20 Years of Aberrant Salience in Psychosis: What Have We Learned?
Am J Psychiatry March 26, 2025 Philip R. Corlett, Kurt M. Fraser 9 citations
The salience hypothesis of psychosis, which links dopamine dysfunction to delusion formation, is critically evaluated against newer evidence. The hypothesis's specific predictions about dopamine dysfunction's neural and behavioral loci in psychosis are found lacking. Advances in tools for measuring and manipulating dopamine circuits inform this critique. Contemporary theories proposing dopamine's role in belief formation, belief updating under uncertainty, and abductive inference are argued to better explain patient behavior and dopamine function. While influential for uniting neurochemistry with clinical phenomenology, the original hypothesis faces challenges, and the authors highlight novel predictions for future research.