Cognition et délire: de la croyance à la
fabulation
Gianfranco Dalla Barba
Phénomènes Délirants et Traumatismes crâniens
Paris13/12/2013
Délire et confabulation
- Similarités:
- Délires et confabulations sont des fausses
croyances
- Le patient délirant « croit » en son délire
- Le confabulateur « croit » en ses
confabulations
- Le délire et la confabulation sont résistants
aux critiques
- Mais il y a une ambigüité: en réalité dans le
délire et dans la confabulation il s’agit de
« vrais » croyances subjectives considérées
comme « fausses » croyances objectives.
Fausses croyances « normales »
Confabulations « normales »
-Kopelman, 1987
-Confusion entre réalité et imagination
-Convictions erronée sur les souvenirs
-Faux souvenirs des enfants
Délire et confabulation
- Différences:
- Signes psychiatriques vs signes
neurologiques
- Les confabulations concernent la mémoire et
la temporalité en général
- Les confabulations sont rarement
accompagnées par d’autres phénomènes
psychotiques
- Il n’y a pas ou peu de traitements cognitifs ou
pharmachologiques
Distorsions Mnésiques
• Confabulations
• Intrusions
• Fausses reconnaissances
• Paramnesies
• “Déjà vu”
• Etc….
Distorsions mnésiques ?
• Sociales
• Médicales
• Théoriques
False memories: Social
• Eyewitness misattribution
– 75,000 criminal trials/year decided on the
basis of eyewitness testimony
– 36/40 (90%) cases in which DNA evidence
established the innocence of wrongfully
imprisoned individuals involved mistaken
eyewitness identification
False memories: Medical
• False memories may impair the ability of
patients to live independently
• For example, patients may believe that
they turned off the stove when they have
only thought about turning it off.
False memories: Theoretical
• The study of false memories may provide
valuable information on the functions of
normal memory
• The role of executive functions
• The role of encoding and retrieval
processes
• Temporal Consciousness
Definition of confabulation
• ”falsification of memory” (Berlyne, 1972)
• ”an extreme form of lying or deception” (Joseph, 1986)
• ”an honest lying” (Moscovitch, 1989)
•
…
Definition of confabulation
• A particular symptom, observable in amnesic patients
unaware of their memory deficit, which consists of both
actions and verbal statements that are unintentionally
incongruous to the patients’ history, background, present
and future situation. (Dalla Barba, 1993)
Hypotheses on the origin of
confabulation
• Moscovitch, 1989, 1995
– Associative vs Strategic retrieval
• Confabulation = deficit of strategic retrieval
Hypotheses on the origin of
confabulation
• Johnson 1991: Reality monitoring
• Schnider & Ptak 1999: Reality filtering
Hypotheses on the origin of
confabulation
• Conway & Tacchi, 1996
• Wishful thinking
Temporal Consciousness (TC)
- A specific form of consciousness that
allows individuals to remember their
personal past, to be oriented in their
present world and to predict their
personal future.
- It is specific because it cannot be
confounded with other forms of
consciousness, perception, imagination
Temporal Consciousness (TC)
- If, for instance the average person
perceive a tiger in front of them, they will
be scared, but if they remember or
imagine such an event, they may not be
scared at all.
- "Re-experiencing the past"
- TC is opposed to KC which allows
individuals to address the past, the
present and the future impersonally
Temporal Consciousness (TC)
- It is experimentally measurable and and
dissociable from impersonal temporality
- It is lost in amnesia following bilateral
hippocampal damage and it is
malfunctioning in confabulation
% correct
% conf
Examples of confabulations in IDKE
questions
• Do you remember what you did on March 13,
1985?
• We spent the day at the Senart Forest
Examples of confabulations in IDKE
questions
• Do you remember what you had for dinner on
Tuesday two weeks ago?
• Steak with French fries
Examples of confabulations in IDKE
questions
• Do you remember what you did on October 9,
1991?
• We spent the day with our children. We played
cards and talked about next holydays
Examples of confabulations in IDKE
questions
• Do you remember what you did for your 27th
birthday?
• Wait a minute… I came back from the army
when I was 23, so the 27th birthday… I think…
Yes! I had dinner at my future wife’s place
Examples of confabulations in IDKE
questions
• Do you remember what you were doing one
year ago?
• One year ago… I was with my wife and my
children
Examples of confabulations in IDKE
questions
• Do you remember what you were wearing on
the first day of summer in 1979?
• A short and a T-shirt
La Corte, et al., 2010
Cognition et délire: de la croyance à la
fabulation
Gianfranco Dalla Barba
Phénomènes Délirants et Traumatismes crâniens
Paris13/12/2013
• Délire
• Confabulation
• Croyances sociales
• Croyances politiques
• Idéologies
• Croyances religieuses
• Amour
• Délire, confabulation… religion…
• Psychopathologie = « Connaissance
Totale »
Périphérie
Noyau