Abstract
Delusions are deeply evidence-resistant. Patients with delusions are unmoved by evidence that is in direct conflict with the delusion, often responding to such evidence by offering obvious, and strange, confabulations. As a consequence, the standard view is that delusions are not evidence-responsive. This claim has been used as a key argumentative wedge in debates on the nature of delusions. Some have taken delusions to be beliefs and argued that this implies that belief is not constitutively evidence-responsive. Others hold fixed the evidence-responsiveness of belief and take this to show that delusions cannot be beliefs. Against this common assumption, I appeal to a large range of empirical evidence to argue that delusions are evidence-responsive in the sense that subjects have the capacity to respond to evidence on their delusion in rationally permissible ways. The extreme evidence-resistance of delusions is a consequence of powerful masking factors on these capacities, such as strange perceptual experiences, motivational factors, and cognitive biases. This view makes room for holding both that belief is constitutively evidence-responsive and that delusions are beliefs, and it has important implications for the study and treatment of delusions.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Wang mostly discusses her experiences with the Capgras and Cotard delusion, which are fairly unusual delusions. These delusions arose, in her case, in the context of schizoaffective disorder, which is a diagnosis often accompanied by a wide range of (common and unusual) delusions.
The DSM’s definition of delusion has been subject to vigorous criticism, both for failing to distinguish delusions from non-delusional beliefs and for wrongly excluding some delusions from the category (Bortolotti 2018; Coltheart 2007). But few contest the claim that deep evidence-resistance is at least present in the vast majority of delusions.
I owe the term “intractable” to Reimer (2010).
Bortolotti and Miyazono (2015) helpfully center this argument in discussing the philosophical literature on belief.
See Helton (forthcoming) for illuminating discussion.
Note that one can accept doxasticism without holding that a full theory of delusions will be limited to studying delusional beliefs. As phenomenological approaches note, a full understanding of delusions involves understanding the subjective experience of delusions, which in turn may require studying more pervasive changes in the patient’s experience of, and perspective on, the world. See Bovet and Parnas (1993), Sass (1994), Sass et al. (2011), Sass (2013) for more on such approaches.
There are parallel debates about other candidate constitutive features of belief, such as inferential integration, action guidance, and reason-giving. On one side, doxasticists use delusions to argue that these are not constitutive features of belief; on the other side, defenders of traditional conceptions of belief appeal to these features to argue that delusions are not beliefs. Discussing these debates is beyond the scope of this paper. See Bortolotti and Miyazono (2015) and Bortolotti (2018) for overviews.
Gerrans (2001) argues for the related view that delusions are performance failures of the subject’s capacity for pragmatic rationality, i.e. the ability to apply rules of rationality in context. In his view, subjects with delusions have a capacity for pragmatic rationality, and just fail to apply it in a wide range of circumstances. Though this is similar to my view, we are concerned with different capacities: the capacity to respond to evidence, in my case, and the capacity to apply rules of reasoning in context, in his. Further, I am not equating delusions with failures to exercise such capacities, as Gerrans does. Instead, I explain why delusions are evidence-resistant in terms of masking factors on the subject’s capacities.
Thanks to an anonymous referee for pressing me to clarify the scope of my claim.
My discussion here draws heavily on Schellenberg (2018)’s discussion of capacities.
This is, of course, just one case. I do not here present data on what fraction of patients with delusions inferentially integrate the evidence in relevantly similar ways. The role of presenting case studies is to make vivid why certain kinds of behavior are indicative of the capacity to respond to counter-evidence. The pervasiveness of those kinds of behavior is a different matter. Thanks to an anonymous referee for pressing me to articulate the role of case studies in the argument.
Thanks to an anonymous referee for pressing me to clarify this point.
Though it is hard to get statistics on just how common evidence-avoidance is in delusion patients, empirically well-supported models (e.g. Freeman et al. (2001)’s model, which focuses on persecutory delusions) ascribe evidence-avoidance a significant role in delusion maintenance. This suggests that it is a pervasive feature of delusions.
Note two complications. First, there is an alternative explanation that is compatible with full evidence-insensitivity: perhaps subjects avoid gathering evidence because they don’t want to receive evidence of their own evidence-insensitivity (thanks to Andy Egan for suggesting this alternative explanation). But this explanation is inferior to the one I propose. It imputes to subjects beliefs about the degree of evidence-sensitivity of their own beliefs. And it does not match the phenomenology of confirmation bias, which is one of wanting to avoid being forced into a view one dislikes, or first-personal descriptions like the ones above. Second, this does not establish that patients have the capacity to respond to evidence to a rationally permissible extent; perhaps they have the capacity to respond by adjusting to some extent in the right direction, but not to a rationally permissible extent (thanks to an anonymous referee for pointing this out). However, it does indicate that counter-evidence can have some substantial effects on patients, which sits poorly with the intractability assumption. I will shortly discuss some reasons why patients with delusions may fail to respond to evidence to a sufficient extent, while still adjusting in the right direction.
Thanks for an anonymous referee for bringing these studies to my attention.
One might worry that this just pushes intractability one step back, to the intractability of these alternative views: why do they accept views that common sense would immediately dismiss? But liberal acceptance does not require failing to respond to counter-evidence to these implausible alternatives. More plausibly, patients simply fail to gather such evidence, in that they may fail to retrieve it from memory and are likely not to receive such counter-evidence from their environment at the moment of acceptance.
These findings cohere with phenomenological descriptions of delusion in schizophrenia, which highlight disturbances in background or bedrock certainties Rhodes and Gipps (2008), “a change in the totality of understandable connections” (Jaspers 1963, p. 97), or “a mutation of the ontological framework of experience itself” (Sass 2013, p. 633) as factors in the formation and maintenance of delusions. One would expect such disturbances to be reflected in accepting options that common sense dismisses.
This study considers only patients with schizophrenia.
As seen in our discussion of the bias against disconfirming evidence, they are typically swayed to a lesser extent than people without schizophrenia. But, as discussed there, this is no objection to the claim that they have and exercise the capacity to rationally respond to evidence in such cases.
The alternative is that they acquire this capacity in therapy, but lacked it beforehand. This alternative implies deep changes to the patient’s cognitive architecture over the course of a small number of therapy sessions, which is implausible.
This result should not be over-stated. CBT is relatively effective as a treatment for delusions, but this is in part because delusions are still poorly understood, and, as a result, we lack highly effective treatments. Indeed, most of the effect sizes found are in the small-to-medium range (Gaag et al. 2014), and there are many cases of delusions where this treatment does not work at all. That said, when it works, it is in part because the delusion is evidence-responsive. When it does not, this is likely due to the kinds of factors I will outline in §3.3.
This explanation paradigmatically applies to cases of Capgras that occur without a schizophrenia diagnosis, but Coltheart et al. (2007) argue that it also extends to such delusions in the context of schizophrenia. Similar explanations in terms of localized brain damage causing perceptual distortions have also been explored for other monothematic delusions.
This brief explanation omits many points of disagreement about Capgras formation. For example, some accounts hold that the first step in delusion formation is not a conscious experience but the mere lack of an autonomic response (Coltheart 2005). And some hold that the patient endorses the experience of seeing their partner as an impostor (Bayne and Pacherie 2004), instead of adopting it as an explanation for the experience that something is off in the interaction (Maher 1999; Stone and Young 1997). Others still think that the perceptual effects we find in Capgras are the result of a top-down disturbance (Campbell 2001: the experience is the result of the delusion, and not the other way around. Which of these views is correct is an interesting question, but it does not affect the point that delusion formation involves a strange experience, which is the key point for my purposes.
Most theorists agree that there are other factors involved in the formation of the delusion, such as a deficit in hypothesis evaluation (Coltheart 2007), reasoning biases such as the tendency to jump to conclusions (Garety and Freeman 1999), a liberal acceptance bias (Moritz and Woodward 2004, Moritz and Woodward 2005), or a bias toward privilege explanatory adequacy (i.e. privileging how well the experience is explained by the hypothesis over how probable the hypothesis antecedently is (McKay 2012)).
See Corlett et al. (2009) for an account of delusion maintenance that emphasizes the role of such reinforcement.
See the essays in Bayne (2010) for discussion of the relationship between delusion and self-deception.
Freeman and Garety (2004) argue that this is an important factor in the maintenance of persecutory delusions.
Thanks to Christopher Willard-Kyle for pressing me on this point.
See Mandelbaum (2019) for compelling defense of this claim.
Indeed, sometimes they explicitly consider other versions of the idea. See Bortolotti (2009), pp. 18–21.
My argument in this paper suggests a novel argumentative strategy for dealing with these debates. Instead of asking whether subjects with delusions act, infer, and feel in belief-characteristic ways most of the time, we should investigate whether subjects with delusions have the relevant capacities (e.g. for acting on a belief, drawing inferences from it, and experiencing corresponding emotional reactions). Focusing on capacities is a promising strategy for accommodating pervasive irrationality on the one hand, and theoretical and practical roles that belief is called upon to play on the other. Exploring this possibility is beyond the scope of this paper.
There is substantial unclarity about what normality consists in: is it the statistically normal case (here, of belief maintenance)? The case where the systems involved in belief maintenance meet their function, whatever that may be? The case that satisfies norms of rationality? This is an important unresolved methodological question in cognitive neuropsychiatry. I am here just assuming that there is some thin (non-moral) notion of normality that allows us to study the functioning and malfunctioning of cognitive mechanisms. Thanks to August Gorman for discussion.
Thanks to Sofia Jeppsson for bringing the nurturing stance to my attention.
Thanks to August Gorman for helpful discussion of the ethical implications of the view.
References
Alexander, M. P., Stuss, D. T., & Benson, D. F. (1979). Capgras’ syndrome: A reduplicative phenomenon. Neurology, 29, 334–339.
Appelbaum, P. S., Robbins, P. C., & Roth, L. H. (1999). Dimensional approach to delusions: Comparison across types and diagnoses. American Journal of Psychiatry, 156(12), 1938–1943.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Bayne, T., & Fernández, J. (2010). Delusion and self-deception: Affective and motivational influences on belief formation. Hove: Psychology Press.
Bayne, T., & Pacherie, E. (2004). Bottom-up or top-down: Campbell’s rationalist account of monothematic delusions. Philosophy, Psychiatry, & Psychology, 11(1), 1–11.
Bayne, T. J., & Pacherie, E. (2005). In defence of the doxastic conception of delusions. Mind and Language, 20(2), 163–88. https://doi.org/10.1111/j.0268-1064.2005.00281.x.
Bell, V., Halligan, P. W., & Ellis, H. D. (2008). Are anomalous perceptual experiences necessary for delusions? The Journal of Nervous and Mental Disease, 196(1), 3–8.
Bentall, R. P., Corcoran, R., Howard, R., Blackwood, N., & Kinderman, P. (2001). Persecutory delusions: A review and theoretical integration. Clinical Psychology Review, 21(8), 1143–1192.
Berrios, G. (1991). Delusions as ‘wrong beliefs’: A conceptual history. British Journal of Psychiatry, 159, 6–13.
Bisiach, E. (1988). Language without thought. In L. Weiskrantz (Ed.), Thought without language (pp. 464–84). Oxford: Oxford University Press.
Blount, G. (1986). Dangerousness of patients with Capgras syndrome. Nebraska Medical Journal, 71, 207.
Bortolotti, L. (2005a). Delusions and the background of rationality. Mind and Language, 20(2), 189–208. https://doi.org/10.1111/j.0268-1064.2005.00282.x.
Bortolotti, L. (2005b). Intentionality without rationality. Proceedings of the Aristotelian Society, 105(3), 385–392. https://doi.org/10.1111/j.0066-7373.2004.00119.x.
Bortolotti, L. (2009). Delusions and other irrational beliefs. Oxford: Oxford University Press.
Bortolotti, L. (2018). Delusion. In E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy (spring 2018 ed.). Stanford: Metaphysics Research Lab, Stanford University.
Bortolotti, L., & Miyazono, K. (2015). Recent work on the nature and development of delusions. Philosophy Compass, 10(9), 636–645. https://doi.org/10.1111/phc3.12249.
Bovet, P., & Parnas, J. (1993). Schizophrenic delusions: A phenomenological approach. Schizophrenia Bulletin, 19(3), 579–597.
Brandenburg, D. (2018). The nurturing stance: Making sense of responsibility without blame. Pacific Philosophical Quarterly, 99, 5–22.
Broome, M. R., Johns, L. C., Valli, I., Woolley, J. B., Tabraham, P., Brett, C., et al. (2007). Delusion formation and reasoning biases in those at clinical high risk for psychosis. The British Journal of Psychiatry, 191(S51), s38–s42.
Bruce, V., & Young, A. (1986). Understanding face recognition. British Journal of Psychology, 77(3), 305–327.
Burge, T. (2010). Origins of objectivity. Oxford: Oxford University Press.
Campbell, J. (2001). Rationality, meaning, and the analysis of delusion. Philosophy, Psychiatry, & Psychology, 8(2), 89–100.
Capgras, J., & Reboul-Lachaux, J. (1994). L’illusion des’ sosies’ dans un délire systématisé chronique. History of Psychiatry, 5(17), 119–133.
Chapman, R. K. (2002). First person account: Eliminating delusions. Schizophrenia Bulletin, 28(3), 545–553.
Chatterjee, A. (1996). Anosognosia for hemiplegia: Patient retrospections. Cognitive Neuropsychiatry, 1(3), 221–237.
Coltheart, M. (2005). Conscious experience and delusional belief. Philosophy, Psychiatry, & Psychology, 12(2), 153–157.
Coltheart, M. (2007). Cognitive neuropsychiatry and delusional belief. Quarterly Journal of Experimental Psychology (2006), 60(8), 1041–1062.
Coltheart, M., Langdon, R., & McKay, R. (2007). Schizophrenia and monothematic delusions. Schizophrenia Bulletin, 33(3), 642–647.
Coltheart, M., Langdon, R., & McKay, R. (2011). Delusional belief. Annual Review of Psychology, 62, 271–298.
Cooper, J. (2007). Cognitive dissonance: 50 years of a classic theory. Thousand Oaks: Sage.
Corlett, P. R., Krystal, J. H., Taylor, J. R., & Fletcher, P. C. (2009). Why do delusions persist? Frontiers in Human Neuroscience, 3, 12.
Cotard, J. (1880). Du délire hypochondriaque dans une forme grave de la méleancolie anxieuse. Annales Medico-psychologiques, 4, 168–174.
Currie, G., & Jureidini, J. (2001). Delusion, rationality, empathy: Commentary on Martin Davies et al. Philosophy, Psychiatry, & Psychology, 8, 159–162. https://doi.org/10.1353/ppp.2001.0006.
Currie, G., & Ravenscroft, I. (2002). Recreative minds: Imagination in philosophy and psychology. Oxford: Oxford University Press.
Davies, A. M. A., & Davies, M. (2009). Explaining pathologies of belief. In M. Broome & L. Bortolotti (Eds.), Psychiatry as cognitive neuroscience: Philosophical perspectives. Oxford: Oxford University Press.
Davies, M., & Coltheart, M. (2000). Pathologies of belief. In M. Davies & M. Coltheart (Eds.), Pathologies of belief. Hoboken: Wiley.
Dawson, E., Savitsky, K., & Dunning, D. (2006). “Don’t tell me, I don’t want to know”: Understanding people’s reluctance to obtain medical diagnostic information. Journal of Applied Social Psychology, 36, 751–768.
Elliot, A. J., & Devine, P. G. (1994). On the motivational nature of cognitive dissonance: Dissonance as psychological discomfort. Journal of Personality and Social Psychology, 67(3), 384–394. https://doi.org/10.1037/0022-3514.67.3.382.
Dozois, D., & Dobson, K. (Eds.). (2010). Handbook of cognitive behavioral therapies. New York: Guilford Press.
Dub, R. (2017). Delusions, acceptances, and cognitive feelings. Philosophy and Phenomenological Research, 94(1), 27–60. https://doi.org/10.1111/phpr.12220.
Egan, A. (2008). Imagination, delusion, and self-deception. In T. Bayne & J. Fernandez (Eds.), Delusion and self-deception: affective and motivational influences on belief formation (Macquarie monographs in cognitive science). East Sussex: Psychology Press.
Ellis, H. D., & Lewis, M. B. (2001). Capgras delusion: A window on face recognition. Trends in Cognitive Sciences, 5(4), 149–156.
Ellis, H. D., & Young, A. W. (1990). Accounting for delusional misidentifications. The British Journal of Psychiatry, 157(2), 239–248.
Festinger, L., Riecken, H. W., & Schachter, S. (1956). When prophecy fails. Minneapolis: University of Minnesota Press.
Flynn, F. G., Cummings, J. L., & Gornbein, J. (1991). Delusions in dementia syndromes: Investigation of behavioral and neuropsychological correlates. The Journal of Neuropsychiatry and Clinical Neurosciences.
Foerstl, H., Almeida, O. P., Owen, A. M., Burns, A., & Howard, R. (1991). Psychiatric, neurological and medical aspects of misidentification syndromes: A review of 260 cases. Psychological Medicine, 21(4), 905–910.
Frankish, K. (2012). Delusions, levels of belief, and non-doxastic acceptances. Neuroethics, 5(1), 23–27. https://doi.org/10.1007/s12152-011-9123-7.
Freeman, D. (2006). Delusions in the nonclinical population. Current Psychiatry Reports, 8(3), 191–204.
Freeman, D. (2007). Suspicious minds: The psychology of persecutory delusions. Clinical Psychology Review, 27(4), 425–457.
Freeman, D., & Garety, P. A. (2004). Paranoia: The psychology of persecutory delusions. East Sussex: Psychology Press.
Freeman, D., Garety, P. A., & Kuipers, E. (2001). Persecutory delusions: Developing the understanding of belief maintenance and emotional distress. Psychological Medicine, 31(7), 1293.
Fuchs, T. (2005). Delusional mood and delusional perception-a phenomenological analysis. Psychopathology, 38(3), 133–139.
Fuchs, T. (2015). The intersubjectivity of delusions. World Psychiatry, 14(2), 178.
Fuchs, T. (2020). Delusion, reality, and intersubjectivity: A phenomenological and enactive analysis. Philosophy, Psychiatry, & Psychology, 27(1), 61–79.
Gaag, M., Valmaggia, L., & Smit, F. (2014). The effects of individually tailored formulation-based cognitive behavioural therapy in auditory hallucinations and delusions: A meta-analysis. Schizophrenia Research,. https://doi.org/10.1016/j.schres.2014.03.016.
Gardner, D. M., Baldessarini, R. J., & Waraich, P. (2005). Modern antipsychotic drugs: A critical overview. CMAJ, 172(13), 1703–1711.
Garety, P. A., & Freeman, D. (1999). Cognitive approaches to delusions: A critical review of theories and evidence. British Journal of Clinical Psychology, 38(2), 113–154. https://doi.org/10.1348/014466599162700.
Garety, P. A., Kuipers, E., Fowler, D., Freeman, D., & Bebbington, P. E. (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31(2), 189–195.
Gerrans, P. (2001). Delusions as performance failures. Cognitive Neuropsychiatry, 6(3), 161–73.
Gilbert, D. (2006). Stumbling on happiness. New York: Knopf.
Greene, J. A. (2005). Cognitive-behavioral therapy. Psychiatric Services, 56(9), 1161–1162.
Harmon-Jones, E., & Harmon-Jones, C. (2007). Cognitive dissonance theory after 50 years of development. Zeitschrift für Sozialpsychologie, 38(1), 7–16.
Helton, G. (2018). If you can’t change what you believe, you don’t believe it. Noûs,. https://doi.org/10.1111/nous.12265.
Jaspers, K. (1963). General psychopathology. Chicago: University of Chicago Press.
Jordan, H. W., & Howe, G. (1980). De Clerambault syndrome (erotomania): A review and case presentation. Journal of the National Medical Association, 72(10), 979–85.
Kapur, S. (2003). Psychosis as a state of aberrant salience: A framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry, 160(1), 13–23.
Kendall, P. C., & Bemis, K. M. (1983). Thought and action in psychotherapy: The cognitive-behavioral approaches. In The clinical psychology handbook (pp. 562–592). Pergamon.
Klayman, J. (1995). Varieties of confirmation bias. Psychology of Learning and Motivation, 32, 385–418. https://doi.org/10.1016/S0079-7421(08)60315-1.
Klayman, J., & Ha, Y. (1987). Confirmation, disconfirmation, and information in hypothesis testing. Psychological Review, 94(2), 211–228. https://doi.org/10.1037/0033-295X.94.2.211.
Adrienne LaFrance. Q-anon is more important than you think. The Atlantic, June 2020. https://www.theatlantic.com/magazine/archive/2020/06/qanon-nothing-can-stop-what-is-coming/610567/.
Lerman, C., Croyle, R. T., Tercyak, K. P., & Hamman, H. (2002). Genetic testing: Psychological aspects and implications. Journal of Consulting and Clinical Psychology, 70, 784–797.
Lincoln, T., & Peters, E. (2018). A systematic review and discussion of symptom specific cognitive behavioural approaches to delusions and hallucinations. Schizophrenia Research, 203, 66–79. https://doi.org/10.1016/j.schres.2017.12.014.
Lüllmann, E., & Lincoln, T. M. (2013). The effect of an educating versus normalizing approach on treatment motivation in patients presenting with delusions: An experimental investigation with analogue patients. Schizophrenia Research and Treatment, 2013.
Maher, B. A. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30(1), 98.
Maher, B. A. (1999). Anomalous experience in everyday life: Its significance for psychopathology. The Monist, 82(4), 547–570.
Mandelbaum, E. (2019). Troubles with Bayesianism: An introduction to the psychological immune system. Mind and Language, 34(2), 141–157. https://doi.org/10.1111/mila.12205.
McKay, R. (2012). Delusional inference. Mind & Language, 27(3), 330–355.
McKay, R. P., & Cipolotti, L. (2007). Attributional style in a case of Cotard delusion. Consciousness and Cognition, 16, 349–359.
Moritz, S., & Woodward, T. S. (2004). Plausibility judgment in schizophrenic patients: Evidence for a liberal acceptance bias. German Journal of Psychiatry, 7(4), 66–74.
Moritz, S., & Woodward, T. S. (2005). Jumping to conclusions in delusional and non-delusional schizophrenic patients. British Journal of Clinical Psychology, 44(2), 193–207.
Moritz, S., & Woodward, T. S. (2006). A generalized bias against disconfirmatory evidence in schizophrenia. Psychiatry Research, 142(2–3), 157–165.
Moritz, S., & Woodward, T. S. (2007). Metacognitive training in schizophrenia: From basic research to knowledge translation and intervention. Current Opinion in Psychiatry, 20(6), 619–625.
Moritz, S., Andreou, C., Schneider, B. C., Wittekind, C. E., Menon, M., Balzan, R. P., et al. (2014). Sowing the seeds of doubt: A narrative review on metacognitive training in schizophrenia. Clinical Psychology Review, 34(4), 358–366.
Mullins, S., & Spence, S. A. (2003). Re-examining thought insertion: Semi-structured literature review and conceptual analysis. The British Journal of Psychiatry, 182(4), 293–298.
Myin-Germeys, I., Nicolson, N. A., & Delespaul, P. A. E. G. (2001). The context of delusional experiences in the daily life of patients with schizophrenia. Psychological Medicine, 31(3), 489.
Nickerson, R. (1998). Confirmation bias: A ubiquitous phenomenon in many guises. Review of General Psychology, 2, 175–220. https://doi.org/10.1037/1089-2680.2.2.175.
Pandis, C., Agrawal, N., & Poole, N. (2019). Capgras’ delusion: A systematic review of 255 published cases. Psychopathology, 52, 1–13. https://doi.org/10.1159/000500474.
Pickard, H. (2015). Psychopathology and the ability to do otherwise. Philosophy and Phenomenological Research, 90(1), 135–163.
Pickard, H., & Ward, L. (2013). Responsibility without blame: Philosophical reflections on clinical practice. In Oxford handbook of philosophy of psychiatry (pp. 1134–1154).
Ramachandran, V. S. (1996). The evolutionary biology of self-deception, laughter, dreaming and depression: Some clues from anosognosia. Medical Hypotheses, 47(5), 347–362.
Reimer, M. (2010). Only a philosopher or a madman: Impractical delusions in philosophy and psychiatry. Philosophy, Psychiatry, and Psychology, 17(4), 315–328. https://doi.org/10.1353/ppp.2010.0028.
Rhodes, J., & Gipps, R. G. T. (2008). Delusions, certainty, and the background. Philosophy, Psychiatry, & Psychology, 15(4), 295–310.
Ryle, G. (1949). The concept of mind. Chicago: University of Chicago Press.
Sarin, F., Wallin, L., & Widerlöv, B. (2011). Cognitive behavior therapy for schizophrenia: A meta-analytical review of randomized controlled trials. Nordic Journal of Psychiatry, 65(3), 162–174.
Sass, L., Parnas, J., & Zahavi, D. (2011). Phenomenological psychopathology and schizophrenia: Contemporary approaches and misunderstandings. Philosophy, Psychiatry, & Psychology, 18(1), 1–23.
Sass, L. A. (1994). The paradoxes of delusion: Wittgenstein, Schreber, and the Schizophrenic mind. Ithaca: Cornell University Press.
Sass, L. A., Pienkos, E. (2013). Delusion: The phenomenological approach. KWM Fulford
Schellenberg, S. (2018). The unity of perception: Content, consciousness, evidence. Oxford: Oxford University Press.
Silva, J. A., Leong, G. B., Weinstock, R., & Boyer, C. L. (1989). Capgras syndrome and dangerousness. Journal of the Americal Academy of Psychiatry and the Law Online, 17(1), 5–14.
Stephens, G. L., & Graham, G. (2004). Reconceiving delusions. International Review of Psychiatry, 16, 236–241.
Stone, T., & Young, A. W. (1997). Delusions and brain injury: The philosophy and psychology of belief. Mind & Language, 12(3–4), 327–364.
Strawson, P. F. (1974). Freedom and resentment, and other essays (Vol. 595). London: Egmont Books.
Todd, J., & Dewhurst, K. (1955). The Othello syndrome: A study in the psychopathology of sexual jealousy. The Journal of Nervous and Mental Disease, 122(4), 367–374.
Turkington, D., Kingdon, D., & Weiden, P. J. (2006). Cognitive behavior therapy for schizophrenia. American Journal of Psychiatry, 163(3), 365–373.
Turnbull, O. H., Jenkins, S., & Rowley, M. L. (2004). The pleasantness of false beliefs: An emotion-based account of confabulation. Neuropsychoanalysis, 6(1), 5–16.
Turner, M., & Coltheart, M. (2010). Confabulation and delusion: A common monitoring framework. Cognitive Neuropsychiatry, 15, 346–376.
Velleman, D. (2000). On the aim of belief. In D. Velleman (Ed.), The possibility of practical reason (pp. 244–81). Oxford: Oxford University Press.
Wang, E. W. (2019). The collected Schizophrenias. Minneapolis: Graywolf Press.
Wessely, S., Buchanan, A., Cutting, J., Everitt, B., Garety, P., & Taylor, P. (1993). Acting on delusions. i: Prevalence. The British Journal of Psychiatry: The Journal of Mental Science, 163, 69–76. https://doi.org/10.1192/bjp.163.1.69.
Williams, B. (1970). Deciding to believe. In B. Williams (Ed.), Problems of the self (pp. 136–51). Cambridge: Cambridge University Press.
Williamson, T. (2002). Knowledge and its limits. Oxford: Oxford University Press.
Woodward, T. S., Moritz, S., Cuttler, C., & Whitman, J. C. (2006). The contribution of a cognitive bias against disconfirmatory evidence (bade) to delusions in schizophrenia. Journal of Clinical and Experimental Neuropsychology, 28(4), 605–617.
Woodward, T. S., Buchy, L., Moritz, S., & Liotti, M. (2007). A bias against disconfirmatory evidence is associated with delusion proneness in a nonclinical sample. Schizophrenia Bulletin, 33(4), 1023–1028.
Woodward, T. S., Moritz, S., Menon, M., & Klinge, R. (2008). Belief inflexibility in schizophrenia. Cognitive Neuropsychiatry, 13(3), 267–277.
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2008). Cognitive behavior therapy for schizophrenia: Effect sizes, clinical models, and methodological rigor. Schizophrenia Bulletin, 34(3), 523–537.
Young, A., & Leafhead, K. (1996). Betwixt life and death: Case studies of the cotard delusion. In P. Halligan & J. Marshall (Eds.), Method in madness: Case studies in cognitive neuropsychiatry. East Sussex: Psychology Press.
Young, A. W., Robertson, I. H., Hellawell, D. J., De Pauw, K. W., & Pentland, B. (1992). Cotard delusion after brain injury. Psychological Medicine, 22(3), 799–804.
Author information
Authors and Affiliations
Corresponding author
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Thanks to Elisabeth Camp, Andy Egan, August Gorman, Sofia Jeppsson, Hannah Read, Susanna Schellenberg, Ernest Sosa, Christopher Willard-Kyle, and three anonymous referees for helpful comments on previous versions of this paper. Thanks to Anita Avramides for first spurring my interest in this topic. Thanks also to participants in the Rutgers Epistemology Seminar and the Rutgers Junior Seminar for helpful discussion.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Flores, C. Delusional evidence-responsiveness. Synthese 199, 6299–6330 (2021). https://doi.org/10.1007/s11229-021-03070-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11229-021-03070-2