Delusion-related aberrant prediction errors are bottom-up
Abstract
Background: Delusions are the fixed false beliefs that characterize serious mental illnesses like schizophrenia. Prediction errors are surprise signals that guide learning. They have been observed during causal learning in the right dorsolateral prefrontal cortex (rDLPFC). They are registered inappropriately in people with delusions, driving learning towards irrelevant events. This learning correlates with delusion severity. We do not know, however, whether the rDLPFC is receiving the error signal, bottom-up, from other nodes, or, alternatively, whether rDLPFC prediction errors are communicated top-down from rDLPFC. It is also possible that the direction of processing differs between patients with delusions compared with otherwise healthy individuals who espouse delusion-like beliefs but are not delusional per se. Methods: Here, we attempt to distinguish these possibilities using cognitive computational neuroimaging, functional, and effective connectivity analyses of task-based fMRI data in people with schizophrenia (SZ, n=29), people with extreme esoteric beliefs (EEB, n=25), and controls with neither (CTR, n=24), focusing on prediction error processing. Results: During Kamin Blocking of causal learning people who endorse delusions evince aberrant prediction error signals in right dorsolateral prefrontal cortex and anterior insula which correlate with delusion severity. Psychophysiological interaction analysis reveals errant coupling between these regions in people with delusions. Effective connectivity analysis locates the dysfunction in schizophrenia to bottom-up prediction error drive from insula to DLPFC. Conclusion: These data provide quantitative computational metrics for distinguishing delusions from other less problematic beliefs and establish that, in schizophrenia, aberrant prediction errors during causal learning arise from errant bottom-up drive from the insula to the rDLPFC. This may then serve as a marker for clinically relevant odd belief and a target for treatment.
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BibTeX
@misc{fan2026delusionrelated,
title = {{Delusion-related aberrant prediction errors are bottom-up}},
author = {Siyan Fan and Santiago Castiello de Obeso and Martin Meyer and Praveen Suthaharan and Joshua Kenney and Daniel J. Hauke and Rick Adams and Sonia Bansal and James Waltz and Molly A. Erickson},
howpublished = {PsyArXiv},
year = {2026},
month = sep,
doi = {10.31234/osf.io/hsepy_v1},
url = {https://osf.io/preprints/psyarxiv/hsepy_v1/},
note = {CC BY 4.0},
}
RIS
TY - UNPB
TI - Delusion-related aberrant prediction errors are bottom-up
AU - Siyan Fan
AU - Santiago Castiello de Obeso
AU - Martin Meyer
AU - Praveen Suthaharan
AU - Joshua Kenney
AU - Daniel J. Hauke
AU - Rick Adams
AU - Sonia Bansal
AU - James Waltz
AU - Molly A. Erickson
PY - 2026
DA - 2026/09/30
PB - PsyArXiv
DO - 10.31234/osf.io/hsepy_v1
UR - https://osf.io/preprints/psyarxiv/hsepy_v1/
AB - Background: Delusions are the fixed false beliefs that characterize serious mental illnesses like schizophrenia. Prediction errors are surprise signals that guide learning. They have been observed during causal learning in the right dorsolateral prefrontal cortex (rDLPFC). They are registered inappropriately in people with delusions, driving learning towards irrelevant events. This learning correlates with delusion severity. We do not know, however, whether the rDLPFC is receiving the error signal, bottom-up, from other nodes, or, alternatively, whether rDLPFC prediction errors are communicated top-down from rDLPFC. It is also possible that the direction of processing differs between patients with delusions compared with otherwise healthy individuals who espouse delusion-like beliefs but are not delusional per se. Methods: Here, we attempt to distinguish these possibilities using cognitive computational neuroimaging, functional, and effective connectivity analyses of task-based fMRI data in people with schizophrenia (SZ, n=29), people with extreme esoteric beliefs (EEB, n=25), and controls with neither (CTR, n=24), focusing on prediction error processing. Results: During Kamin Blocking of causal learning people who endorse delusions evince aberrant prediction error signals in right dorsolateral prefrontal cortex and anterior insula which correlate with delusion severity. Psychophysiological interaction analysis reveals errant coupling between these regions in people with delusions. Effective connectivity analysis locates the dysfunction in schizophrenia to bottom-up prediction error drive from insula to DLPFC. Conclusion: These data provide quantitative computational metrics for distinguishing delusions from other less problematic beliefs and establish that, in schizophrenia, aberrant prediction errors during causal learning arise from errant bottom-up drive from the insula to the rDLPFC. This may then serve as a marker for clinically relevant odd belief and a target for treatment.
ER -