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“Altogether, these observations suggest that several processes contribute to psychotic experience: the loss of familiarity with the world, hypothetically associated with noisy information processing; increased novelty detection mediated by the hippocampus; associated alterations of prefrontal cortical processing, which have reliably been associated with impairments in working memory and other executive functions; increased top-down effects of prior beliefs mediated by the frontal cortex that may reflect compensatory efforts to cope with an increasingly complex and unfamiliar world; and finally disinhibition of subcortical dopaminergic neurotransmission, which increases salience attribution to otherwise irrelevant stimuli. Furthermore, increased noise of chaotic or stress-dependent dopamine firing can reduce the encoding of errors of reward prediction elicited by primary and secondary reinforcers, thus contributing to a subjective focusing of attention on apparently novel and mysterious environmental cues while reducing attention and motivation elicited by common and natural and social stimuli.”

Andreas Heinz
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