Definition: Confabulation is defined as the spontaneous creation of memories that never occurred or of actual events that have been distorted to another place and/or time. It is a symptom of various memory disorders in which made-up stories fill in any gaps in memory.
German psychiatrist Karl Bonhoeffer coined the term “confabulation” in 1900. He used it to describe when a person gives false answers or answers that sound fantastical or made up.
While this condition may at first sound like lying, confabulation only occurs when any person has a condition that affects his/her memory. This is why confabulation is often described as “honestly lying.”
Most known cases of confabulation are symptomatic of brain damage or dementia, such as an aneurysm, Alzheimer’s disease, or Wernicke–Korsakoff syndrome (a common manifestation of thiamine deficiency caused by alcoholism). Additionally, confabulation often occurs in people who are suffering from anticholinergic toxidrome when interrogated about bizarre or irrational behaviour.
Confabulated memories of all types most often occur in autobiographical memory and are indicative of a complicated and intricate process that can be led astray at any point during encoding, storage, or recall of a memory. This type of confabulation is commonly seen in Korsakoff’s syndrome.
Types of Confabulation –
There are two types of confabulation: provoked and spontaneous.
- Provoked confabulation occurs when a person is asked a question that requires them to rely on their memory to answer.
- Confabulations may also be classified as verbal or behavioural. Verbal confabulations are more common and involve only talking about false memories. Behavioural confabulations, on the other hand, occur when the patient acts on these faulty beliefs.
Confabulated memories almost always occur in one’s autobiographical memory — the memory system of an individual’s own life experiences which are brought to awareness in episodes or segments. While there are many hypotheses regarding the origins of confabulation, the most well-received theories point to neurological problems.
Spontaneous confabulation occurs when the person is unprovoked, yet shares a supposedly autobiographical anecdote about something that happened to them. This type is less common than provoked confabulation and can result is some outlandish tales.
Causes, Sign and Symptoms of Confabulation: A variety of conditions can result in confabulation. These include memory disorders, injuries, and mental health disorders. As a result, doctors haven’t identified a specific cause. Some cases of confabulation resolve on their own over time as the brain heals itself, but other cases are more permanent.
Confabulation may also be a symptom of many different conditions, such as:
- Korsakoff’s syndrome
- Split-brain syndrome
- Anton’s syndrome
- Capgras syndrome
- Alzheimer’s disease
- Brain tumours
Confabulation is associated with several characteristics:
- Typically verbal statements but can also be non-verbal gestures or actions.
- Can include autobiographical and non-personal information, such as historical facts, fairy-tales, or other aspects of semantic memory.
- The account can be fantastic or coherent.
- Both the premise and the details of the account can be false.
- The account is usually drawn from the patient’s memory of actual experiences, including past and current thoughts.
- The patient is unaware of the accounts’ distortions or inappropriateness and is not concerned when errors are pointed out.
- There is no hidden motivation behind the account.
- The patient’s personality structure may play a role in his/her readiness to confabulate.
Diagnosis and Treatment of Confabulation: Spontaneous confabulations, due to their involuntary nature, cannot be manipulated in a laboratory setting. However, provoked confabulations can be researched in various theoretical contexts. The mechanisms found to underlie provoked confabulations can be applied to spontaneous confabulation mechanisms. The basic premise of researching confabulation comprises finding errors and distortions in memory tests of an individual.
Treatment usually focuses on addressing the underlying disorder to help reduce confabulation. There are also psychotherapy techniques that may help to correct the symptom. An example is cognitive rehabilitation, in which you “relearn” cognitive skills. This could include learning to question the things someone is saying and consider answering “I’m not sure” or “I don’t know” instead of confabulating. Other techniques include:
- keeping a diary
- having a family member re-orient someone with confabulation to their surroundings
Furthermore, improvements were maintained at a three-month follow-up and were found to generalize to everyday settings.