The Predictive Coding Account of Psychosis.
Biol Psychiatry May 25, 2018 Philipp Sterzer, Rick A. Adams, Paul Fletcher et al. 901 citations
Psychosis may stem from altered predictive coding in the brain, where prior beliefs are combined with sensory signals to interpret the world. The canonical account suggests that weakened prior beliefs relative to sensory data lead to maladaptive inferences. However, evidence is mixed: some studies find weakened priors, others stronger priors. Hallucinations and delusions may involve distinct predictive coding alterations. Challenges include non-uniform deficits across sensory modalities, hierarchical processing where lower and higher levels interact non-linearly, and the role of active inference—anticipating how actions affect sensations. Considering these complexities could reconcile conflicting findings and yield a more comprehensive framework for psychosis.