Confabulation

In psychology, confabulation is a memory error consisting of the production of fabricated, distorted, or misinterpreted memories about oneself or the world. It is generally associated with certain types of brain damage (especially aneurysm in the anterior communicating artery) or a specific subset of dementias.^[1] While still an area of ongoing research, the basal forebrain is implicated in the phenomenon of confabulation. People who confabulate present with incorrect memories ranging from subtle inaccuracies to surreal fabrications, and may include confusion or distortion in the temporal framing (timing, sequence or duration) of memories.^[2] In general, they are very confident about their recollections, even when challenged with contradictory evidence.^[3]

Confabulation occurs when individuals mistakenly recall false information, without intending to deceive. Brain damage, dementia, and anticholinergic toxidrome can cause this distortion. Two types of confabulation exist: provoked and spontaneous, with two distinctions: verbal and behavioral. Verbal statements, false information, and the patient's unawareness of the distortion are all associated with this phenomenon. Personality structure also plays a role in confabulation.

Numerous theories have been developed to explain confabulation. Neuro­psycho­log­i­cal theories suggest that cognitive dysfunction causes the distortion. Self-identity theories posit that people confabulate to preserve themselves. The temporality theory believes that confabulation occurs when an individual cannot place events properly in time. The monitoring and strategic retrieval account theories argue that confabulation arises when individuals cannot recall memories correctly or monitor them after retrieval. The executive control and fuzzy-trace theories also attempt to explain why confabulation happens.

Confabulation can occur with nervous system injuries or illnesses, including Korsakoff's syndrome, Alzheimer's disease, schizophrenia, and traumatic brain injury. It is believed that the right frontal lobe of the brain is damaged, causing false memories. Children are especially susceptible to forced confabulation as they are highly impressionable. Feedback can increase confidence in false memories. In rare cases, confabulation occurs in ordinary individuals.

Different memory tests, including recognition tasks and free recall tasks, can be used to study confabulation. Treatment depends on the underlying cause of the distortion. Ongoing research aims to develop a standard test battery to discern between different types of confabulations, distinguish delusions from confabulations, understand the role of unconscious processes, and identify pathological and nonpathological confabulations.