Chapter

The history of confabulation

Armin Schnider

in The Confabulating Mind

Published on behalf of Oxford University Press

Published in print February 2008 | ISBN: 9780199206759
Published online February 2013 | e-ISBN: 9780191754487 | DOI: http://dx.doi.org/10.1093/med/9780199206759.003.0002
The history of confabulation

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Since the early descriptions of confabulations in the 1880s up into the 1960s, an incredibly rich literature on false productions from memory by patients suffering from diverse illnesses has accrued. Korsakoff was the first to draw attention to a consistent syndrome composed of anterograde and retrograde amnesia, confabulation, and disorientation. Most patients had chronic alcoholism, others had severe infections presumably inducing malabsorption. The syndrome was soon also described in patients recovering from severe brain trauma and patients with senile dementia; it was much later recognized as a sequel of subarachnoid haemorrhage. A toxic origin was widely accepted; the anatomical basis appeared to be diffuse.

Different manifestations of confabulations were described: fantastic, implausible and incoherent ‘falsifications of memory’ in syphilitic and psychotic patients; fleeting and superficial confabulations that patients with diverse diseases, including senile dementia, produced in response to questions; and stable confabulations dominating the behaviour of chronic alcoholics and patients with traumatic brain injury or subarachnoid haemorrhage. Many authors insisted on the plausibility of the latter confabulations and their roots in the patients’ real past.

Classifications varied. Authors used terms like ‘out-of-embarrassment, compensatory, momentary, fantastic, provoked, spontaneous’ to describe the character of the confabulations they had observed. Table 2.1 summarizes these classifications and the supposed mechansims. Although gap-filling was the most commonly assumed mechanism, sometimes even used as part of the definition, the list of hypotheses was long. Most current theories – dysexecutive, monitoring, temporality, constructive deficit, or personality traits – were anticipated on the basis of clinical observation alone.

Chapter.  14165 words. 

Subjects: Psychiatry

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