Confabulations: definition, causes and common symptoms

The phenomenon of human memory is one of the most studied cognitive functions throughout the history of science, since in addition to being extremely complex, it is also highly treacherous.

One of the distorting phenomena of people's reality is conspiracy, understood as false products of memory.

• Recommended article: "Types of memory: how do we store memories?"

What are conspiracies?

The conspiracies constitute a curious phenomenon and difficult to explain. First of all, could be defined as a kind of false memory due to a memory retrieval problem.

But there are differences between false memories and conspiracies, and it is that the latter go beyond the category of normal; either because of the high frequency with which they appear or because of their strangeness.

On the other hand, the person who suffers from them is not aware of it, coming to take these memories for genuine and not doubting their veracity. The content of the conspiracies varies greatly from one person to another, and can contain from stories related to the experiences of the patient or other people, or become genuine constructions completely invented by the patient.

Furthermore, the degree of credibility may also differ from person to person. Managing to contain from the most common stories (telling that he has gone to buy bread), and therefore credible; even the most absurd and disproportionate stories (telling that one has been abducted by aliens).

Classification of conspiracies: Kopelman vs. Schnider

Throughout history, conspiracies have been classified according to four criteria:

• Contents: differentiated in limits of true or false, probability of occurrence, positive or negative, etc.
• How they appear: provoked or spontaneous.
• Terrenos in which it manifests: autobiographical, episodic, general semantic or personal semantic.
• Clinical syndrome in which it appears.

However, the most accepted classification by the scientific society is the one made by Kopelman. Which he considered that the most relevant thing to take into account was the way in which these arose; distinguishing itself into two types. They are as follows.

1. Spontaneous conspiracies

They are the least frequent and are usually related to another integrated amnesic syndrome together with another dysfunction.

2. Caused conspiracies

These phenomena are much more frequent in amnesic patients and are observed during the administration of a memory test. They are similar to the errors that a healthy person can present when trying to memorize something with a prolonged retention interval, and may represent a habitual response based on a memory altered.

Another classification was the one proposed by Schnider, who ordered them into four genres according to the different production mechanisms. Although these groupings are not universally valid in the scientific community, they can help the reader understand what they are about.

3. Simple provoked intrusions

This term includes the distortions that appear when the person is pressured to recall the details of a story. An example would be when the person tries to remember a list of words and unconsciously introduces new words that are not in it.

According to Schnider, these types of intrusions do not correspond to a specific recovery mechanism.

4. Momentary conspiracies

They refer to the false statements that a patient makes when he is prompted to make a comment in a conversation. Compared to other more fantastic content confabulations, these can be completely plausible and credible on the part of the listener, although they may be incompatible with the current state of the person and his circumstances.

For example, the patient may report that he is going to make a trip abroad when, in reality, he is admitted to the hospital.

Momentary conspiracies are the most common of all, but they are not yet fully understood, so it is not clear whether they have a mechanism of their own.

5. Fantastic conspiracies

As the name suggests, these conspiracies have no basis in reality; and they are frequent in patients with paralytic dementias and psychosis.

These conspiracies are absolutely inconceivable from the logical point of view and are completely meaningless. In addition, if they are not accompanied by the behavior that corresponds to them.

Causes

Usually the report of confabulations is typical of patients with damage to prefrontal areas of the brain, specifically the basal forebrain; including here the orbitofrontal and ventromedial areas.

The disorders and diseases that present the highest number of conspiracies are the following:

• Wernike-Korsakoff syndrome
• Brain tumors
• Herpes simplex encephalitis
• Fronto-temporal dementias
• Multiple sclerosis
• Anterior communicating cerebral artery infarcts

On the other hand, from the neuropsychological point of view, three hypotheses are distinguished, which differ in the degree to which memory impairment affects conspiracies. These are the hypothesis focused on memory dysfunction, focused on executive dysfunction, or the dual hypothesis.

1. Memory dysfunction

This first assumption is based on the idea that amnesia is a necessary condition for the patient to conspire. At the time the conspiracies were considered a different form of amnesia. A belief that is still held today since these appear predominantly in neurological disorders that lead to memory impairment.

From this hypothesis, it is insisted that conspiracies are a way of "filling in" the gaps left by amnesia.

2. Executive dysfunction

Executive function includes internally self-directed cognitive skills with a specific goal. These functions direct our behavior and our cognitive and emotional activity.

Therefore, this hypothesis establishes that the conspiracies are the result of problems in this executive function. The supporting evidence for this theory is that such confabulations decrease when executive functioning improves.

3. Dual hypothesis

The third and final hypothesis maintains that the production of conspiracies is due to a joint involvement of deficient procedures both at the level of memory and executive functioning.

Explanatory models of conspiracies

The difficulty of defining conspiracies in a concrete way, explaining them as false memories but which are completely true for the patient; makes necessary the elaboration of explanatory models by the researchers.

During the beginning of the investigations in the confabulations, the models insisted that these arose from the need on the part of the patient to compensate for the memory gaps. However, despite taking into account the emotional aspects, this model has been surpassed today.

On the other hand, from neuropsychology there are several suggestions to explain this phenomenon. These are grouped between those that define conspiracies as a problem of temporality, and those that give greater relevance to the recovery process.

1. Theories of temporality

This theory supports that a conniving patient suffers from a distorted sense of chronology. In this sense, patients are able to remember what happened but not the proper chronological order.

The theory of temporality is supported by the observation that most conspiracies can find their origin in a true but misplaced memory.

2. Recovery theories

Human memory is considered a reconstructive process, and conspiracies are a great example of this.

According to these theories, conspiracies are the product of a deficit in the memory retrieval process. The strongest evidence is that it affects both the most distant memories and those acquired once the deficit is installed.

Even so, the recovery of memories is not a unique process, so it would be necessary to determine which specific aspects are those that are deteriorated.