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Authors' reply

Published online by Cambridge University Press:  02 January 2018

Rachel Upthegrove
Affiliation:
Department of Psychiatry, School of Clinical & Experimental Medicine, University of Birmingham, Birmingham, Bipolar Disorder Research Network and Early Intervention Service, Birmingham and Solihull Mental Health Foundation Trust, Birmingham, UK. Email: R.Upthegrove@bham.ac.uk
Ian Jones
Affiliation:
National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK
Nick Craddock
Affiliation:
National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff and Bipolar Disorder Research Network, UK
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2016 

We would agree that deficits of theory of mind may prove one mechanism that differentiates pathways to delusional belief rather than hallucinations. Indeed, a symptom-specific approach to research across diagnostic groups is increasingly called for. National Institute of Mental Health Research Domain Criteria encourage this approach, and there is already a volume of research on the causes of hallucinations, and childhood experiences therein. Reference Insel, Cuthbert, Garvey, Heinssen, Pine and Quinn1Reference Modinos, Costafreda, van Tol, McGuire, Aleman and Allen3 Persecutory delusional beliefs – and a specific neurobiology for these – have also been investigated, with significant results centring around salience, prediction error and social cognitive processing. Reference Upthegrove, Ross, Brunet, McCollum and Jones4Reference Corlett and Fletcher6 Further focus on the distinction between primary and secondary delusions, and those with content outside the persecutory, is also needed.

References

1 Insel, T, Cuthbert, B, Garvey, M, Heinssen, R, Pine, DS, Quinn, K, et al. Research domain criteria (RDoC): toward a new classification framework for research on mental disorders. Am J Psychiatry 2010; 167: 748–51.CrossRefGoogle Scholar
2 Sitko, K, Bentall, RP, Shevlin, M, Sellwood, W. Associations between specific psychotic symptoms and specific childhood adversities are mediated by attachment styles: an analysis of the National Comorbidity Survey. Psychiatry Res 2014; 217: 202–9.CrossRefGoogle ScholarPubMed
3 Modinos, G, Costafreda, SG, van Tol, MJ, McGuire, PK, Aleman, A, Allen, P. Neuroanatomy of auditory verbal hallucinations in schizophrenia: a quantitative meta-analysis of voxel-based morphometry studies. Cortex 2013; 49: 1046–55.CrossRefGoogle ScholarPubMed
4 Upthegrove, R, Ross, K, Brunet, K, McCollum, R, Jones, L. Depression in first episode psychosis: the role of subordination and shame. Psychiatry Res 2014; 217: 177–84.CrossRefGoogle ScholarPubMed
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6 Corlett, PR, Fletcher, PC. Delusions and prediction error: clarifying the roles of behavioural and brain responses. Cogn Neuropsychiatry 2015; 20: 95105.CrossRefGoogle ScholarPubMed
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