Islands of Inference: A Neurodevelopmental Architecture for Fixed Delusions.
Paul Goldsmith
Psychopathology May 4, 2026 DOI: 10.1159/000552299 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Theoretical or philosophical paper Peer reviewed |
|---|---|
| Topics | Philosophy of mind |
| Keywords | Delusions Psychopathology Schizophrenia Theory of mind |
| Key points | Proposes that delusions arise from focal cortical regions with greater representational depth than surrounding networks, leading to fixed, internally coherent beliefs that cannot be revised by broader circuits. |
Abstract
Delusions can be strikingly selective: individuals may hold highly elaborated, unshakeable beliefs in one domain while remaining otherwise cognitively intact. Models emphasising dopaminergic salience or belief-updating failures account for the intensity and persistence of delusions but struggle to explain their circumscribed nature. This paper develops a conceptual framework that complements dominant functional accounts. Subtle neurodevelopmental variation in cortical micro-architecture, as commonly occurs, may give rise to focal cortical regions ("islands") with greater representational depth than their surrounding networks. When such a region supports high-order social inference - particularly advanced theory of mind - it may generate internally coherent narratives that exceed the integrative capacity of neighbouring circuits. These inferences cannot be adequately contextualised, simulated, or revised by the broader network and therefore become fixed. The "Islands of Inference" model accounts for several core features of schizophrenia, including the social content of delusions, their typical onset in late adolescence, their resistance to counter-evidence, and their progression over time. It also clarifies the distinct roles of dopamine and cannabis: neuromodulators amplify the influence of the island's output without determining its content. Finally, the framework clarifies implications for empirical investigation. During delusional thought, focal regions within the mentalising network should support deeper internal representations than their surrounding circuits, even when those neighbouring areas are active and coherent. This framework reframes delusions as reflecting a failure of architectural constraint rather than global cognitive dysfunction and suggests new directions for empirical investigation and treatment.
Comparable studies
Other theoretical and historical papers on philosophy of mind, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. | 2003 | Theoretical or philosophical paper | |
| From dopamine to salience to psychosis--linking biology, pharmacology and phenomenology of psychosis. | 2005 | Theoretical or philosophical paper | |
| How do the brain's time and space mediate consciousness and its different dimensions? Temporo-spatial theory of consciousness (TTC). | 2017 | Theoretical or philosophical paper | |
| The phenomenology of deep brain stimulation-induced changes in OCD: an enactive affordance-based model. | 2013 | Theoretical or philosophical paper | |
| Looking for the Self: Phenomenology, Neurophysiology and Philosophical Significance of Drug-induced Ego Dissolution | 2017 | Theoretical or philosophical paper |
Citations in the library
Cites 7
- Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry 2003
- Gone to Pot – A Review of the Association between Cannabis and Psychosis Frontiers in Psychiatry May 22, 2014
- Phenomenological and neurocognitive perspectives on delusions: A critical overview. World Psychiatry June 1, 2015
- A new predictive coding model for a more comprehensive account of delusions. The Lancet Psychiatry April 1, 2024
- Double bookkeeping in schizophrenia spectrum disorder: an empirical-phenomenological study. European Archives of Psychiatry and Clinical Neuroscience September 1, 2024
and 2 more in the library