Confabulation Explained

In psychiatry, Confabulation (verb: confabulate) is a memory disturbance, defined as the production of fabricated, distorted or misinterpreted memories about oneself or the world, without the conscious intention to deceive. Individuals who confabulate present incorrect memories ranging from "subtle alterations to bizarre fabrications", and are generally very confident about their recollections, despite contradictory evidence.

Description

Confabulation is distinguished from lying as there is no intent to deceive and the person is unaware the information is false. Although individuals can present blatantly false information, confabulation can also seem to be coherent, internally consistent, and relatively normal.

Most known cases of confabulation are symptomatic of brain damage or dementias, such as aneurysm, Alzheimer's disease, or Wernicke–Korsakoff syndrome (a common manifestation of thiamine deficiency caused by alcoholism). Additionally confabulation often occurs in people who are suffering from anticholinergic toxidrome when interrogated about bizarre or irrational behavior.

Confabulated memories of all types most often occur in autobiographical memory, and are indicative of a complicated and intricate process that can be led astray at any point during encoding, storage, or recall of a memory. This type of confabulation is commonly seen in Korsakoff's syndrome.

Distinctions

Two types of confabulation are often distinguished:

• Provoked (momentary, or secondary) confabulations represent a normal response to a faulty memory, are common in both amnesia and dementia, and can become apparent during memory tests.
• Spontaneous (or primary) confabulations do not occur in response to a cue and seem to be involuntary. They are relatively rare, more common in cases of dementia, and may result from the interaction between frontal lobe pathology and organic amnesia.

Another distinction is that between:

• Verbal confabulations, spoken false memories and are more common, and
• Behavioral confabulations, occur when an individual acts on their false memories.

Signs and Symptoms

Confabulation is associated with several characteristics:

1. Typically verbal statements but can also be non-verbal gestures or actions.
2. Can include autobiographical and non-personal information, such as historical facts, fairytales, or other aspects of semantic memory.
3. The account can be fantastic or coherent.
4. Both the premise and the details of the account can be false.
5. The account is usually drawn from the patient’s memory of actual experiences, including past and current thoughts.
6. The patient is unaware of the accounts’ distortions or inappropriateness, and is not concerned when errors are pointed out.
7. There is no hidden motivation behind the account.
8. The patient’s personality structure may play a role in their readiness to confabulate.

Confidence in False Memories

Confabulation of events or situations may lead to an eventual acceptance of the confabulated information as true. For instance, people who knowingly lie about a situation may eventually come to believe that their lies are truthful with time. In an interview setting, people are more likely to confabulate in situations in which they are presented false information by another person, as opposed to when they self-generate these falsehoods. Further, people are more likely to accept false information as true when they are interviewed at a later time (after the event in question) than those who are interviewed immediately or soon after the event. Affirmative feedback for confabulated responses is also shown to increase the confabulator’s confidence in their response. For instance, in culprit identification, if a witness falsely identifies a member of a line-up, he will be more confident in his identification if the interviewer provides affirmative feedback. This effect of confirmatory feedback appears to last over time, as witnesses will even remember the confabulated information months later.

https://en.wikipedia.org/wiki/Confabulation