Psychol Med 28:1189–1198

    Article  CAS  PubMed  Google Scholar 

  43. Rossell SL, Shapleske J, David AS (2000) Direct and indirect semantic priming with neutral and emotional stimuli in schizophrenia: relationship with delusions. Cogn Neuropsychiatry 5(4):271–292

    Article  Google Scholar 

  44. Rossell SL, Batty R (2008) Elucidating semantic disorganisation from a word comprehension task: do patients with schizophrenia and bipolar disorder show differential processing of nouns, verbs and adjectives? Schizophr Res 102:63–68

    Article  PubMed  Google Scholar 

  45. Spitzer M, Braun U, Hermle L, Maier S (1993) Associative semantic network dysfunction in thought-disordered schizophrenic patients: direct evidence from indirect semantic priming. Biol Psychiatry 34:864–877

    Article  CAS  PubMed  Google Scholar 

  46. Tamyln D, McKenna PJ, Mortimer AM, Lund CE, Hammond S, Baddeley AD (1992) Memory impairment in schizophrenia: its extent, affiliations and neuropsychological character. Psychol Med 22:101–115

    Article  Google Scholar 

  47. Uhlhaas PJ, Mishara AL (2007) Perceptual anomalies in schizophrenia: integrating phenomenology and cognitive neuroscience. Schizophr Bull 33(1):142–156

    Article  PubMed  Google Scholar 

  48. Yeap S, Kelly SP, Sehatpur P, Magno E, Garavan H, Thakore JH, Foxe JJ (2008) Visual sensory processing deficits in schizophrenia and their relationship to disease state. Eur Arch Psychiatry Clin Neurosci 258:305–316

    Article  PubMed  Google Scholar 

  49. Young HF, Bentall RP (1997) Probabilistic reasoning in deluded, depressed and normal subjects: effects of task difficulty and meaningful versus non-meaningful material. Psychol Med 27:455–465

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Faculty of Medicine, Nursing and Health Sciences, Cognitive Neuropsychiatry Laboratory, Monash-Alfred Psychiatry Research Centre, School of Psychology and Psychiatry, Monash University, 1st Floor, Old Baker Building, The Alfred, Commercial Road, Melbourne, VIC, 3004, Australia

    Susan L. Rossell & Rachel A. Batty

  2. Department of Behavioural Science, University of Melbourne, Melbourne, Australia

    Susan L. Rossell

  3. Macquarie Centre for Cognitive Science (MACCS), Macquarie University, Sydney, NSW, Australia

    Susan L. Rossell & Laura Hughes

Authors
  1. Susan L. Rossell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rachel A. Batty
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Laura Hughes
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Susan L. Rossell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rossell, S.L., Batty, R.A. & Hughes, L. Impaired semantic memory in the formation and maintenance of delusions post-traumatic brain injury: a new cognitive model of delusions. Eur Arch Psychiatry Clin Neurosci 260, 571–581 (2010). https://doi.org/10.1007/s00406-010-0101-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00406-010-0101-6

Keywords

Search

Navigation