In this article, we are going to explain all you need to know about the word “Confabulation”, Imagine that someone tells us the following story: “This morning I have been walking through the forest that surrounds this building.
I go out every morning to walk. I like to have fresh air on my face. By the way, this building is mine. As you see, it’s very big.
I would like to leave it to my children, but they have their life and I do not think they want to take charge. ” Up to here nothing strange.
But if this story is told by an old woman tied to a wheelchair and locked in a wing of a residence for the elderly … What is happening? Welcome to the confabulation!
Without a doubt, it is a striking and interesting phenomenon. Those who suffer it live it with maximum reality, that is, they believe that what they say is true.
Throughout the article, the concept of confabulation will be deepened, as well as the possible neuronal causes and cognitive models.
Finally, a little research will be done on the intervention and treatment. However, this last point, because of a lack of research, is still to be developed.
Confabulation, a strange story
As defined by Ardeno, Bebibre, and Triviño (2013), “confabulation is an alteration that mainly affects episodic memory – although it also compromises semantic memory – altering both the genesis of new memories and the recovery of the oldest traces” .
What does this mean? Patients are able to create the most unlikely stories by mixing real memories with new fictitious memories.
They can also relate something that happened to them years ago as if it had happened a few days ago.
In 1987, Kopelman, proposed two types of confabulations, the provoked and the spontaneous.
However, Dalla Barba and Boissé (2010), proposed a new classification of confabulations and affirm that the great majority are related to ” the general memory of habits and daily activities that are placed at the wrong time “.
Types of confabulations (Dalla Barba and Boissé, 2010)
Inventions Are those in which the person invents an event that has nothing to do with your life.
Fantasies or bizarre confabulations. Patients with this type of confabulations can produce completely invented stories but believe in them firmly.
For example, to say that a brother comes to visit us every day when he lives in another country.
In general, those who listen to these patients without knowing them may think that nothing happens to them.
The improbability of the story can be seen when someone in a wheelchair says that he runs through the woods every day or when we have knowledge of someone’s biography.
For example, if a family member who is able to walk and who is more or less autonomous, tells us that every day he drives to the city, only we can know the truth.
Cognitive models of confabulation
Deficit of temporality
According to Dalla Barba and Boissé (2010), patients access memories through long-term memory.
In this way, they remain trapped in the past. So, it is not strange that they fill up mental gaps with events of the past.
Deficit coding and information monitoring
Mitchell and Johnson (2009), propose the hypothesis of reality monitoring to explain the most bizarre confabulations.
According to the authors, there is “a deficit both in the monitoring of the timeline and in the monitoring of reality, that is, in the ability to differentiate real memories from imagined ones” .
Thus, the authors point out that “confabulations do not arise only in relation to the temporal context of memories (that is, real memories displace in time and place), but that they occur with all kinds of memory traces, such as thought, associations, and imaginations “.
At this point also highlights the hypothesis of source monitoring. What is it about? According to Schnider, (2003), he proposes that the confabulation takes place “when the individual confuses the source or origin from which memory comes, incorrectly locating an event that happened in another or, even, with the current reality”.
A deficit in strategic recovery
The team of Gilboa (2006), proposes that ” the conspiracies are produced by a failure in the recovery processes and not so much in the coding “.
That is, when there is a mental gap and the patient does not know how to fill it, he makes memories, however, there is a failure in this recovery.
As the authors affirm, ” confabulations would arise from the deficit when using effective recall strategies, which include the use of passwords, the use of search strategies and in-memory filtering and conscious monitoring of memories”.
The team of Schacter (2007), proposes that it is an error in episodic memory.
This type of memory, beyond remembering and reproducing events that have taken place in the past, also imagines and simulates future events.
The episodic memory carries out a constructive process, thus, it would be an error in this elaboration process.
Neuroanatomical correlate of confabulation
On the other hand, the team of Gilboa (2006), has collected cases in which the confabulation has appeared after damage to the frontal structures.
They claim that “injury to the ventromedial cortex is necessary but not sufficient, requiring the added damage of the orbital cortex. ” Disease Alzheimer is also related to the occurrence of confabulation.
Cases of confabulation have been described after suffering:
Cerebrovascular accidents in the middle and anterior cerebral arteries.
- Frontobasal cranioencephalic traumatisms.
- Subdural hematomas
- Herpetic encephalitis
- Intervention and treatment
Some patients, after the injury, recover within a few weeks and stop confabulating.
However, others can be left to chronicle. Normally, the latter are those whose injury is greater.
Despite being a problem that can incapacitate on a daily basis, there is still much to investigate, especially its intervention.
The treatment is usually pharmacological and therapeutic. Cognitive-behavioural therapies are usually applied, but their efficacy is still not fully demonstrated.
As highlighted by Ardeno, Bebibre and Triviño (2013), “contrasting the reality and making the patient aware of his mistakes seems to be the key to reducing conspiracies in these people. “