Negative mood invites psychotic false perception in dementia

Hiroyuki Watanabe, Yoshiyuki Nishio, Yasuyuki Mamiya, Wataru Narita, Osamu Iizuka, Toru Baba, Atsushi Takeda, Tatsuo Shimomura, Etsuro Mori, Hiroyuki Watanabe, Yoshiyuki Nishio, Yasuyuki Mamiya, Wataru Narita, Osamu Iizuka, Toru Baba, Atsushi Takeda, Tatsuo Shimomura, Etsuro Mori

Abstract

Background: There is increasing evidence for predictive coding theories of psychosis, which state that hallucinations arise from abnormal perceptual priors or biases. However, psychological processes that foster abnormal priors/biases in patients suffering hallucinations have been largely unexplored. The widely recognized relationship between affective disorders and psychosis suggests a role for mood and emotion.

Methods: Thirty-six patients with dementia with Lewy bodies (DLB), a representative condition associated with psychosis of neurological origin, and 12 patients with Alzheimer's disease (AD) were enrolled. After an experimental mood induction, the participants underwent the pareidolia test, in which visual hallucination-like illusions were evoked and measured.

Results: In DLB patients, the number of pareidolic illusions was doubled under negative mood compared to that under neutral mood. In AD patients, there was no significant difference in the number of pareidolic responses between negative and neutral mood conditions. A signal detection theory analysis demonstrated that the observed affective modulation of pareidolic illusions was mediated through heightened perceptual bias, not sensory deterioration.

Conclusions: The current findings demonstrated that abnormal perceptual priors in psychotic false perception have an affective nature, which we suggest are a type of cognitive feeling that arises in association with perception and cognition.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Outline of the experiment.
Fig 1. Outline of the experiment.
sSTAI, short form of the State-Trait Anxiety Inventory; MMSE, Mini-Mental State Examination.
Fig 2. Effects of the mood induction…
Fig 2. Effects of the mood induction procedure on mood and pareidolic illusions.
(A) In both the DLB and AD groups, the sSTAI scores were highest under the negative mood condition and lowest under the positive mood condition, which indicates that the target moods were successfully induced by the experimental manipulations. DLB, dementia with Lewy body disease; AD, Alzheimer's disease; sSTAI, short form of the State-Trait Anxiety Inventory. (B) In the DLB group, the numbers of pareidolic responses were significantly larger under the negative mood condition (24.1 ± 20.5) than those under the neutral mood condition (11.2 ± 16.1) and were similar between the positive (9.4 ± 15.4) and neutral mood conditions. There were no significant differences in the number of pareidolic responses across the 3 mood conditions in the AD group.
Fig 3. Signal detection theory analysis of…
Fig 3. Signal detection theory analysis of the pareidolia test for DLB patients.
(Left) No significant differences were observed across the 3 mood conditions in de' (discrimination ability). (Right) Ce (criterion/bias) was significantly modulated by the induced mood and was highest under the negative mood condition and lowest under the positive mood condition. DLB, dementia with Lewy body disease.

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