Delusions and Social Reflection

Background: Neuroimaging studies have demonstrated associations between delusions in psychotic disorders and abnormalities of brain areas involved in social cognition, including medial prefrontal cortex (MPFC), posterior cingulate cortex, and lateral temporal cortex (LTC)). General population studies have linked subclinical delusional thinking to impaired social cognition, raising the question of whether a specific pattern of brain activity during social perception is associated with delusional beliefs. Here, we tested the hypothesis that subclinical delusional thinking is associated with changes in neural function while subjects made judgments about themselves or others (“social reflection” (SR)). Methods: Neural responses during SR and non-social tasks, as well as resting-state activity, were measured using fMRI in 22 healthy subjects. Delusional thinking was measured using the Peters et al. Delusions Inventory. Results: Delusional thinking was negatively correlated with responses of the left LTC during SR (r = -.61, p = .02, Bonferroni corrected) and connectivity between the left LTC and left ventral MPFC, and was positively correlated with connectivity between the left LTC and the right middle frontal and right inferior temporal cortices. Conclusions: Delusional thinking in the general population may be associated with reduced activity and aberrant functional connectivity of cortical areas involved in social reflection.