Cole, Scott ORCID:
https://orcid.org/0000-0001-8176-283X, Fotopoulou, Aikaterina,
Oddy, Michael and Moulin, Christopher (2014) Implausible Future
Events in a Confabulating Patient with an Anterior Communicating
Artery Aneurysm. Neurocase, 20 (2). pp. 208-224.
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Past and Future Confabulation

Implausible Future Events in a Confabulating Patient with an Anterior Communicating
Artery Aneurysm
Scott N. Cole1, Aikaterini Fotopoulou3, Michael Oddy2, Christopher J.A. Moulin1
1

Institute of Psychological Science, University of Leeds, UK
2
3

Brain Injury Rehabilitation Trust, UK

Institute of Psychiatry, King’s College London, UK

Published by Taylor & Francis: Scott N. Cole , Aikaterini Fotopoulou , Michael Oddy &
Christopher J. A. Moulin (2013): Implausible future events in a confabulating patient with an
anterior communicating artery aneurysm, Neurocase:The Neural Basis of Cognition,
DOI:10.1080/13554794.2012.741259

keywords: confabulation, episodic future thinking, mental time travel, autobiographical
memory, episodic memory, imagined events
Address for Correspondence:
Scott N. Cole
Institute of Psychological Sciences
University of Leeds
Leeds, UK
LS2 9JT
Tel. +44 (0)113 3439199
Fax. +44 (0) 113 3435749
Email: cole.s.n80@gmail.com

1

Past and Future Confabulation

Abstract
Patient MW, a known confabulator, and healthy age-matched controls produced past and
future events. Events were judged on emotional valence and plausibility characteristics. No
differences in valence were found between MW and controls, although a positive emotional
bias toward the future was observed. Strikingly, MW produced confabulations about future
events that were significantly more implausible than those produced by healthy controls
whereas MW and healthy controls produced past events comparable in plausibility. A
neurocognitive explanation is offered based on differences between remembering and
imagining. Possible implications of this single case in relation to confabulation and mental
time travel are discussed.

2

Past and Future Confabulation

Introduction
A recent focus in human memory research is the overlap between cognitive processes used in
retrieving past events from one’s personal life and the construction of imagined future events.
Neuroimaging and behavioural data suggest that imagining and remembering draw upon
similar brain regions and mental processes (Abraham, Schubotz & von Cramon., 2008; Addis
et al., 2007, 2009; Botzung, Denova & Manning, 2008; D’Argembeau & Van der Linden,
2004; Hassabis, Kumaran & Maguire, 2007a; Okuda et al., 2003; Schacter & Addis, 2007)
and emerges at around 3-5 years of age (see Atance & O’Neill, 2001; Perner & Ruffman,
1995). In the current paper we examine these issues from a neuropsychological viewpoint. In
short, does a patient who re-constructs implausible memories of non-existent past events also
show a similar generation of implausible future events?
The relationship between remembering and imagining has its roots in neuropsychology – for
instance, patients with circumscribed amnesia find it difficult to imagine future events (e.g.
Hassabis, Kumaran, Vann & Maguire, 2007b; patient DB, Klein, Loftus & Kihlstrom, 2002;
patient KC, Tulving, 1985, 2002). Recently, there has been an upsurge in interest in this
relationship in healthy populations, and in particular neuroimaging studies (e.g. Addis et al.,
2007, 2009; Botzung, Denvoka & Manning., 2008; Hassabis, Kumaran & Maguire., 2007a;
Okuda et al., 2003). In these studies, whereby participants are required to reconstruct
autobiographical events or construct novel but plausible future events, a core network has
been delineated. This system covers the medial temporal lobe (in particular, the hippocampal
cortex), posterior cortices and medial prefrontal regions (Abraham, Schubotz, & von Cramon,
2008; Addis, Wong, & Schacter, 2007; Botzung, Denkova, & Manning, 2008; Szpunar,
Watson, & McDermott, 2007), An emerging consensus is that both past and future events

3

Past and Future Confabulation
may be mentally constructed using a common episodic construction system (Addis et al.,
2007; Atance & O’Neill, 2001; Schacter & Addis., 2007; Suddendorf, Addis & Corballis.,
2009) or at the least that imagining future events is heavily reliant on memory (Szpunar &
McDermott, 2008; D’Argembeau & Van der Linden, 2004; Okuda et al, 2003). In particular,
Addis, Schacter and colleagues have focussed on the novel re-combination of episodic details
involved in simulating future events and its commonalities with episodic memory (Addis et
al., 2007, 2009, Schacter & Addis, 2007, constructive episodic simulation hypothesis). One
underexplored question that may be pertinent to these theoretical perspectives is what
happens to imagined future events when the autobiographical memory system becomes
distorted as per confabulation after brain damage. One recent experimental study has found
that confabulators misrecognise more false autobiographical memories and future events as
true, recent memories than non-confabulating amnesics (Fotopoulou et al, 2007a). These
results suggest that the same deficit in reality monitoring may be responsible for
confabulations, irrespective of their temporal source or context.
Interestingly, some researchers have tentatively suggested a link between
remembering and imagining in pathological forms of memory distortion (Dalla Barba,
Cappelletti,, Signorini, & Denes, 1997; Schacter & Addis., 2007). In two notable studies of
confabulation (Dalla Barba et al., 1997, 1999), Dalla Barba and colleagues specifically
assessed future confabulation using a word-cue paradigm and ten questions (e.g. ‘what are
you going to do in a few minutes?) that mirror ten questions referring to the past
(Confabulation Battery, Dalla Barba, 1993a). In both tasks they found that the percentage of
future confabulations was equal to or greater than past confabulations. Intriguingly, a positive
correlation has been demonstrated between past and future confabulation on the word-cue
task (Dalla Barba et al., 1997) and the confabulation battery (Lee et al., 2007). In the current

4

Past and Future Confabulation
paper we emulate this approach but we also aim to compare the qualities of the confabulated
future and past events and particularly their valence and plausibility characteristics.
Overall, there are many instances of patients anticipating unlikely personal events in the
confabulation literature. For example, patients hospitalized for many years confidently insist
they are only visiting for brief observation and need to go to a meeting; and in some extreme
cases act upon these false beliefs (e.g. Fotopoulou, Solms & Turnbull., 2004; Schnider, von
Daniken & Gutbrod, 1996; Talland, 1961). These often mirror the character of plausible past
confabulations, in the sense that one can trace a relation between the confabulated future
event and events that occurred in the patient’s pre-injury life. To explain these observations
and to contextualise our case study, we shall now describe strategic retrieval, source
monitoring, temporality and motivational explanations of confabulation.
Strategic retrieval can be defined as higher-level effortful memory processes which
consist of searching and retrieving details from long-term memory and monitoring their
relevance based on task demands (Conway, 2005; Moscovitch, 1989; Moscovitch & Melo,
1997). To date, several authors have argued that confabulation arises out of disruption to
strategic retrieval processes (Burgess & Shallice, 1996; Gilboa, Alain, Stuss, Melo, Miller, &
Moscovitch, 2006; Moscovitch & Melo, 1997). Supporting evidence for this view comes
from the fact that confabulations are equally likely to concern post-injury events as they are
distant pre-injury events (implicating retrieval, not encoding). Furthermore, a combination of
deficits affecting memory and executive function, typically found in confabulating patients,
are seen as critical in the disruption of retrieval processes which lead to confabulatory
behaviour (Gilboa et al., 2006).
A line of research particularly relevant to this study is source monitoring - the ability
to reflect upon and accurately determine the origin of stored representations (Johnson,

5

Past and Future Confabulation
Hashtroudi & Lindsay, 1993). A critical aspect of source monitoring involves distinguishing
between internally generated mental experiences (e.g. daydreams, imagined scenarios) and
perceptions derived from external sources (cf. reality monitoring; Johnson & Raye, 1981;
Johnson, 1991; Johnson, Hashtroudi & Lindsay, 1993). Importantly, errors of reality
monitoring resulting from brain damage, such as confusing previous thoughts with actual past
experiences, can lead to confabulatory behaviour (i.e., Johnson, 1991; Johnson, Hayes,
D’Esposito & Raye., 2000). However, to date, reality monitoring accounts of confabulation
have focussed on how impaired reality monitoring can lead to distortions of the past, rather
than the future (Johnson, 1991; Johnson et al., 2000; see also Turner, Cipolotti & Shallice,
2010). Under the Multiple-Entry Modular memory framework (Johnson, 1991) a
neurocognitive system was delineated which consists of perceptual and reflective processes.
Reflective processes may include using metamemory ‘heuristics’ (e.g. ‘I know it is a memory
as it is more perceptually rich than an imagined event’ see Johnson, Foley, Suengas & Raye.,
1988) as well as judgements of the memory’s internal consistency and plausibility. Of interest
here, confabulation could represent a disruption of reflective source monitoring processes
(Johnson, 1991). Such reality monitoring processes could apply to future events in the same
way as for personal memories and the same underlying source monitoring mechanism could
underlie remembering the past and imagining the future (Johnson & Sherman, 1990).
Dalla Barba (2002) suggests that confabulation affects all levels of subjective temporality
(past, present and future). Unlike dense amnesic patients, his patients were aware of their
own subjective temporality (e.g. patient G.A, Dalla Barba et al., 1997). However this
invariably corresponded to the patient’s life prior to brain injury as opposed to a reality that
was currently relevant. In this version of temporality theory, confabulators have a distorted
rather than non-existent subjective temporality (see Schnider., 2003 for another variation).
Williams & Rupp (1938) stated that ‘never has the confabulation been a pure fiction
6

Past and Future Confabulation
emanating from the imagination. Much of the vividness of the confabulation arises from the
juxtaposition in time of a colourful past contrasted with an uneventful present, and when
viewed in its proper time sequence, much of its colour is lost’ (p. 401). Following this view,
temporal confusion theories can account for both apparently fantastic and non-fantastic
confabulations and may explain why some confabulators have an inaccurate view of their
past, present and future (e.g. Dalla Barba et al., 1997).
An alternative view that may account for personal biases in confabulation is that of
the Self Memory System (Conway & Pleydell-Pearce, 2000; Conway, 2005) whereby
autobiographical memory forms the basis for understanding the self. The importance of
motivational aspects of confabulation is demonstrated by the inclusion of personal biases in
several recent cognitive formulations of confabulation (see Gilboa et al., 2006; Metcalf,
Langdon & Coltheart., 2007; Fotopoulou et al., 2007b, 2008). Several experimental studies
provide support for the role of the self in autobiographical memories (Rathbone et al., 2008,
2009) and future events (Rathbone et al., 2011). Recent evidence examining how the contents
of long term memory are sampled to imagine future events (Szpunar & McDermott, 2008)
indicates that inaccurate future plans could reflect distorted autobiographical memories. The
present or ‘working self’- that dynamically evaluates autobiographical knowledge in relation
to current goals- may also have an influence in how future selves are envisaged (Conway,
Pleydell-Pearce, Whitecross, & Sharpe, 2003; Conway, 2005): Distorted or idealised working
self mental models, therefore, could determine the plausibility (or implausibility) of
confabulated future events (see Conway & Taachi, 1996 for a case example).
Indeed, a key concept in the study of confabulation is plausibility and this has been used to
describe and categorize earlier (Berlyne, 1972; Talland, 1961) and recent (Metcalf, Langdon
& Coltheart, 2007) observations of the disorder. Plausible confabulations are typically
grounded in the patient’s pre-morbid habits and lifestyle. Patients often produce a variety of
7

Past and Future Confabulation
reports that reflect this, including underestimating the current year (e.g. patient GT, Berlyne,
1972) and claiming they have recently seen loved ones (e.g. patient SD, Metcalf et al., 2007;
patient MB, Dalla Barba, 1993b) or had been performing household tasks (e.g. patient GA,
Dalla Barba et al., 1997). Most notably these consist of contextual errors that are derived
from genuinely experienced events. Implausible confabulations are narratives that are
qualitatively different from the patient’s actual memories or are generally bizarre or
improbable. Descriptions of implausible confabulations can be traced back to Korsakoff’s
initial clinical observations (Korsakoff, 1889/1996). There are several examples of highly
implausible confabulations resulting from neurological damage. Dalla Barba described a
patient who, when asked about a previous trip to the cinema, claimed he had met a famous
Italian TV host (Dalla Barba, 1993a) and Kopelman, Ng & Van den Brouke, (1997)
described a patient who described her own wedding even though she was unmarried. This
notion of confabulation resembles ‘fantastic’ confabulation characterised by Berlyne (1972)
which has been linked specifically with frontal lobe damage (Kopelman, 1987). There are
more examples of this type in the confabulation literature (e.g. patient E.S., Fotopoulou et al.,
2004; patient A.B., Kopelman et al., 1997), but there are far fewer patients in general who
consistently produce florid or fantastic confabulations. The bizarre content is often produced
in severe and acute cases of neurogenic confabulation, although long term confabulators
similar to the one reported here, have also been documented (Schnider, Ptak, von Daniken &
Remonda, 2000).
Despite its usefulness as a concept, some hold reservations over plausibility as a reliable
measure. This is largely because classifying an account as implausible or bizarre typically
relies upon subjective judgements which may be affected by preconceptions held by the
researcher (Kopelman, Ng & Van den Brouke, 1997; Johnson et al., 2000). Also, confusion
arises in the interpretation of what can be defined as an implausible confabulation. Some
8

Past and Future Confabulation
confabulations can be internally consistent and probable but dramatically inconsistent with an
individual’s autobiography (e.g. patient GA, Dalla Barba et al., 1997). On the other hand,
they can be generally improbable and clearly false (e.g. ‘my dead friend is in New York’, ‘I
went to have afternoon tea on Mars’). In this study, to overcome these limitations, we used a
clear conceptual definition of general plausibility which independent judges used to rate
statements (see Method and Appendix A). This definition, adapted from Scoboria Mazzoni,
Kirsch & Relyea (2004), specified a plausible event as one that could have occurred or has
the potential to occur to people in general. To our knowledge, this case study is the first in the
confabulation literature to formally assess plausibility and may provide a novel characteristic
with which researchers can assess past and future confabulation.
In sum, the current study attempted to directly assess the plausibility of
confabulations produced by a known confabulator. Furthermore, this measure was utilised to
assess quantitative differences between past and future events produced by a confabulator and
five healthy age-matched controls. If there are overlapping processes in the remembering of
past events and the imagining of future events, we might expect to observe equally
implausible events produced for the past as for the future. If confabulation results from
temporal confusion or dysfunctional retrieval monitoring then it would seem to be a deficit
which would equally affect future and past events. To address these issues we used a wordcue paradigm (Crovitz & Shiffman, 1974) to elicit past and future personal events to explore
these issues with a persistent confabulator, MW. Considering the relevance of emotional
valence in confabulation (Fotopoulou, Solms & Turnbull., 2004; Fotopoulou, 2010), we also
assessed whether MW’s events were more positive than controls’ and attempted to replicate
the positive emotional bias for future versus past events (e.g. Berntsen & Jacobsen, 2008;
Newby-Clark & Ross, 2003).

9

Past and Future Confabulation

Patient MW
Case Description
MW, a right-handed 63-year old man, had a long career in the Police Force and
became a Detective Chief Inspector in the late 1980s. He had no known psychiatric history.
There was no evidence of ‘tale spinning’ before the onset of his injury, and he was described
as a charismatic and well-respected man, according to his wife and a former colleague. In
October, 1990 he was found unconscious by his wife. After hospital admission, a CT scan
indicated a ruptured aneurysm of the anterior communicating artery. The aneurysm was
clipped, but MW suffered a vasospasm five days later, occluding blood flow and resulting in
a severe frontal lobe infarction. During subsequent months in the post-operative period,
clinical notes indicated he was ‘profoundly disoriented in time and place’ and spontaneously
confabulated. Confabulatory behaviour is not uncommon in the period after an anterior
communicating artery aneurysm (Metcalf, Langdon & Coltheart, 2007).
He was discharged to his wife soon after but needed continual care. In the acute stage,
medical notes indicated that MW reported visual hallucinations of ‘spiders coming out of the
skirting board’. Later, MW described these earlier experiences to us with emotional distance
and objectivity. Clinical reports described him as socially disinhibited (e.g. telling
inappropriate jokes), impulsive, with problems in planning. For these reasons and due to
some episodes of verbal aggression, MW attended a rehabilitation unit for several years until
entering supervised community accommodation.
Confabulation in Everyday Life

10

Past and Future Confabulation
MW’s confabulations continued from the time of injury through to when our main
assessments took place 17 years post-injury. His confabulations were momentary and
spontaneous (Berlyne, 1972). According to carers, MW would confabulate about past
happenings and future plans at a rate of approximately 5 per day. For example, MW would
claim he had seen a famous person when visiting town that day despite being supervised by
the carer the entire time. On one occasion, his wife recalled an incident in which MW said he
had ‘received a message’ that a close friend had died. However, she was aghast to see the
friend in question on the high street the week after, especially as she had already sent the
condolence letter. MW would also tell rehabilitation staff future plans that were patently false
(e.g. ‘I’m going on that quiz next month’), sometimes specifying the date when they would
occur, similar to other cases reported by Dalla Barba and colleagues (1997, 1999).
Neuropsychological Evaluation
MW’s scores on a range of standardised psychometric tests can be seen in Table 1. MW was
well oriented to his surroundings and had a Full Scale IQ of 102 on the Wechsler Adult
Intelligence Scale (WAIS III; Wechsler, 1997a). Across the subtests of anterograde memory,
MW scores were normal or below average (e.g. visual immediate memory), with a
significantly reduced Memory Index (84, Wechsler Memory Scale III, 1997b) compared with
his normal Verbal Intelligence Score (114) which reached significance at the .01 level.
Interestingly, most of his memory scores were reduced by intra-list and extra-list intrusions
(often seen as confabulation-like behaviour, e.g. Dalla Barba, 1993b; Fotopoulou et al., 2004;
Kopelman et al., 1997; Schnider et al., 1996). In addition, MW had difficulty with memory
tests associated with executive function such as the backward digit span (Standard Score=8,
25th %ile). In tests designed to assess executive function, MW was impaired on the
Wisconsin Card Sorting Test (WCST; Heaton, 1993), Brixton Test (Burgess & Shallice,
1997) and several subtests of the BADS (Wilson et al., 1996).
11

Past and Future Confabulation
(Insert Table 1 about here)

Autobiographical Memory Interview
We administered the Autobiographical Memory Interview (Kopelman, Wilson & Baddeley,
1990). MW’s retrograde memory was characterised by errors of commission, not omission:
all MW erroneous responses about his personal past were confabulatory. To assess the
veridicality of his responses, a transcription of the interview was sent to his wife. She
classified his responses as either confabulations or accurate memories, although all responses
were given with apparent confidence in their accuracy. A greater amount of memories were
retrieved from childhood and early adulthood and conversely a greater amount of
confabulations were produced for more recent time periods (Childhood: personal semantic=
10%, autobiographical incidents= 33%; Early adulthood; personal semantic = 20%,
autobiographical incidents= 45% Recent life: personal Semantic= 33%, autobiographical
incidents= 44%). In terms of confabulations not tied to a specific episode, when asked what
qualifications he gained, he stated ‘four; GCEs in History, English, Biology, Metalwork’ (his
wife confirmed that MW gained none of these). In terms of autobiographical events, MW
either produced repeated confabulations that happened to another individual (He would
repeatedly re-tell a story of seeing a Lion after a day shift even though he heard this had
happened to a friend) or events grounded in an accurate personal context with confabulatory
detail. These mirrored the confabulations he produced in everyday life.
Confabulation Battery
To assess his confabulations more formally, the Confabulation Battery (Dalla Barba, 1993a)
modified for English speakers (Kopelman et al., 1997) was administered which consisted of

12

Past and Future Confabulation
seven sections including two Don’t Know (DK) sections in which answers are generally
unknown (e.g. How many Renault cars were sold in 1985?) which assesses the general
propensity to fill gaps with confabulatory responses in the absence of a correct answer. We
also included the ‘Future Episodic’ section used previously (Dalla Barba et al., 1997, 1999).
All responses were transcribed and coded according to Dalla Barba’s criteria (all responses
except ‘don’t know’ were classed as confabulations in Don’t Know sections). A copy of the
transcript was also sent to MW’s wife. To corroborate MW’s responses the first author
consulted rehabilitation staff, medical notes and the transcript returned by MW’s wife.
Consistent with his performance on the AMI, MW produced false memories on both the
Personal Semantic (15%) and Episodic (33%) sections. In the Episodic Section, when asked
his recollection of Princess Diana’s death, his response was: “actually, I got up and switched
the TV on and I couldn’t believe what I was seeing because I had protected her the year
before” [actually he had guarded her but before 1990, not in 1996]. It appears that these
confidently held beliefs were derived from directly experienced happenings or heard of
events. None of the confabulations in these tests could be defined as ‘semantically
anomalous’ (Dalla Barba, 1993b) or ‘fantastic’ (Berlyne, 1972). In the Future Episodic
Section, MW produced plausible future incidents (as confirmed by his wife who gave ‘7’
(‘extremely plausible’) ratings for all his responses), and MW said ‘don’t know’ when he was
unsure of his future plan.
Summary
In short, MW retained average intellectual function for his age but showed clear executive
deficits and scored slightly below average on tests of memory function, demonstrating some
evidence of confabulatory behaviour under formal testing. MW’s test scores on the AMI and
Confabulation Battery confirmed a pattern of responses indicative of a confabulating patient.

13

Past and Future Confabulation

Past – Future Word Cue Task
Overview of Methods
We administered MW and controls an adapted version of a standard cue-word task (Crovitz
& Schiffman, 1974) to elicit (a) eight specific personal memories and (b) sixteen specific
plausible, semantically and autobiographically, i.e. in the context of his life, future events.
Considering the data amassed regarding MW’s confabulatory behaviour related to past
events, we decided to double the amount of cues for the future condition to allow a greater
understanding of his potential future confabulations. We subsequently asked three
independent and naive judges to assess the plausibility and valence of event protocols
originating from MW and five non-confabulating controls. We also asked MW for subjective
confidence ratings of his own ‘future events’ and subjective ranking of half of them (those
produced in the first week of the Past-Future Word Cue Task) in terms of plausibility.
Transcriptions of MW’s confabulations were sent to his wife to calculate the frequency of
confabulation in each temporal direction. Details of these methods are presented below.
Control Participants
In total, five healthy aged participants (2 male) comparable in age (Mean=69.4, SD=4.56,
Range = 63-75; MW=63), and intellect (National Adult Reading Test; Mean=42.4, SD=2.97;
MW=41) to MW were recruited from the Institute of Psychological Sciences Older Adult
Participant Panel and gave written informed consent in accordance with Institute ethical
procedures. Participants from the control group had no significant psychological or
neurological disorders and all achieved high Mini Mental State Examination (Folstein,
Folstein & McHugh, 1975) scores of 29 including MW. Each participant completed past and
future components of a Past-Future Word Cue Task.

14

Past and Future Confabulation
Materials
The same eight common nouns (train, market, money, cinema, hospital, letter, mountain,
restaurant) as Dalla Barba et al (1997, 1999) were used for past and future events in addition
to a further 8 nouns (house, garden, bar, book, car, gift, bicycle, seaside) which were
appended to the list of future event cues. Words were presented in large black type on
separate size A5 white cards.
Procedure
Participants were asked to recall plausible personal past events or imagine plausible
future events, which were unique in time and place and lasted no longer than a day. In the
future condition, participants were instructed to imagine and describe specific events they
envisage to plausibly happen in their personal future. All participants performed this task
individually in a quiet environment. To illustrate the specificity required, participants were
given an example of a general and specific past and future event. Participants were allowed to
describe events from any temporal period (recent or remote) and tasks in both conditions
were participant-paced. To allow participants a chance to practice, two practice trials were
provided (using the words ‘farm’ and ‘police station’). If participants understood the task,
they were presented with each cue card separately from the experiment proper and asked to
describe a past or future event related with that word. If participants appeared to struggle to
bring to mind an event, the experimenter encouraged participants to produce events related to
autobiographical life-time periods (e.g. school days for past, retirement/travelling for future).
Participants were given up to two prompts of the nature ‘that’s fine but can you imagine a
specific incident related to that situation?’ to encourage specific descriptions. Prompts were
only given until a coherent event was produced or until both prompts were used. All cue
words were presented in a pseudo-random order using an online randomiser tool (Urbaniak &

15

Past and Future Confabulation
Plous, 2007). The order of conditions was not counterbalanced, because of the single case
design: Participants always started with the ‘memory’ condition. To avoid fatigue and
concentration problems, MW was tested in two sessions (eight past and eight future cues
presented in Session 1; an additional eight future cues presented in session 2), conducted one
week apart. All control participants were tested in a single interview.
Subjective Ratings
To assess MW’s subjective experience of the events, two measures were taken.
Firstly, after each event description, MW was asked to rate how confidently he thought the
events did happen or would happen in the future (1-7, 1 =no confidence, 7 = extremely
confident). Secondly, considering only his future events, in the second session, he was
represented with 8/16 of his future events on separate cards (arranged randomly on the
interview table) and asked to rank them in order of general plausibility (i.e. the likelihood that
the event could happen to someone in general). This was included because a rigid adherence
toward his implausible future events may indicate a more sever disorder concerning MW’s
ongoing perceptions about his future. On the other hand, acknowledging the improbability of
his future events would indicate a moderate disorder limited to wilful event generation.
Corroboration of MW’s Responses
Transcriptions of MW’s confabulations were sent to his wife to calculate the frequency of
confabulation in each temporal direction. Past events were classed as confabulations if they
were incorrect in content or context (or both). Partial errors and inconsistencies were not
classed as confabulations. Future confabulations were defined as events unlikely to occur to
MW personally considering his probable future activities (see Dalla Barba et al., 1997).
Judges’ Plausibility and Valence Scoring

16

Past and Future Confabulation
A questionnaire was constructed containing all of MW’s statements and a randomly selected
subset from the five controls participants (10 past, 20 future). Specifically, two events from
each control participant were included in the past section (30 total ratings) and four from each
control in the future section (60 total ratings). Statements were randomly intermixed and
presented in two parts (past, future; same order for each judge).
Three judges were selected who were all postgraduate students at the University of Leeds.
Judges were unaware that any statement originated from neurological patient/s and were
blind to the hypotheses of the study. They were told they would be required to rate a series of
statements oriented toward either the past or the future. Judges were told that each statement
was from a different individual and had to rate each statement separately (any common
information such as location was removed so that judges would not link the origin of
statements via inter-event consistency).
To assess the qualities of statements, each judge rated each on a continuous 1-7 scale for
event plausibility (1=extremely implausible, 7=extremely plausible) and valence (1=negative,
4=neutral, 7=positive). The definition of plausibility was based on Scoboria et al’s (2004)
definition of general plausibility. That is, the likelihood that an event will occur in the general
population. This can be dissociated from personal plausibility: The likelihood a certain event
could have or will occur to oneself (Scoboria et al., 2004). In line with procedures defined by
Fotopoulou et al (2007b), valence was rated in terms of the self-representation described in
each statement. See Appendix A for scorer instructions for both scales

Results
Inter-rater Reliability
17

Past and Future Confabulation
Intraclass correlations (one-way random effects) calculated for both measures indicated a
moderate to high inter-rater reliability between the three judges (Valence: + .62; Plausibility:
+.82). Although inconsistency did exist in that a small proportion of statements rated on
opposite sides of the mid-point of each scale by different judges (plausibility, .15; valence,
.15), in these circumstances the mean difference between ratings was only 2.9. Furthermore,
no statement was rated on opposite extremes of either scale (i.e. 1 and 7).
Event Production and Corroboration Scores
On average, healthy controls produced 7.8 (SD=0.5) past events and 14.6 (SD=1.1) future
events. MW produced 7 past events (z score = -1.6) and 16 future events (z score = 1.3). In
terms of confabulation frequency, MW’s wife identified as confabulations fewer past events
(57%) than future events (95%).

Qualities of Past and Future Events
Judges’ ratings of Plausibility of Past and Future Events
The different pattern in ratings associated with the past and future statements produced by
MW and controls are illustrated in the frequency distributions presented in Table 2. To
illustrate the type of events produced by MW, a sample of representative past and future
events are presented in Appendix B. To explore whether MW’s mean plausibility rating
differed significantly from the control group, two modified t-tests for single case designs
were conducted separately for past and future events (Crawford & Garthwaite, 2002). This
method is preferable to z scores as it uses a t distribution based on the control statistics rather
than estimated population parameters (Crawford & Garthwaite, 2002). Furthermore, to
provide more conservative probability estimates of MW’s performance, two-tailed (rather
than one-tailed) tests were applied. This analysis showed that past events produced by
controls and MW did not differ in their plausibility, t(4)= -0.29, p = .79 [z score = -.31] (see
18

Past and Future Confabulation
Table 3 for mean and SD results). When MW’s responses were split into confabulations and
true memories (4 confabulations, 3 corroborated events), only confabulated events differed
somewhat from past events produced by healthy controls, but this difference was not
significant as assessed by this small number of events (confabulations, M=3.5, SD=1.8, z = 1.13, t(4) = -0.91, p = .41; verified, M=6.0, SD=0.9, z = .56, t(4) = 0.51, p = .64, Crawford &
Garthwaite (2002)’s t-test).
(Insert Table 2 about here)
(Insert table 3 about here)
For future events, MW’s statements were significantly less plausible than those produced by
controls, t(4) = -3.65, p < .05, two-tailed [z score = -4.0]. Although around 85% of MW’s
future events were rated on the implausible side of the scale, this was only the case for 3% of
all events produced by controls. Subdividing future events into plausible and implausible
events as judged by MW’s spouse (providing an analogue to the analysis with past events)
was unfeasible as only 1/16 of these was classed as personally likely (‘Most likely to happen
to me in the future is that I’ll go into hospital and probably die there’).
It was also optimal to directly assess whether the difference in plausibility between MW’s
past and future events was statistically significant. Following the recommendations for testing
for dissociations between two tasks in single case studies when the N of the control group is
small, the Bayesian Standardized Difference Test was applied (Crawford, Garthwaite &
Howell, 2009). This test showed that the difference in MW’s scores could be classed as a
classic dissociation (p < .05) as a difference was exhibited in the future but not past condition
(verifying the above analyses) and there was a sufficiently large standardized difference
between the past and future when compared with the control sample scores. Furthermore, it

19

Past and Future Confabulation
was estimated that 1.3% (95% CI, 0.00 – 13.8) of the normal population would be expected
to exhibit a greater degree of dissociation between past and future scores than MW.
Judges’ ratings of Valence of Past and Future Events
Two separate, modified t-tests were also calculated for emotional valence (Crawford &
Garthwaite, 2002). These indicated no significant differences between the emotional valence
of MWs events compared to the control group for past [t(4) = -0.43, p = .69] or future
statements [t(4) = 0.30, p = .78]. These findings were confirmed when z scores were
computed for past (z = -.47) and future (z = .33) events, showing only small deviations from
the sample means. Dividing MW’s past events into accurate and confabulatory responses led
to similarly non-significant findings (confabulations, M=3.2, SD=1.5, t(4) = -0.55, p = .61;
verified, M=3.8, SD=2.3, t(4) = -0.23, p = .83, Crawford & Garthwaite (2002)’s t-test). The
Bayesian Standardized Difference Test showed that the pattern of MW’s valence ratings
could not be defined as a dissociation (p = .56) with an estimated 28% (95% CI, 5.2% - 62.8)
of the population exhibiting a greater past-future discrepancy than MW.
As can be observed in Appendix B, many of MW’s future events rated as implausible were
prima facie wishful. To explore the emotional characteristics of his future confabulations, a
correlation between emotional valence and plausibility ratings (on MW’s 48 future event
ratings) was conducted. This revealed a significant relationship between valence and
plausibility such that implausible future events were more likely to be given positive ratings,
Spearman’s r = -.37, p < .01. This was not the case however for healthy controls,
Spearman’s r = -.20, p = .14.
Generally, results indicated that past events were rated around the neutral scale point (MW
and controls combined, M=3.86, SD=1.82; 95% confidence intervals, 3.35 - 3.38), whereas
future events were rated as somewhat positive (MW and controls combined, M=4.90,
20

Past and Future Confabulation
SD=1.26; 95% confidence intervals, 4.66 - 5.14). Thus some evidence demonstrating a
positivity bias was found for future versus past events for MW and healthy controls (see
Table 3).
Subjective Awareness
Confidence in Past and Future Events
Following each event description, MW was asked to report the extent to which he believed
the event occurred in his personal past and to what extent he believed each future event was
likely to occur some time in the future. On a scale from 1-7 (1 indicating no confidence, 7
indicating certainty), MW responded 7 to all his past and future events. These ratings
reflected the confident tone with which MW described past and future events.
Perception of Future Events
Although independent ratings were analysed, it was also important to gain an understanding
of the future events from MW’s perspective. In contrast to immediate responses made after
each event, when asked to rank the events in terms of plausibility, MW placed 75% of his
own future events (6/8) on one side of the table and stated that they were implausible. He
then indicated that only two imaginings were plausible, i.e. ‘Most likely to happen to me in
the future is that I’ll go into hospital and probably die there.’ and ‘Trains will become
supersonic [SNC: where will you be?] I will be flying one.’: The former example coinciding
with his wife’s categorisation of this future event as personally plausible and the latter
example was clearly personally and generally implausible. MW therefore correctly identified
one plausible future event from 7 options. Interestingly, he also stated that many events were
‘merely wishful’. When the researcher asked directly whether his future events were a ‘wish,

21

Past and Future Confabulation
dream or desire’, MW answered ‘Yes’ in response to all future events except: ‘I will most
likely die in hospital’1.

22

Past and Future Confabulation

Discussion
Neuropsychological investigations have found parallel deficits in episodic future thinking and
episodic memory (e.g. Hassabis et al., 2007b; Levine et al., 1998; Tulving, 1985, 2000). The
current investigation focussed on the distortion of mental time travel into the past and future
in a known confabulator. Patient MW persistently confabulates in everyday life after
suffering prefrontal damage (verified by neuropsychological and medical data). On testing,
MW confabulated across all domains of autobiographical knowledge (except for orientation
to the present), but performed normally on tests of general semantic knowledge and
intelligence. When asked to generate past and future events in a cue-word paradigm, a
positive bias was found; future events were more emotionally positive than past events. This
finding was consistent across MW and controls. However, MW’s future (but not past) events
were dramatically more implausible than those produced by age-matched healthy controls.
The theoretical implications in relation to confabulation and mental time travel are discussed.
Turning first to emotional valence, it is noteworthy that the current study replicated a
common finding in the mental time travel literature. That is, although past and future events
are generally positive, future events display an additional positive bias (Berntsen & Jacobsen,
2008; Newby-Clark & Ross, 2003). Furthermore, Newby-Clark & Ross (2003) found that
individuals take longer to generate negative (versus positive) future happenings, whereas
latencies for positive and negative past events were equivalent. In the current study, a positive
future bias was demonstrated across the valence ratings for healthy controls and MW. Even
though this study used independent valence ratings, it further demonstrates the human
tendency toward perceiving the future as favourable, positive or even idealised (Newby-Clark
& Ross, 2003)2.

23

Past and Future Confabulation
Considering recent formulations of episodic memory, can the present findings regarding
plausibility be interpreted in the context of the constructive episodic simulation hypothesis
(Schacter & Addis, 2007), which assumes that the generation of past and future events relies
on a core neuro-cognitive network (see Addis, Wong & Schacter, 2007)? Intriguingly, the
fact that temporal direction (past or future) determined the plausibility of MW’s statements
suggests that future event construction may be more sensitive than episodic memory to
damage extending to the prefrontal lobes. Taking a broader perspective, this difference might
be explained by specific differences between episodic memory and episodic future thinking.
Namely, although episodic memory does not represent an exact mental replay of experience
(Bartlett, 1932; Schacter & Addis, 2007), memory retrieval has a single ‘destination’: That is,
a memory search is conducted to elicit a single experienced event which is re-activated at
retrieval (Moscovitch et al., 2005). Future event construction is more flexible: The future has
not happened and multiple permutations can be envisaged. This makes classifying
confabulations concerning a future especially difficult as judgements must depend on
likelihood rather than memorial evidence (see below for further discussion).
In support of this idea, in a recent fMRI study, Addis et al. (2009) found that flexibly
combining details into a novel event was associated with greater activity in the medial PFC
and anterior hippocampus when contrasted with remembering a personal event. This
replicated previous findings which associated future thinking with additional activity in
prefrontal regions (Addis, Wong & Schacter, 2007; Okuda et al., 2003). Although mnemonic
details are sampled when constructing the future, it is most likely the intensive combination
of details that place additional demands upon executive processes. Subsequently, differential
activity in prefrontal regions has been attributed to processes specific to imagination rather
than prospection per se (Addis et al., 2009). As a result of using additional executive
resources, imagined events often take longer to generate and result in less specific
24

Past and Future Confabulation
representations (Conway, Pleydell-Pearce, Whitecross, & Sharp, 2003; D'Argembeau & Van
der Linden, 2004; Anderson & Dewhurst, 2009). Thus, where executive processes are limited
in MW, it is possible that the additional reconstruction processes may disproportionately
reduce monitoring of future events (although still affecting past event monitoring to a
moderate extent), hence why less plausible events were observed when they were imagined in
the future rather than remembered. The contrasting plausibility of MW’s past and future
events may reflect specific differences between processes involved in remembering and
imagining events. Of course, semantic memory may also have a role in generating and
monitoring past and future-oriented thoughts (see Klein, Loftus & Kihlstrom, 2002).
However, a satisfactory examination of differences between episodic and semantic thoughts
about the past and future (in healthy and brain damaged populations) was beyond the scope
of this paper.
The temporality account described by Dalla Barba and colleagues (1997) implies that
confabulation can affect past, present and future. MW’s pattern of responses appears
concordant with this view. In particular, his claim to have protected Princess Diana on the
AMI was derived from MW’s actual experience as a police officer but was temporally
displaced by around 7 years. However, several points counter the view that all temporal
domains are similarly affected by confabulation. MW confabulated when asked about his
personal past and future (on the Confabulation Battery and Cue-word Task), but provided an
accurate account of his present circumstances (orientation sections of Confabulation Battery
and RBMT). Also, in a recent study of Alzheimer’s patients, past and future confabulations
correlated positively, whereas present orientation failed to correlate with either (Lee et al.,
2007). Thus, there may be differences between present orientation and other forms of
subjective time which involve mental time travel (Tulving, 1985).

25

Past and Future Confabulation
The case described here is more consistent with a deficient executive function explanation of
confabulatory behaviour as MW demonstrated clear impairments on classic tests of executive
function (e.g. WCST, see Table 1) and displayed everyday behaviours (see DEX scores) and
a pathology consistent with a dysexecutive syndrome. Furthermore, MW failed to display
florid confabulations on memory tests with greater experimenter-cues (e.g. Confabulation
Battery), which was in stark contrast to his responses on word-cue tasks in which strategic
searches are self-guided: In the Cue-word task MW produced 57% past and 95% future
confabulations compared with a 30% for the Autobiographical Memory Interview and
Confabulation Battery, as verified by his wife and rehabilitation staff. Therefore the data
presented here lends itself to an explanation of confabulation by which strategic retrieval
dysfunction (Burgess & Shallice, 1996; Gilboa et al., 2006; Metcalf et al., 2007; Moscovitch
& Melo, 1997) leads to errors in distinguishing the sources of mental representations
(Johnson, 1991; Johnson et al., 2000; Turner et al., 2010). In fact, bizarre or fantastic
confabulations are associated with disruption of the executive reflective component of source
monitoring (Johnson, 1991). In Johnson’s words, ‘without the past and the reality-checking
processes that evaluate imagined futures against the backdrop of the past people could make
up and visualise any future’ (p. 514, Johnson, 1990). This is consistent with the idea of a
mechanism of deficient reality checking underlying confabulation which normally constrains
and monitors images the future.
Although MW’s fantastic future simulations did not differ in valence from the similar
productions of controls, both were positive in valence. A range of research indicates that
confabulation can be modulated by motivation (Conway & Taachi, 1996; Fotopoulou et al.,
2004; 2007b; 2008; 2010). According to the affective impulsivity hypothesis (see Fotopoulou,
2008; 2010), false constructions become self-enhancing as a consequence of reduced
executive control over confabulatory content. This hypothesis offers an explanation of the

26

Past and Future Confabulation
positive emotional bias observed in confabulatory content compared with responses derived
from non-confabulators (e.g. Fotopoulou et al, 2004; 2007a & b) and, specifically, why
MW’s more implausible future events were more likely to be emotionally positive. Although
the case presented here did not replicate the particular emotional bias found in these studies
because there was not a difference between MW and controls, some of the repeated
confabulations of MW seem consistent with this hypothesis. The majority of MW’s future
events were characterised by holding powerful positions (e.g. owning a bicycle shop, Mount
Kilimanjaro, and a beach resort, see Appendix B). It is possible that a lack of cognitive
control increased the prevalence of wished-for, implausible future events. Furthermore, the
cognitive bias toward wished-for events could have resulted from MW’s distorted working
self model (see Conway, 2005) of unrealistic, limitless possibilities. Several researchers have
acknowledged the relation between confabulations and personal biases (Metcalf et al., 2007),
habits (Dalla Barba, 2002) or goals/wishes (Conway & Taachi, 1996; Conway, 2005). In
MW, it was speculated that the relatively rare (implausible) distortions of past and future
produced by MW may have represented MW’s underlying pattern of preferences and
personal goals.
Some apparent paradoxical findings in terms of MWs future statements deserve attention.
The fact that MW probably retained knowledge of the task instructions throughout testing
sessions (on commencing the second testing session, MW was asked to tell the experimenter
the instructions of the future event task. He responded “you want me to give you some details
of the future which are plausible” (verbatim)), and indeed accurately described his future
events as ‘merely wishful’ - whilst being unable to produce more than one plausible future
event - may appear somewhat surprising. However, it is plausible that MW could not apply
that awareness specifically at the time of event construction. Firstly, it is largely agreed that
confabulation is beyond conscious manipulation but is a by-product of reduced cognitive
27

Past and Future Confabulation
control at retrieval (Conway, 2005; Moscovitch & Melo, 1997): As such, the concept of
confabulation as ‘lying’ or filling gaps in memory have been largely discarded (see
Schneider, 2008 for a review). Secondly, a recent study which explored patterns of eventrelated potentials in a group of confabulating amnesic patients indicated an early top-down
monitoring process beyond conscious awareness (Gilboa, Alain, He, Stuss & Moscovitch,
2009). Lastly, if MWs confabulations were conscious ‘lies’ or fabrications, MW would have
remained consistent in this lie throughout testing (e.g. repeating his fantastical plans) but this
was not the case. According to Crosson and colleagues (1989) it is possible to have
intellectual awareness (the knowledge that one has certain aberrant behaviours associated
with organic deficits) without awareness of a deficit when it occurs. Similarly, with reference
to the Multiple-Entry Modular framework (Johnson, 1991), MW’s confabulatory deficit may
be traced to a dysfunction of habitual reflective processes (i.e. mistaking wishful thoughts or
intentions for likely future events) which was not correctly rectified by reflective processes
typically under wilful executive control. In a particular way though, presenting MW with a
set of his own future plans caused recognition of their implausible content. In this context,
MW may have had an abstract awareness of his confabulations, without an ability to apply
this to his confabulatory behaviour spontaneously. A possible avenue for researchers of
confabulation might be to elucidate if confabulators are necessarily unaware of their false
accounts, memory defects and the other disorders.
In this case study of ‘future confabulation’ we chose a dimension – general plausibility – to
distinguish MW’s future events from controls. This proved useful as a marker of
confabulation as future events could not be verified by relatives/rehabilitation staff as with
memories. Also, it is acknowledged there is some circularity in considering implausible
future events confabulatory per se and that plausibility is orthogonal to the clear
classifications that can be obtained for past confabulations (see also Berryhill et al., 2010).
28

Past and Future Confabulation
There are of course other ways in which confabulations could be conceptualised apart from
their general plausibility and it may be interesting to explore its link with personal plausibility
as Scoboria and colleagues (2004) had done in healthy adults. We would encourage the
consideration of a coherent and reliable method of distinguishing confabulated from plausible
future events.
In conclusion, MW’s case provides an interesting insight into past and future thinking and
confabulation. Case studies can be extremely insightful in cognitive neuropsychology,
especially in the recent literature on mental time travel (see Schacter & Addis, 2007). The
data from MW indicates that dimensions of past and future event construction may be
dissociated. Although past and future event construction involves overlapping processes, the
unknown nature of the future may increase the implausible nature of confabulations.
However, systematic group studies will be necessary to assess the generality of this finding to
other confabulating patients.

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Past and Future Confabulation

Footnotes
1.No control data is available for comparison.
2.It is noteworthy that the positivity bias could have been due to the more advanced age of
MW and the control participants. However, to our knowledge, the future positivity bias has
only been investigated in young healthy adults (e.g. Berntsen & Jacobsen, 2008; NewbyClark & Ross, 2003). Therefore to answer the question of whether this particular bias exists
in older age requires further empirical investigation, possibly comparing the bias in young
and old participants.

30

Past and Future Confabulation

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Acknowledgements
The authors wish to thank Martin A. Conway for providing invaluable guidance on this case
study and two anonymous reviewers for their helpful comments. We would also like to thank
the Brain Injury Rehabilitation Trust for their assistance, a registered charity that provides
community-based rehabilitation for adults with brain injury. We extend our gratitude to MW
and his wife for all their encouraging help in this research.

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Past and Future Confabulation

Table 1: Scores on Standard Neuropsychological Measures

Note: RBMT = Rivermead Behavioural Memory Test – II (Wilson, Cockburn & Baddeley,
2003) BADS = Behavioural Assessment of the Dysexecutive Syndrome (Wilson et al., 1996),
DEX Questionnaire = Dysexecutive Questionnaire measuring the frequency of dysexecutive
behaviours on a 0-4 likert-type scale, WCST =Wisconsin Card Sorting Test (Heaton, 1993)

Psychometric Tests
Tests of Intelligence
WAIS III
Verbal
Performance
Tests of Memory
WMS-III
Visual Immediate
Auditory Immediate
Auditory Delayed
Visual Delayed
Delayed Recognition
Working Memory
General Memory
RBMT Orientation
RBMT Total Screening
Score
RBMT Profile Score
Tests of Executive Function
Hayling & Brixton Tests
Hayling Total
Hayling 2 Errors
Brixton Test
BADS
DEX Questionnaire
DEX MW self-report ratings
DEX Spouse ratings
Rule Shift
Action Programme
Key Search
Temporal Judgement

Score
Index Scores

Description

114
87

High Average
Low Average

68
102
105
75
75
96
84
Raw Scores
14/14
7/12

Extremely Low
Average
Average
Borderline
Borderline
Average
Low Average

16/24

Moderately Impaired

Scaled Scores
5
4
2

Moderate Average
Low Average
Impaired

(0=never ,4=very often)
M=0.95 (SD= 1.36)
M=3.50 (SD= 1.15)
Scaled Scores
3
4
4
1
38

Normal
Poor Memory

Z Scores
-0.75
0.44
1.06
-2.36

Past and Future Confabulation
Zoo Map
Modified Six Elements
Age-corrected Standard
Score
WCST
Categories completed
Perseverative errors
Non-perseverative errors

2
2
88

-0.48
-1.90
Low Average

1
58%
5%

Impaired (10%ile)
Impaired (<1%ile)
Impaired(<1%ile)

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Past and Future Confabulation

Table 2: Distribution of Plausibility Ratings (in percentages)

Note: Percentages were used as each condition varied in the absolute amount of ratings
recorded (see Results). CG = Control Group

Response
1/implausible
2
3
4
5
6
7/plausible

MW
10.0
10.0
10.0
10.0
25.0
20.0
15.0

Past
CG
3.3
6.7
3.3
13.3
26.7
26.7
20.0

MW
60.4
16.7
8.3
4.2
10.4
0.0
0.0

40

Future
CG
0.0
0.0
3.3
5.0
18.3
48.3
25.0

Past and Future Confabulation

Table 3: Mean (SD) ratings for Past and Future Events

Note: For plausibility, the 1-7 scale was unidirectional 1=extremely implausible, 7 =
extremely plausible, whereas for emotional valence, the scale was bi-directional, 1=negative,
4 = neutral, 7 = positive.

Past
Plausibility
Valence

MW
4.6 (1.9)
3.4 (1.9)

Future
CG
5.1 (1.6)
4.2 (1.7)

41

MW
1.9 (1.3)
5.1 (1.3)

CG
5.9 (1.0)
4.7 (1.2)

Past and Future Confabulation
Appendix A.
Instructions given to Independent Judges:
Instructions for Scoring Past Events
You will be shown some memories from a number of different individuals. I would like you
to judge the valence (pleasantness/unpleasantness) and plausibility of each event.
Valence
For each event below, consider the following: Is there anything in the way the memory is
described which suggests this was a positive (e.g. ‘I bought a house for my son, which made
me very happy’), neutral (e.g. ‘I went to the shops and bought a fridge-freezer’) or negative
event (e.g. ‘I was dragged to a wedding last month and I had to speak to people I really didn’t
like’)? Please rate the statement for valence on a 7-point scale (4=Neutral).
Plausibility
Then, in terms of plausibility, consider the degree you believe that the event could have
occurred or has the potential to occur to people in general. In other words: Is there anything
in the way the memory is described (e.g. the setting or time) which indicated it is an
implausible (e.g. ‘In 1880 I went go on holiday with my family’ or ‘I went to Mars for my
last birthday’) or extremely plausible memory (e.g. ‘Last year I went to buy a ticket at
Kensington Station before boarding the tube train’)? Please rate the statement for plausibility
on a 7-point scale (1=Not at all Plausible, 4=Moderately Plausible, 7=Extremely Plausible).
Instructions for Scoring Future Events
You will be shown some personal future events from a number of different individuals. I
would like you to judge the valence (pleasantness/unpleasantness) and plausibility of each
event.
Valence
For each event below, consider the following: Is there anything in the way the plan is
described which suggests this will be a positive (e.g. ‘I will buy a house for my son, which
will make me very happy’) neutral (e.g. ‘I will go to a shop to buy a fridge-freezer’) or
negative (e.g. ‘I will get dragged to a wedding next month and I will have to speak to people I
really don’t like’). Once you have considered these points, please rate the statement for
valence on a 7-point scale (4=neutral).
Plausibility
Then, in terms of plausibility, consider the degree you believe that the event could occur or
has the potential to occur to people in general. In other words, is there anything in the way the
future event is described (e.g. the setting or time) which indicates it is an implausible (e.g. ‘In
2600 I will go on holiday with my family’ or ‘I will go to Mars for my next birthday’) or
42

Past and Future Confabulation
extremely plausible plan (e.g. ‘Next year I will go to buy a ticket at Kensington Station
before boarding the tube train’)? Please rate the statement for plausibility on a 7-point scale
(1=Not at all Plausible, 4=Moderately Plausible, 7=Extremely Plausible).

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Past and Future Confabulation
Appendix B.
Representative Examples of Past and Future Statements
MW’s Past Statements

MW’s Future Statements

Accurate Memory

Cue Word: Mountain

Cue Word: Train

MW: I will buy mount Kilimanjaro and
Mount Fuji

MW: I remember when I was a kid
going to Cornwall with my parents and
we got straight through tickets and I was
entrusted to keep the tickets, and when
we got to King’s Cross station I’d lost
the tickets on to Cornwall…so we had to
pay again.

[prompt for a specific event]
MW: Rent them out, if Sir Anthony
Hopkins can own Snowdon, and Sean
Connery can own Ben Nevis, I can own
Kilimanjaro!

Mean Plausibility Rating: 6.00

[prompt for a specific event]

Mean Valence Rating: 1.67
Confabulation

MW: I would live right on the summit of
mount Fuji. I would have one there and
one on Kilimanjaro

Cue word: Hospital

Mean Plausibility Rating:1.33

MW: I came home from work one
night…I said to the wife ‘I’ve got a
terrible headache C’ and went to bed.
The next thing I know I wake up in
Intensive Care in the Royal
Infirmary…and I died twice…and the
Professor that saved me went mad…he
turned up at work one day unshaven in
pyjamas..and the sister said to him
‘Professor, you’re supposed to be
operating Today’, and he looked at her
and said ‘Sister, I am doing no more
operations’, and he walked out the
hospital and nobody’s seen him since.

Mean Valence Rating: 5

Mean Plausibility Rating: 2.33
Mean Valence Rating: 2.67

Cue word: Train
MW: Trains will become supersonic. I
will be driving one.
Mean Plausibility Rating: 1.00
Mean Valence Rating: 6.33
Cue word: Garden
MW: I own a garden on the moon and all
the other planets.
[prompt for a specific event]
MW: I will have them on all the planets
and I will grow plants indigenous to the
planets
Mean Plausibility Rating: 1.00
Mean Valence Rating: 4.33

Comparison Past Event

Comparison Future Event

Cue word: House

Cue word: House
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Past and Future Confabulation
Control Participant: “Yeah I suppose it
was looking at our son who was getting
married, was looking for houses and we
went to look at one somewhere in the
Shipley area because his wife had got a
job teaching there, and we went to look
round this house with her parents as well
and we all sort of gave our little bit of
opinions, kitchen floor looked a bit damp
but on the whole for the price it seemed
ok and then as we drove away my son
suddenly realised although most of the
houses were privately owned...”
Mean Plausibility Rating: 5.67

Control Participant: “It’s back, my
daughter, her big house, family house is
on the market and she’ll be looking for a
new one um I imagine it will be smaller
perhaps three bedrooms (PROMPT)
yeah, um yep no doubt I shall be helping
to clean it whilst she moves in um and
saying ‘does that look right there or does
that look right there?’ and probably
weeding the garden. Don’t think I’ll offer
to do any decorating this time, I might
tidy the garden um and help make the
beds up.”

Mean Valence Rating:2.67

Mean Plausibility Rating: 5.67
Mean Valence Rating: 4.67

45