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A Predictive Coding Account of Psychotic Symptoms in Autism Spectrum Disorder

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Abstract

The co-occurrence of psychotic and autism spectrum disorder (ASD) symptoms represents an important clinical challenge. Here we consider this problem in the context of a computational psychiatry approach that has been applied to both conditions—predictive coding. Some symptoms of schizophrenia have been explained in terms of a failure of top–down predictions or an enhanced weighting of bottom–up prediction errors. Likewise, autism has been explained in terms of similar perturbations. We suggest that this theoretical overlap may explain overlapping symptomatology. Experimental evidence highlights meaningful distinctions and consistencies between these disorders. We hypothesize individuals with ASD may experience some degree of delusions without the presence of any additional impairment, but that hallucinations are likely indicative of a distinct process.

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Acknowledgments

Philip Corlett acknowledges support by the Connecticut Mental Health Center (CMHC) and Connecticut State Department of Mental Health and Addiction Services (DMHAS). P.R.C. was funded by R01MH067073, the NCPTSD, an IMHRO/ Janssen Rising Star Translational Research Award and CTSA Grant Number UL1 TR000142 from the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official view of NIH or the CMHC/DMHAS.

Author Contributions

GIS wrote large parts of the mansucript. FRV contibuted to the conceptualization of the manuscript and provided extensive editing. PRC wrote large parts of the manuscript. All authors approved the final manuscript.

Funding

Gerrit van Schalkwyk acknowledges the support of the AACAP Pilot Award supported by Pfizer. Gerrit van Schalkwyk and Fred Volkmar acknowledge the support of the Yale Child Study Center Associates.

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  1. Child Study Center, Yale University School of Medicine, New Haven, CT, USA

    Gerrit I. van Schalkwyk & Fred R. Volkmar

  2. Department of Psychiatry, Clinical Neuroscience Research Unit, Connecticut Mental Health Center, Yale University School of Medicine, 230 South Frontage Road, New Haven, CT, 06510, USA

    Philip R. Corlett

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The authors report no relevant conflicts. There was no funding for this work. Author GIVS is supported by an AACAP Pilot Award for General Psychiatry Residents. Author FRV is supported by the Harris endowment and the Yale Child Study Center Associates. PRC is supported by the Connecticut Mental Health Center (CMHC) and Connecticut State Department of Mental Health and Addiction Services (DMHAS), by NIMH R01MH067073, the NCPTSD, an IMHRO/ Janssen Rising Star Translational Research Award and CTSA Grant Number UL1 TR000142 from the National Center for Research Resources (NCRR) and the National Center for Advancing Translational Science (NCATS), components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research. The contents of this work are solely the responsibility of the authors and do not necessarily represent the official view of NIH or the CMHC/DMHAS.

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van Schalkwyk, G.I., Volkmar, F.R. & Corlett, P.R. A Predictive Coding Account of Psychotic Symptoms in Autism Spectrum Disorder. J Autism Dev Disord 47, 1323–1340 (2017). https://doi.org/10.1007/s10803-017-3065-9

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