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Classification and external resources
Specialty Psychiatry







Two types of confabulation are often distinguished:

  • Provoked (momentary, or secondary) confabulations represent a normal response to a faulty memory, are common in both amnesia and dementia,[9] and can become apparent during memory tests.[10]
  • Spontaneous (or primary) confabulations do not occur in response to a cue[10] and seem to be involuntary.[11] They are relatively rare, more common in cases of dementia, and may result from the interaction between frontal lobe pathology and organic amnesia.[9]

Another distinction is that between:[11]

  • Verbal confabulations, spoken false memories are more common, and
  • Behavioral confabulations, occur when an individual acts on their false memories.

Signs and symptoms[edit]

Confabulation is associated with several characteristics:

  3. The account can be fantastic or coherent.
  7. There is no hidden motivation behind the account.
  8. The patient's personality structure may play a role in their readiness to confabulate.[4]


Theories of confabulation range in emphasis. Some theories propose that confabulations represent a way for memory-disabled individuals to maintain their self-identity.[10] Other theories use neurocognitive links to explain the process of confabulation.[12] Still other theories frame confabulation around the more familiar concept of delusion.[13] Other researchers frame confabulation within the fuzzy-trace theory.[14] Finally, some researchers call for theories that rely less on neurocognitive explanations and more on epistemic accounts.[15]

Neuropsychological theories[edit]

The most popular theories of confabulation come from the field of neuropsychology or cognitive neuroscience.[12] Research suggests that confabulation is associated with dysfunction of cognitive processes that control the retrieval from long-term memory. Frontal lobe damage often disrupts this process, preventing the retrieval of information and the evaluation of its output.[16][17] Furthermore, researchers argue that confabulation is a disorder resulting from failed "reality monitoring/source monitoring" (i.e. deciding whether a memory is based on an actual event or whether it is imagined.[18] Some neuropsychologists suggest that errors in retrieval of information from long-term memory that are made by normal subjects involve different components of control processes than errors made by confabulators.[19] Kraepelin distinguished two subtypes of confabulation, one of which he called simple confabulation, caused partly by errors in the temporal ordering of real events. The other variety he called fantastic confabulation, which was bizarre and patently impossible statements not rooted in true memory. Simple confabulation may result from damage to memory systems in the medial temporal lobe. Fantastic confabulations reveal a dysfunction of the Supervisory System,[20] which is believed to be a function of the frontal cortex.

Self-identity theory[edit]

Some argue confabulations have a self-serving, emotional component in those with memory deficits that aids to maintain a coherent self-concept.[10] In other words, individuals who confabulate are motivated to do so, because they have gaps in their memory that they want to fill in and cover up.

Temporality theory[edit]

Support for the temporality account suggests that confabulations occur when an individual is unable to place events properly in time.[10] Thus, an individual might correctly state an action they performed, but say they did it yesterday, when they did it weeks ago. In the Memory, Consciousness, and Temporality Theory, confabulation occurs because of a deficit in temporal consciousness or awareness.[21]

Monitoring theory[edit]

Along a similar notion are the theories of reality and source monitoring theories.[11] In these theories, confabulation occurs when individuals incorrectly attribute memories as reality, or incorrectly attribute memories to a certain source. Thus, an individual might claim an imagined event happened in reality, or that their friend told them about an event they actually heard about on television.

Strategic retrieval account theory[edit]

Supporters of the strategic retrieval account suggest that confabulations occur when an individual cannot actively monitor a memory for truthfulness after its retrieval.[11] An individual recalls a memory, but there is some deficit after recall that interferes with the person establishing its falseness.

Executive control theory[edit]


In the context of delusion theories[edit]


Fuzzy-trace theory[edit]

Fuzzy-trace theory, or FTT, is a concept more commonly applied to the explanation of judgement decisions.[14] According to this theory, memories are encoded generally (gist), as well as specifically (verbatim). Thus, a confabulation could result from recalling the incorrect verbatim memory or from being able to recall the gist portion, but not the verbatim portion, of a memory.


Epistemic theory[edit]



Associated neurological and psychological conditions[edit]


Wernicke–Korsakoff syndrome is a neurological disorder typically characterized by years of chronic alcohol abuse and a nutritional thiamine deficiency.[25] Confabulation is one salient symptom of this syndrome.[26][27] A study on confabulation in Korsakoff’s patients found that they are subject to provoked confabulation when prompted with questions pertaining to episodic memory, not semantic memory, and when prompted with questions where the appropriate response would be "I don’t know."[28] This suggests that confabulation in these patients is "domain-specific." Korsakoff’s patients who confabulate are more likely than healthy adults to falsely recognize distractor words, suggesting that false recognition is a "confabulatory behavior."


Schizophrenia is a psychological disorder in which confabulation is sometimes observed. Although confabulation is usually coherent in its presentation, confabulations of schizophrenic patients are often delusional[30] Researchers have noted that these patients tend to make up delusions on the spot which are often fantastic and become increasingly elaborate with questioning.[31] Unlike patients with Korsakoff's and Alzheimer's, patients with schizophrenia are more likely to confabulate when prompted with questions regarding their semantic memories, as opposed to episodic memory prompting.[32] In addition, confabulation does not appear to be related to any memory deficit in schizophrenic patients. This is contrary to most forms of confabulation. Also, confabulations made by schizophrenic patients often do not involve the creation of new information, but instead involve an attempt by the patient to reconstruct actual details of a past event.

Traumatic brain injury (TBI) can also result in confabulation. Research has shown that patients with damage to the inferior medial frontal lobe confabulate significantly more than patients with damage to the posterior area and healthy controls.[33] This suggests that this region is key in producing confabulatory responses, and that memory deficit is important but not necessary in confabulation. Additionally, research suggests that confabulation can be seen in patients with frontal lobe syndrome, which involves an insult to the frontal lobe as a result of disease or traumatic brain injury (TBI).[34][35][36] Finally, rupture of the anterior or posterior communicating artery, subarachnoid hemorrhage, and encephalitis are also possible causes of confabulation.[16][37]

Location of brain lesions[edit]


Developmental differences[edit]

While some recent literature has suggested that older adults may be more susceptible than their younger counterparts to have false memories, the majority of research on forced confabulation centers around children.[40] Children are particularly susceptible to forced confabulations based on their high suggestibility.[41][42] When forced to recall confabulated events, children are less likely to remember that they had previously confabulated these situations, and they are more likely than their adult counterparts to come to remember these confabulations as real events that transpired.[43] Research suggests that this inability to distinguish between past confabulatory and real events is centered on developmental differences in source monitoring. Due to underdeveloped encoding and critical reasoning skills, children's ability to distinguish real memories from false memories may be impaired. It may also be that younger children lack the meta-memory processes required to remember confabulated versus non-confabulated events.[44] Children's meta-memory processes may also be influenced by expectancies or biases, in that they believe that highly plausible false scenarios are not confabulated.[45] However, when knowingly being tested for accuracy, children are more likely to respond, "I don’t know" at a rate comparable to adults for unanswerable questions than they are to confabulate.[46][47] Ultimately, misinformation effects can be minimized by tailoring individual interviews to the specific developmental stage, often based on age, of the participant.[48]

Provoked versus spontaneous confabulations[edit]

There is evidence to support different cognitive mechanisms for provoked and spontaneous confabulation.[49] One study suggested that spontaneous confabulation may be a result of an amnesic patient’s inability to distinguish the chronological order of events in his memory. In contrast, provoked confabulation may be a compensatory mechanism, in which the patient tries to make up for his memory deficiency by attempting to demonstrate competency in recollection.

Confidence in false memories[edit]

Confabulation of events or situations may lead to an eventual acceptance of the confabulated information as true.[50] For instance, people who knowingly lie about a situation may eventually come to believe that their lies are truthful with time.[51] In an interview setting, people are more likely to confabulate in situations in which they are presented false information by another person, as opposed to when they self-generate these falsehoods.[52] Further, people are more likely to accept false information as true when they are interviewed at a later time (after the event in question) than those who are interviewed immediately or soon after the event.[53] Affirmative feedback for confabulated responses is also shown to increase the confabulator’s confidence in their response.[54] For instance, in culprit identification, if a witness falsely identifies a member of a line-up, he will be more confident in his identification if the interviewer provides affirmative feedback. This effect of confirmatory feedback appears to last over time, as witnesses will even remember the confabulated information months later.[55]

Among normal subjects[edit]


Diagnosis and treatment[edit]

Spontaneous confabulations, due to their involuntary nature, cannot be manipulated in a laboratory setting.[11] However, provoked confabulations can be researched in various theoretical contexts. The mechanisms found to underlie provoked confabulations can be applied to spontaneous confabulation mechanisms. The basic premise of researching confabulation comprises finding errors and distortions in memory tests of an individual.

Deese–Roediger–McDermott lists[edit]


Recognition tasks[edit]


Free recall tasks[edit]



Treatment for confabulation is somewhat dependent on the cause or source, if identifiable. For example, treatment of Wernicke–Korsakoff syndrome involves large doses of vitamin B in order to reverse the thiamine deficiency.[57] If there is no known physiological cause, more general cognitive techniques may be used to treat confabulation. A case study published in 2000 showed that Self-Monitoring Training (SMT)[58] reduced delusional confabulations. Furthermore, improvements were maintained at a three-month follow-up and were found to generalize to everyday settings. Although this treatment seems promising, more rigorous research is necessary to determine the efficacy of SMT in the general confabulation population.


Although significant gains have been made in the understanding of confabulation in recent years, there is still much to be learned. One group of researchers in particular has laid-out several important questions for future-study. They suggest more information is needed regarding the neural-systems that support the different cognitive processes necessary for normal source=monitoring. They also proposed the idea of developing a standard neuro-psychological test battery able to discriminate between the different types of confabulations. And there is a considerable amount of debate regarding the best approach to organizing and combining neuro-imaging, pharmacological, and cognitive/behavioral approaches to understand confabulation.[59]


See also[edit]


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Further reading[edit]