CONFABULATION (Pseudoreminiscence)

A distortion of memory, or paramnesia, in which gaps in recall are filled by fictional events and experiences.Confabulations can be differentiated from delusions by the fact that the fictional material refers to specific times, places, and people, whereas delusions tend to be more generalized. Though sometimes these fabrications are palpably fictitious and absurdly simple, they may also be elaborate, detailed, and plausible-sounding. In any case, the patient himself accepts them as fact.Confabulation must also be distinguished from pseudologia fantastica, aclinical syndrome characterized by fantasies having no relation to reality. Typical examples are found among antisocial, or psychopathic, individuals who tell tall tales to give their ego a lift or to get out of a tight situation. In most cases these tales are believed only momentarily and are dropped as soon as they are contradicted by evidence. The confabulator, on the other hand, sticks steadfastly to his story. See ANTISOCIAL REACTION.The motives behind confabulation are usually unconscious. The individual hides his embarrassment due to actual memory loss by inventing details. In some brain-injury cases, for example, the patient may deny that he is ill at all, or give a fictitious reason to explain why he is in the hospital: “I tripped over the cat and hit my head on a golf ball,” “I was blown up by an atomic explosion.” One indication of confabulation is that many irrelevant details are usually included in the fictitious stories. Another is that the patient may spontaneously change his story from moment to moment, or in response to questions or suggestions made by the therapist. See ANOSOGNOSIA. Confabulation is found principally in Korsakoff’s syndrome, and to a lesser extent in other organic psychoses, such as senile psychosis (senile dementia), lead poisoning, general paresis, Wernicke’s syndrome, and cases of severe head injury. See these topics.