The degree to which numerous existing models of delusion formation disagree or propose common mechanisms remains unclear. To achieve a comprehensive understanding of delusion aetiology, we summarised 53 theoretical models of delusions extracted from a systematic literature search. We identified central aspects and unique or overarching features of five core perspectives: cognitive (n = 22), associative learning (n = 4), social (n = 6), neurobiological (n = 6), and Bayesian inference (n = 15). These perspectives differ in foci and mechanistic explanations. Whereas some postulate delusions to result from associative and operant learning, others assume a disbalance in the integration of prior beliefs and sensory input or emphasise the relevance of information processing biases. Postulated moderators range from maladaptive generalised beliefs over neurocognitive impairment to dopamine, stress, and affective dysregulation. The models also differ in whether they attempt to explain delusion formation in general or the delusional content (i.e., persecutory). Finally, some models postulate functional aspects of delusions, such as insight relief. Despite their differences, the perspectives converge on the idea that delusions form as an explanation for an experienced ambiguity. Building on this common ground, we propose an integrative framework incorporating essential mechanistic explanations from each perspective and discuss its implications for research and clinical practice.

中文翻译：

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桥接视角 - 53 种妄想理论模型的回顾和综合


许多现有的妄想形成模型在多大程度上不同意或提出共同机制仍不清楚。为了全面了解妄想病因，我们总结了从系统文献检索中提取的 53 个妄想理论模型。我们确定了五个核心观点的中心方面和独特或总体特征：认知 （n = 22）、联想学习 （n = 4）、社交 （n = 6）、神经生物学 （n = 6） 和贝叶斯推理 （n = 15）。这些观点在焦点和机械解释上有所不同。一些人假设妄想是由联想和操作性学习引起的，而另一些人则假设先验信念和感官输入的整合不平衡，或者强调信息处理偏差的相关性。假设的调节因素范围从对神经认知障碍的适应不良普遍信念到多巴胺、压力和情感失调。这些模型在它们是否试图解释一般的妄想形成或妄想内容（即迫害）方面也有所不同。最后，一些模型假设妄想的功能方面，例如洞察力缓解。尽管存在差异，但观点都集中在这样一个观点上，即妄想的形成是对体验到的模糊性的解释。基于这个共同点，我们提出了一个综合框架，其中包含来自每个角度的基本机制解释，并讨论了其对研究和临床实践的影响。