Confabulation


Confabulation

Description, Causes and Risk Factors:

Confabulation is the word used when an imagination or mind's thought becomes confused with memory or else the true memory is mystified with false memory. According to psychology confabulation is the impulsive descriptive account of events that never happened. It comprises of the formation of false memories, perceptions, or beliefs about the self or the surroundings - habitually as an outcome of neurological or psychological dysfunction. Once it is a subject of memory, confabulation is the confusion of imagination with memory, or the perplexed application of true memories.

While the accurate causes of confabulation are not known, it may occur whenever there is damage to certain parts of the brain, for instance the basal forebrain. The invention of experiences or situations, often narrated in a complete and reasonable way to fill in and cover up cognitive impairment or memory loss, which may be caused by alcoholism, especially in people with Korsakoff's psychosis; head injuries; dementia; or lead poisoningis also called fabrication. It may have a psychological basis or may be the source of some sort of damage to the brain or certain drugs used in chemical warfare like Quinuclidinyl benzilate can cause the damage. Patient's with Korsakoff's syndrome and Wernicke dementia often display this condition it is also commonly seen in Alzheimer's disease.

Theories of confabulation range in emphasis. Some theories propose that confabulations represent a way for memory-disabled individuals to maintain their self-identity. Other theories use neurocognitive links to explain the process of confabulation. Still other theories frame confabulation around the more familiar concept of delusion. Other researchers frame confabulation within the fuzzy-trace theory. Finally, some researchers call for theories that rely less on neurocognitive explanations and more on epistemic accounts.

Confabulation

Neuropsychological theories: The most popular theories of confabulation come from the field of neuropsychology or cognitive neuroscience. Research suggests that confabulation is associated with dysfunction of cognitive processes that control the retrieval from long-term memory. Frontal lobe damage often disrupts this process, preventing the retrieval of information and the evaluation of its output. Furthermore, researchers argue that confabulation is a disorder resulting from failed “reality monitoring/source monitoring” (i.e. deciding whether a memory is based on an actual event or whether it is imagined. Some neuropsychologists suggest that errors in retrieval of information from long-term memory that are made by normal subjects involve different components of control processes than errors made by confabulators. Detection of these errors are considered part of the Supervisory System, which is believed to be a function of the frontal cortex.

RESEARCH: Several theories have been proposed to account for the complex cognitive mechanisms underlying the various forms and manifestations of confabulation. As regards the content of confabulations, deficit accounts explain what is lacking in the confabulations, but accounts of the positive features of the content may also be required to explain what remains. There is reason to believe that the content of confabulations is not motivationally neutral; in particular, they appear to "improve" the world experienced by the patient, making it more pleasant than the reality of the situation demands. The present study investigated the content of the confabulations of a neurological patient, ES: A 56-year-old man, who developed a striking confabulatory syndrome following removal of a meningioma in the pituitary and suprasellar region. ES's cognitive abilities were severely compromised, and he confabulated continuously and bizarrely. Raters presented with transcriptions of ES's confabulations found them to represent significantly more pleasant experiences than their corresponding, misrepresented realities. This finding suggests that confabulations include motivated (or "wishful") content. The influence of this motivational feature of confabulation must be considered in parallel with the memory and executive deficits which contribute to the mechanism of confabulation.

Symptoms:

Signs:

    Typically verbal statements but can also be non-verbal gestures or actions.

  • Can include autobiographical and non-personal information, such as historical facts, fairytales, or other aspects of semantic memory.

  • The account can be fantastic or coherent.

  • Both the premise and the details of the account can be false.

  • The account is usually drawn from the patient's memory of actual experiences, including past and current thoughts.

  • The patient is unaware of the accounts' distortions or inappropriateness, and is not concerned when errors are pointed out.

  • There is no hidden motivation behind the account.

  • The patient's personality structure may play a role in their readiness to confabulate.

Diagnosis:

Spontaneous confabulations, due to their involuntary nature, cannot be manipulated in a laboratory setting.However, provoked confabulations can be researched in various theoretical contexts. The mechanisms found to underlie provoked confabulations can be applied to spontaneous confabulation mechanisms. The basic premise of researching confabulation comprises finding errors and distortions in memory tests of an individual.

Confabulations can be detected in the context of the Deese-Roediger-McDermott paradigm by using the Deese-Roediger-McDermott lists.Participants listen to audio recordings of several lists of words centered around a theme, known as the critical word. The participants are later asked to recall the words on their list. If the participant recalls the critical word, which was never explicitly stated in the list, it is considered a confabulation. Participants often have a false memory for the critical word.

Recognition Tasks: Confabulations can also be researched by using continuous recognition tasks.These tasks are often used in conjunction with confidence ratings. Generally, in a recognition task, participants are rapidly presented with pictures. Some of these pictures are shown once; others are shown multiple times. Participants press a key if they have seen the picture previously. Following a period of time, participants repeat the task. More errors on the second task, versus the first, are indicative of confusion, representing false memories.

Free Recall Tasks: Confabulations can also be detected using a free recall task, such as a self-narrative task.Participants are asked to recall stories (semantic or autobiographical) that are highly familiar to them. The stories recalled are encoded for errors that could be classified as distortions in memory. Distortions could include falsifying true story elements or including details from a completely different story. Errors such as these would be indicative of confabulations.

Treatment:

Treatment for confabulation is somewhat dependent on the cause or source, if identifiable. For example, treatment of Wernicke-Korsakoff syndrome involves large doses of vitamin B in order to reverse the thiamine deficiency. If there is no known physiological cause, more general cognitive techniques may be used to treat confabulation. In a recent case study, Self-Monitoring Training (SMT) was shown to reduce delusional confabulations. Furthermore, improvements were maintained at a three-month follow-up and were found to generalize to everyday settings. Although this treatment seems promising, more rigorous research is necessary to determine its efficacy in the general confabulation population.

NOTE: The above information is for processing purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.

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