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Capgras Syndrome and Other Delusions of Misidentification: Integrating Neuropsychological Models of Delusion Formation with Psychoanalytic Object-Relations Theory

  • Psychosis (AO Ahmed, Section Editor)
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Abstract

Purpose of Review

We show how psychoanalytic object-relations theory (PsyObjT) aligns with recent neuropsychological theories of delusions of misidentification (DMI), including the four-level model postulated by Feinberg (Conscious Cogn 20(1):75-81, 11), to enhance our understanding of these complex and fascinating delusions.

Recent Findings

We explain the mixed phenotypical expressions of DMI (Capgras, Fregoli, re-duplication, inter-metamorphosis, and mirrored-self misidentification) as combinations of disturbances of the fundamental attributes of the uniqueness, permanence, authenticity, and familiarity of mental representations of people and objects.

Summary

Delusions of misidentification (DMI) involve striking disruptions of essential mental processes, including the maintenance of stable mental representations of the self and others. We introduce this article with a brief report of a patient with features of both Capgras syndrome and delusions of re-duplication. After providing a brief overview of PsyObjT, which describes the psychological origins of mental representations of the self and others, we describe how the complimentary perspectives of neuropsychology and modern PsyObjT explain how the classic DMI syndromes take shape in the mind. The companion article in this issue (Leighton et al.) synthesizes neuropsychological models of DMI. We recommend it as an introduction to this contribution.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Signer SF. Self-substitution as a variant of the Capgras syndrome. Psychopathology. 1994;27(3–5):232–9.

    Article  CAS  Google Scholar 

  2. Kernberg O. Object-relations theory and clinical psychoanalysis. New York: Jason Aronson; 1976.

    Google Scholar 

  3. Klein M. Notes on some schizoid mechanisms. Int J Psychoanal. 1946;27:99–110.

    CAS  PubMed  Google Scholar 

  4. Sandler J, Sandler AM. On the development of object relationships and affects. Int J Psychoanal. 1978;59(2–3):285–96.

    CAS  PubMed  Google Scholar 

  5. Quiroga RQ, Reddy L, Kreiman G, Koch C, Fried I. Invariant visual representation by single neurons in the human brain. Nature. 2005;435(7045):1102–7.

    Article  CAS  Google Scholar 

  6. Gergely G. Reapproaching Mahler: new perspectives on normal autism, symbiosis, splitting and libidinal object constancy from cognitive developmental theory. J Am Psychoanal Assoc. 2000;48(4):1197–228.

    Article  CAS  Google Scholar 

  7. Baillargeon R. Object permanence in 3½-and 4½-month-old infants. Dev Psychol. 1987;23(5):655–64.

    Article  Google Scholar 

  8. Tyson P. Object relations, affect management, and psychic structure formation. The concept of object constancy. Psychoanal Stud Child. 1996;51:172–89.

    Article  CAS  Google Scholar 

  9. Fonagy P, Target M. Playing with reality: I. Theory of mind and the normal development of psychic reality. Int J Psychoanal. 1996;77(2):217–33.

    PubMed  Google Scholar 

  10. Berson RJ. Capgras’ syndrome. Am J Psychiatry. 1983;140:969–78.

    Article  CAS  Google Scholar 

  11. Feinberg TE. Neuropathologies of the self: clinical and anatomical features. Conscious Cogn. 2011;20(1):75–81.

    Article  Google Scholar 

  12. Garrett M. Who are you? Capgras and other delusions of misidentification. Book Chapter In: Hardy KV, Turkington D, editors. Decoding delusions: demystifying clinical interventions for working with strongly held beliefs. American Psychiatric Association PressSS (in press); 2022.

  13. Wilkinson S. A mental files approach to delusional misidentification. Rev Philos Psychol. 2016;7(2):389–404. The author proposes that misidentification illusions involve errors in the creation and retrieval of memory files. Errors in linking singular mental representations of a person with the stable file representing the whole person are influenced by affect and result in loss of the sense that the person has continuous identity over time.

    Article  Google Scholar 

  14. Jaspers K. General psychopathology. Manchester: Manchester University Press; 1963.

    Google Scholar 

  15. Murez M, Recanati F. Mental files: an introduction. Rev Philos Psychol. 2016;7(2):265–81.

    Article  Google Scholar 

  16. Darby R, Prasad S. Lesion-related delusional misidentification syndromes: a comprehensive review of reported cases. J Neuropsychiatry Clin Neurosci. 2016;28(3):217–22. This study set to determine the clinical course, neuroanatomical localization, neuropsychological abnormalities, and delusional content in patients with delusions of misidentification occurring after focal neurological injuries.

    Article  Google Scholar 

  17. Margariti MM, Kontaxakis VP. Approaching delusional misidentification syndromes as a disorder of the sense of uniqueness. Psychopathology. 2006;39(6):261–8.

    Article  Google Scholar 

  18. Young G. Delusional misidentification. New York: Nova Science Publishers, Inc.; 2010.

    Google Scholar 

  19. Currie G. Imagination, delusion, and hallucinations. In: Coltheart M, Davies M, editors. Pathologies of belief. Oxford: Blackwell Publishing; 2000.

    Google Scholar 

  20. Capgras J, Reboul-Lachaux J. L’Illusion des ‘sosies’ dans un délire systématisé chronique. Hist Psychiatry. 1994;5(17):119–33. https://doi.org/10.1177/0957154X9400501709.

    Article  Google Scholar 

  21. Stern DN. The Interpersonal World of the infant: a view from psychoanalysis and developmental psychology. New York: Basic Books; 1985.

    Google Scholar 

  22. Kahneman D. Thinking, fast and slow. New York: Farrar, Straus and Giroux; 2011.

    Google Scholar 

  23. Todd J. The syndrome of Capgras. Psychiatr Q. 1957;31(2):250–65.

    Article  CAS  Google Scholar 

  24. Schafer R. Aspects of internalization. Madison: International Universities Press, Inc; 1968.

    Google Scholar 

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Correspondence to Michael Garrett.

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Garrett, M., Leighton, E. Capgras Syndrome and Other Delusions of Misidentification: Integrating Neuropsychological Models of Delusion Formation with Psychoanalytic Object-Relations Theory. Curr Behav Neurosci Rep 9, 84–92 (2022). https://doi.org/10.1007/s40473-022-00249-w

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