20 Years of Aberrant Salience in Psychosis: What Have We Learned?
Level 5 - mechanism / opinion, no new human data
Narrative review and theoretical critical evaluation without systematic review methodology.
PubMed 40134268 · doi:10.1176/appi.ajp.20240556
What was done
The authors performed a narrative critical review evaluating the 20-year trajectory of Shitij Kapur's aberrant salience hypothesis of psychosis. They examined its predictions regarding the neural and behavioral loci of dopamine dysfunction against recent advances in dopamine circuit measurement, circuit manipulation tools, and newer computational theories of belief formation.
What was found
The abstract reports no quantitative results. The authors found that the original hypothesis's specific predictions regarding the neural and behavioral loci of dopamine dysfunction are lacking when evaluated against modern data. Instead, they argue that contemporary models framing dopamine's role in belief updating under uncertainty and abductive inference better align with behavioral and neurobiological data in patients with hallucinations and delusions.
Why it matters
Kapur's aberrant salience model has been the dominant framework for understanding delusion formation for two decades; this evaluation provides a conceptual pivot toward updated computational neuroscience models of belief updating and inference.
Limits
The paper is a narrative theoretical review rather than an empirical study or systematic review with quantitative pooling. The abstract does not specify literature search methods, study selection criteria, or sample sizes across evaluated literature.
Cited by
- context Elevated dopamine and adrenaline, particularly from amphetamines, induce a self-interested, egocentric psychological state where an individual's own ideas feel uniquely important.