Delusions and Faces

This article contrasts the cognitive neuropsychiatric approach with the traditional psychiatric approaches to delusions to develop testable cognitive theories of delusions so as to render the generation of delusions psychologically understandable. It illustrates how cognitive neuropsychiatrists use the Bruce and Young model of face processing to explain the generation of misidentification delusions. The study of facial expression highlights that future cognitive neuropsychiatric study of self and non-self face processing using different representational media in patients with mirrored-self misidentification delusions will likely be informative with regard to advancing scientific understanding of the putative differences between self and non-self recognition. It reviews cognitive neuropsychiatric research into the Capgras delusion and shows the distinction between overt face recognition and person identity authentication, and suggests the need for further modification of Bruce and Young's model to remove direct pathways between the person's identity module and the affective response system and to incorporate a separate integrative device.