It is generally associated with certain types of brain damage (especially aneurysm in the anterior communicating artery) or a specific subset of dementias.
[6] Although individuals can present blatantly false information, confabulation can also seem to be coherent, internally consistent, and relatively normal.
[6] Most known cases of confabulation are symptomatic of brain damage or dementias, such as aneurysm, Alzheimer's disease, or Wernicke–Korsakoff syndrome (a common manifestation of thiamine deficiency caused by alcohol use disorder).
[8] Several forms of confabulation have been distinguished which vary in terms of behaviour, mechanism, and location of brain damage.
Frontal lobe damage often disrupts this process, preventing the retrieval of information and the evaluation of its output.
[21][22] 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).
Support for the temporality account suggests that confabulations occur when an individual is unable to place events properly in time.
[18] More recently, a monitoring account for delusion, applied to confabulation, proposed both the inclusion of conscious and unconscious processing.
The other is the conscious, provoked way in which a memory is recalled intentionally by the individual to explain something confusing or unusual.
As a child develops into an adult, there is obvious improvement in the acquisition, retention, and retrieval of both verbatim and gist memory.
Fuzzy-trace Theory, governed by these 5 principles, has proved useful in explaining false memory and generating new predictions about it.
[20] In 2009, theories underlying the causation and mechanisms for confabulation were criticized for their focus on neural processes, which are somewhat unclear, as well as their emphasis on the negativity of false remembering.
Researchers suggest this is due to damage in the posterior cortical regions of the brain, which is a symptom characteristic of Alzheimer's disease.
[35] Researchers have noted that these patients tend to make up delusions on the spot which are often fantastic and become increasingly elaborate with questioning.
[39][40][41] Finally, rupture of the anterior or posterior communicating artery, subarachnoid hemorrhage, and encephalitis are also possible causes of confabulation.
[43][44] Behaviourally spontaneous confabulation may occur in the context of dementia or the Wernicke–Korsakoff syndrome where brain damage is difficult to localise.
[15][5] 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.
[48] Research suggests that this inability to distinguish between past confabulatory and real events is centered on developmental differences in source monitoring.
It may also be that younger children lack the meta-memory processes required to remember confabulated versus non-confabulated events.
[49] 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.
[51][52] Ultimately, misinformation effects can be minimized by tailoring individual interviews to the specific developmental stage, often based on age, of the participant.
[54] One study suggested that spontaneous confabulation may be a result of an amnesic patient's inability to distinguish the chronological order of events in their memory.
In contrast, provoked confabulation may be a compensatory mechanism, in which the patient tries to make up for their memory deficiency by attempting to demonstrate competency in recollection.
[56] 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.
Subtle distortions and intrusions in memory are commonly produced by normal subjects when they remember something poorly.
The basic premise of researching confabulation comprises finding errors and distortions in memory tests of an individual.
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 neuropsychological test battery able to discriminate between the different types of confabulations.
Some researchers suggest that unconscious emotional and motivational processes are potentially just as important as cognitive and memory problems.
Research suggests that confabulation occurs along a continuum of implausibility, bizarreness, content, conviction, preoccupation, and distress, and impact on daily life.