%0 Journal Article %T Understanding Cognitive Behavioral Therapy for Psychosis Through the Predictive Coding Framework. %A Sheffield JM %A Brinen AP %A Feola B %A Heckers S %A Corlett PR %J Biol Psychiatry Glob Open Sci %V 4 %N 4 %D 2024 Jul %M 38952435 暂无%R 10.1016/j.bpsgos.2024.100333 %X Psychological treatments for persecutory delusions, particularly cognitive behavioral therapy for psychosis, are efficacious; however, mechanistic theories explaining why they work rarely bridge to the level of cognitive neuroscience. Predictive coding, a general brain processing theory rooted in cognitive and computational neuroscience, has increasing experimental support for explaining symptoms of psychosis, including the formation and maintenance of delusions. Here, we describe recent advances in cognitive behavioral therapy for psychosis-based psychotherapy for persecutory delusions, which targets specific psychological processes at the computational level of information processing. We outline how Bayesian learning models employed in predictive coding are superior to simple associative learning models for understanding the impact of cognitive behavioral interventions at the algorithmic level. We review hierarchical predictive coding as an account of belief updating rooted in prediction error signaling. We examine how this process is abnormal in psychotic disorders, garnering noisy sensory data that is made sense of through the development of overly strong delusional priors. We argue that effective cognitive behavioral therapy for psychosis systematically targets the way sensory data are selected, experienced, and interpreted, thus allowing for the strengthening of alternative beliefs. Finally, future directions based on these arguments are discussed.
Delusions are distressing and disabling psychiatric symptoms. Cognitive behavioral therapy for psychosis (CBTp) is the leading psychotherapeutic approach for treating delusions. Predictive coding is a contemporary cognitive neuroscience framework that is increasingly being used to explain mechanisms of delusions. In this article, we attempt to integrate CBTp within the predictive coding framework, outlining how effective CBTp techniques impact aspects of the predictive coding model to contribute to cutting-edge treatment and cognitive neuroscience research on delusions and inform recommendations for treatment advancement.