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Paranoia is the belief that harm is intended by others. It may arise from selective pressures to infer and avoid social threats, particularly in ambiguous or changing circumstances. We propose that uncertainty may be sufficient to elicit learning differences in paranoid individuals, without social threat. We used reversal learning behavior and computational modeling to estimate belief updating across individuals with and without mental illness, online participants, and rats chronically exposed to methamphetamine, an elicitor of paranoia in humans. Paranoia is associated with a stronger prior on volatility, accompanied by elevated sensitivity to perceived changes in the task environment. Methamphetamine exposure in rats recapitulates this impaired uncertainty-driven belief updating and rigid anticipation of a volatile environment. Our work provides evidence of fundamental, domain-general learning differences in paranoid individuals. This paradigm enables further assessment of the interplay between uncertainty and belief-updating across individuals and species. Everyone has had fleeting concerns that others might be against them at some point in their lives. Sometimes these concerns can escalate into paranoia and become debilitating. Paranoia is a common symptom in serious mental illnesses like schizophrenia. It can cause extreme distress and is linked with an increased risk of violence towards oneself or others. Understanding what happens in the brains of people experiencing paranoia might lead to better ways to treat or manage it. Some experts argue that paranoia is caused by errors in the way people assess social situations. An alternative idea is that paranoia stems from the way the brain forms and updates beliefs about the world. Now, Reed et al. show that both people with paranoia and rats exposed to a paranoia-inducing substance expect the world will change frequently, change their minds often, and have a harder time learning in response to changing circumstances. In the experiments, human volunteers with and without psychiatric disorders played a game where the best choices change. Then, the participants completed a survey to assess their level of paranoia. People with higher levels of paranoia predicted more changes would occur and made less predictable choices. In a second set of experiments, rats were put in a cage with three holes where they sometimes received sugar rewards. Some of the rats received methamphetamine, a drug that causes paranoia in humans. Rats given the drug also expected the location of the sugar reward would change often. The drugged animals had harder time learning and adapting to changing circumstances. The experiments suggest that brain processes found in both rats, which are less social than humans, and humans contribute to paranoia. This suggests paranoia may make it harder to update beliefs. This may help scientists understand what causes paranoia and develop therapies or drugs that can reduce paranoia. This information may also help scientists understand why during societal crises like wars or natural disasters humans are prone to believing conspiracies. This is particularly important now as the world grapples with climate change and a global pandemic. Reed et al. note paranoia may impede the coordination of collaborative solutions to these challenging situations.

This paper outlines a hierarchical Bayesian framework for interoception, homeostatic/allostatic control, and meta-cognition that connects fatigue and depression to the experience of chronic dyshomeostasis. Specifically, viewing interoception as the inversion of a generative model of viscerosensory inputs allows for a formal definition of dyshomeostasis (as chronically enhanced surprise about bodily signals, or, equivalently, low evidence for the brain's model of bodily states) and allostasis (as a change in prior beliefs or predictions which define setpoints for homeostatic reflex arcs). Critically, we propose that the performance of interoceptive-allostatic circuitry is monitored by a metacognitive layer that updates beliefs about the brain's capacity to successfully regulate bodily states (allostatic self-efficacy). In this framework, fatigue and depression can be understood as sequential responses to the interoceptive experience of dyshomeostasis and the ensuing metacognitive diagnosis of low allostatic self-efficacy. While fatigue might represent an early response with adaptive value (cf. sickness behavior), the experience of chronic dyshomeostasis may trigger a generalized belief of low self-efficacy and lack of control (cf. learned helplessness), resulting in depression. This perspective implies alternative pathophysiological mechanisms that are reflected by differential abnormalities in the effective connectivity of circuits for interoception and allostasis. We discuss suitably extended models of effective connectivity that could distinguish these connectivity patterns in individual patients and may help inform differential diagnosis of fatigue and depression in the future.

In its full sense, perception rests on an agent's model of how its sensory input comes about and the inferences it draws based on this model. These inferences are necessarily uncertain. Here, we illustrate how the Hierarchical Gaussian Filter (HGF) offers a principled and generic way to deal with the several forms that uncertainty in perception takes. The HGF is a recent derivation of one-step update equations from Bayesian principles that rests on a hierarchical generative model of the environment and its (in)stability. It is computationally highly efficient, allows for online estimates of hidden states, and has found numerous applications to experimental data from human subjects. In this paper, we generalize previous descriptions of the HGF and its account of perceptual uncertainty. First, we explicitly formulate the extension of the HGF's hierarchy to any number of levels; second, we discuss how various forms of uncertainty are accommodated by the minimization of variational free energy as encoded in the update equations; third, we combine the HGF with decision models and demonstrate the inversion of this combination; finally, we report a simulation study that compared four optimization methods for inverting the HGF/decision model combination at different noise levels. These four methods (Nelder-Mead simplex algorithm, Gaussian process-based global optimization, variational Bayes and Markov chain Monte Carlo sampling) all performed well even under considerable noise, with variational Bayes offering the best combination of efficiency and informativeness of inference. Our results demonstrate that the HGF provides a principled, flexible, and efficient-but at the same time intuitive-framework for the resolution of perceptual uncertainty in behaving agents.

This paper describes an active inference scheme for visual searches and the perceptual synthesis entailed by scene construction. Active inference assumes that perception and action minimize variational free energy, where actions are selected to minimize the free energy expected in the future. This assumption generalizes risk-sensitive control and expected utility theory to include epistemic value; namely, the value (or salience) of information inherent in resolving uncertainty about the causes of ambiguous cues or outcomes. Here, we apply active inference to saccadic searches of a visual scene. We consider the (difficult) problem of categorizing a scene, based on the spatial relationship among visual objects where, crucially, visual cues are sampled myopically through a sequence of saccadic eye movements. This means that evidence for competing hypotheses about the scene has to be accumulated sequentially, calling upon both prediction (planning) and postdiction (memory). Our aim is to highlight some simple but fundamental aspects of the requisite functional anatomy; namely, the link between approximate Bayesian inference under mean field assumptions and functional segregation in the visual cortex. This link rests upon the (neurobiologically plausible) process theory that accompanies the normative formulation of active inference for Markov decision processes. In future work, we hope to use this scheme to model empirical saccadic searches and identify the prior beliefs that underwrite intersubject variability in the way people forage for information in visual scenes (e.g., in schizophrenia).

The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the pandemic in 2020 increased individuals’ paranoia and made their belief updating more erratic. A proactive lockdown made people’s belief updating less capricious. However, state-mandated mask-wearing increased paranoia and induced more erratic behaviour. This was most evident in states where adherence to mask-wearing rules was poor but where rule following is typically more common. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable. People who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines and the QAnon conspiracy theories. These beliefs were associated with erratic task behaviour and changed priors. Taken together, we found that real-world uncertainty increases paranoia and influences laboratory task behaviour. Suthaharan et al. show that levels of paranoia increased in the general population during the early stages of the COVID-19 pandemic, in association with more erratic belief updating. Government policies also played a role.

Background: Current theories of psychosis highlight the role of abnormal learning signals, i.e., prediction errors (PEs) and uncertainty, in the formation of delusional beliefs. We employed computational analyses of behaviour and functional magnetic resonance imaging (fMRI) to examine whether such abnormalities are evident in at-risk mental state (ARMS) individuals. Methods: Non-medicated ARMS individuals (n=13) and control participants (n=13) performed a probabilistic learning paradigm during fMRI data acquisition. We used a hierarchical Bayesian model to infer subject-specific computations from behaviour - with a focus on PEs and uncertainty (or its inverse, precision) at different levels, including environmental 'volatility' - and used these computational quantities for analyses of fMRI data. Results: Computational modelling of ARMS individuals' behaviour indicated volatility estimates converged to significantly higher levels than in controls. Model-based fMRI demonstrated increased activity in prefrontal and insular regions of ARMS individuals in response to precision-weighted low-level outcome PEs, while activations of prefrontal, orbitofrontal and anterior insula cortex by higher-level PEs (that serve to update volatility estimates) were reduced. Additionally, prefrontal cortical activity in response to outcome PEs in ARMS was negatively associated with clinical measures of global functioning. Conclusions: Our results suggest a multi-faceted learning abnormality in ARMS individuals under conditions of environmental uncertainty, comprising higher levels of volatility estimates combined with reduced cortical activation, and abnormally high activations in prefrontal and insular areas by precision-weighted outcome PEs. This atypical representation of high- and low-level learning signals might reflect a predisposition to delusion formation. Footnotes * Supplementary Materials correctly appended.

Impulsivity is a multidimensional construct with distinct implications for the pathophysiology and treatment of various neuropsychiatric conditions, including substance use disorders, behavioural addictions, attention deficit hyperactivity disorder, psychosis, and personality disorders. One proposed behavioural subtype, premature responding impulsivity (PRI), appears to be influenced by neuromodulatory pathways frequently implicated in these disorders, in particular dopamine neurotransmission, known for its role in contingency learning. Still, the neurobiological basis of PRI in humans remains insufficiently understood. Here, we theorize that PRI reflects the brain's capacity to adapt to environmental uncertainty. To test this hypothesis, twenty-four healthy adults (mean age 22.6 years; 12 females) completed a novel decision-making task featuring alternating stable and volatile probabilistic cue contingencies while undergoing functional magnetic resonance imaging (fMRI). A hierarchical Bayesian model estimated PRI as an urgency-to-respond process, whose parameters were dynamically modulated by volatility. These model-derived indices correlated with established trait impulsivity measures, supporting their construct validity. Model-based fMRI analyses identified a distributed cortico-subcortical network including anterior insula, dorsal anterior cingulate cortex, striatum, and monoaminergic midbrain regions, whose activity tracked within-trial PRI estimates as they evolved over time. Connectivity analyses further showed that high volatility enhanced interactions between subnetworks typically associated with promoting or inhibiting impulsive action. Together, these results outline a neurocomputational account in which environmental uncertainty modulates PRI through interacting brain circuits, offering a principled framework for further probing the transdiagnostic role of impulsivity across neuropsychiatric and neuropsychopharmacological contexts.Competing Interest StatementThe authors have declared no competing interest.

Paranoia is the belief that harm is intended by others. It may arise from selective pressures to infer and avoid social threats, particularly in ambiguous or changing circumstances. We propose that uncertainty may be sufficient to elicit learning differences in paranoid individuals, without social threat. We used reversal learning behaviour and computational modelling to estimate belief updating across individuals with and without mental illness, online participants, and rats exposed to chronic methamphetamine, an elicitor of paranoia in humans. Paranoia is associated with a strong but immutable prior on volatility, accompanied by elevated sensitivity to perceived changes in the task environment. Methamphetamine exposure in rats recapitulates this impaired uncertainty-driven belief updating and rigid anticipation of a volatile environment. Our work provides evidence of fundamental, domain-general learning differences in paranoid individuals. This paradigm enables further assessment of the interplay between uncertainty and belief-updating across individuals and species.

Background Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by impairments of social interaction and communication as well as repetitive, stereotyped behaviour. Previous research indicates that ASD without intellectual impairment is associated with underactivity and reduced functional connectivity of the brain’s mentalizing pathway, to which the right temporo-parietal junction (rTPJ) serves as an important entry point and hub. In this study, we aim to utilize functional magnetic resonance imaging (fMRI) to localize activation maxima in the rTPJ and other regions involved in social cognition to generate individualized targets for neuro-navigated, intermittent theta burst stimulation (iTBS) in order to modulate brain activity in a region centrally engaged in social information processing. Methods In this single-blind, randomized, between-subject neuroimaging-guided brain stimulation study we plan to recruit 52 participants with prediagnosed ASD and 52 controls without ASD aged between 18 and 65 years. Participants will be classified into two groups and will randomly receive one session of either verum- or sham-iTBS. Effects will be assessed by using well-established experimental tasks that interrogate social behaviour, but also use computational modelling to investigate brain stimulation effects at this level. Discussion This study aims to use personalized, non-invasive brain stimulation to alter social information processing in adults with and without high-functioning ASD, which has not been studied before with a similar protocol or a sample size of this magnitude. By doing so in combination with behavioural and computational tasks, this study has the potential to provide new mechanistic insights into the workings of the social brain. Trial registration German Clinical Trial Register, DRKS-ID: DRKS00028819. Registered 14 June 2022.