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20 Years of Aberrant Salience in Psychosis: What Have We Learned?

Am J Psychiatry March 26, 2025 Peer reviewed DOI: 10.1176/appi.ajp.20240556 via PubMed Central

Summary

The concept of aberrant salience, which proposes that psychosis arises from a malfunction in the brain's ability to assign significance to stimuli, has been influential for 20 years. This review assesses what has been learned from this framework. It finds strong support for the idea that dopamine dysregulation leads to aberrant assignment of salience to irrelevant stimuli, contributing to delusions and hallucinations. However, the review also highlights limitations, including challenges in directly measuring aberrant salience in humans and the need for more precise models linking neurobiology to subjective experience.

Study at a glance

Design review
Key finding The aberrant salience model of psychosis is well-supported by evidence linking dopamine dysregulation to the misattribution of significance to irrelevant stimuli, but faces challenges in direct measurement and requires more precise neurobiological-to-experiential models.

Abstract

20 Years of Aberrant Salience in Psychosis: What Have We Learned?

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