Drawing on sociocultural theories and Bayesian accounts of brain function, in this article we construe psychiatric conditions as disorders of social interaction to fully account for their complexity and dynamicity across levels of description and temporal scales. After an introduction of the theoretical underpinnings of our integrative approach, we take autism spectrum conditions (ASC) as a paradigm example and discuss how neurocognitive hypotheses can be translated into a Bayesian formulation, i.e., in terms of predictive processing and active inference. We then argue that consideration of individuals (even within a Bayesian framework) will not be enough for a comprehensive understanding of psychiatric conditions and consequently put forward the dialectical misattunement hypothesis, which views psychopathology not merely as disordered function within single brains but also as a dynamic interpersonal mismatch that encompasses various levels of description. Moving from a mere comparison of groups, i.e., “healthy” persons versus “patients,” to a fine-grained analysis of social interactions within dyads and groups of individuals will open new avenues and may allow to avoid an overly neurocentric scope in psychiatric research as well as help to reduce social exclusion.

Wong W: Understanding dialectical thinking from a cultural-historical perspective. Philos Psychol 2006;19:239-260.
Dafermos M: Rethinking the crisis in social psychology: a dialectical perspective. Soc Personal Psychol Compass 2015;9:394-405.
Bidell T: Vygotsky, Piaget and the dialectic of development. Hum Dev 1988;31:329-348.
Lawler J: Dialectical philosophy and developmental psychology: Hegel and Piaget on contradiction. Hum Dev 1975;18:1-17.
Vygotsky LS: Mind in Society: The Development of Higher Psychological Processes. Cambridge, Harvard University Press, 1930-1935/1980.
Vagenas E: The Soviet Psychology for the Development of the Child. Athens, Synchroni Epochi, 2003.
Hoel EP, Albantakis L, Tononi G: Quantifying causal emergence shows that macro can beat micro. Proc Natl Acad Sci USA 2013;110:19790-19795.
Haken H: Synergetics: Introduction and Advanced Topics. Berlin, Springer, 2004.
Vygotsky LS: Thought and language. Athens, Gnosi (translated in Greek by Maria and Angelina Rodi), 1934/1964.
Dafermos M: The Cultural Historical Theory of Vygotsky. Athens, Atrapos, 2002.
Stephan KE, Mathys C: Computational approaches to psychiatry. Curr Opin Neurobiol 2014;25:85-92.
Huys QJM, Maia TV, Frank MJ: Computational psychiatry as a bridge from neuroscience to clinical applications. Nat Neurosci 2016;19:404-413.
Friston K: The free-energy principle: a unified brain theory? Nat Rev Neurosci 2010;11:127-138.
Bolis D, Becchio C, Schilbach L: Revisiting psychological definitions at the interface of sociocultural historical theories and predictive coding; in Worlding the Brain: Patterns, Rhythms, Narratives in Neuroscience and the Humanities. Amsterdam, 2016, p 10. https://worldingthebrain2016.files.wordpress.com/2015/12/booklet-wtb.pdf.
Bolis D, Schilbach L: Beyond one Bayesian brain: modeling intra- and inter-personal processes during social interaction. Commentary on “Mentalizing homeostasis: the social origins of interoceptive inference” by Fotopoulou & Tsakiris. Neuropsychoanalysis 2017;19:35-38.
Bolis D, Schilbach L: Observing and participating in social interactions: action perception and action control across the autistic spectrum. Dev Cogn Neurosci DOI: 10.1016/j.dcn.2017.01.009.
Wing L: The history of ideas on autism. Autism 1997;1:13-23.
Dakin S, Frith U: Vagaries of visual perception in autism. Neuron 2005;48:497-507.
Plaisted Grant K, Davis G: Perception and apperception in autism: rejecting the inverse assumption. Philos Trans R Soc B Biol Sci 2009;364:1393-1398.
Treffert DA: The savant syndrome: an extraordinary condition. A synopsis: past, present, future. Philos Trans R Soc London B Biol Sci 2009;364:1351-1357.
Frith U, Happé F: Autism: beyond “theory of mind” (review). Cognition 1994;50:115-132.
Baron-Cohen S: Is Asperger syndrome/high-functioning autism necessarily a disability? Dev Psychopathol 2000;12:489-500.
Frith U: Autism: A Very Short Introduction. Oxford, Oxford University Press, 2008.
Baron-Cohen S, Leslie AM, Frith U: Does the autistic child have a “theory of mind?” Cognition 1985;21:37-46.
Senju A, Southgate V, White S, Frith U: Mindblind eyes: an absence of spontaneous theory of mind in Asperger syndrome. Science 2009;325:883-885.
Schilbach L, Eickhoff SB, Cieslik EC, Kuzmanovic B, Vogeley K: Shall we do this together? Social gaze influences action control in a comparison group, but not in individuals with high-functioning autism. Autism 2012;16:151-162.
di Pellegrino G, Fadiga L, Fogassi L, Gallese V, Rizzolatti G: Understanding motor events: a neurophysiological study. Exp Brain Res 1992;91:176-180.
Rizzolatti G, Craighero L: The mirror-neuron system. Annu Rev Neurosci 2004;27:169-192.
Oberman LM, Hubbard EM, McCleery JP, Altschuler EL, Ramachandran VS, Pineda JA: EEG evidence for mirror neuron dysfunction in autism spectrum disorders. Cogn Brain Res 2005;24:190-198.
Ramachandran VS, Oberman LM: Broken mirrors: a theory of autism. Sci Am 2006;295:62-69.
Dapretto M, Davies MS, Pfeifer JH, Scott AA, Sigman M, Bookheimer SY, et al: Understanding emotions in others: mirror neuron dysfunction in children with autism spectrum disorders. Nat Neurosci 2006;9:28-30.
Perkins T, Stokes M, McGillivray J, Bittar R: Mirror neuron dysfunction in autism spectrum disorders. J Clin Neurosci 2010;17:1239-1243.
Southgate V, Hamilton AF: Unbroken mirrors: challenging a theory of autism. Trends Cogn Sci 2008;12:225-229.
Fan Y-T, Decety J, Yang C-Y, Liu J-L, Cheng Y: Unbroken mirror neurons in autism spectrum disorders. J Child Psychol Psychiatry 2010;51:981-988.
Wang Y, Hamilton AF: Social top-down response modulation (STORM): a model of the control of mimicry in social interaction. Front Hum Neurosci 2012;6:153.
Dumas G, Soussignan R, Hugueville L, Martinerie J, Nadel J: Revisiting mu suppression in autism spectrum disorder. Brain Res 2014;1585:108-119.
Chevallier C, Kohls G, Troiani V, Brodkin ES, Schultz RT: The social motivation theory of autism. Trends Cogn Sci 2012;16:231-239.
Modahl C, Green L, Fein D, Morris M, Waterhouse L, Feinstein C, et al: Plasma oxytocin levels in autistic children. Biol Psychiatry 1998;43:270-277.
Bartz JA, Zaki J, Bolger N, Ochsner KN: Social effects of oxytocin in humans: context and person matter. Trends Cogn Sci 2011;15:301-309.
Modi ME, Young LJ: The oxytocin system in drug discovery for autism: animal models and novel therapeutic strategies. Horm Behav 2012;61:340-350.
Gordon I, Vander Wyk BC, Bennett RH, Cordeaux C, Lucas MV, Eilbott JA, et al: Oxytocin enhances brain function in children with autism. Proc Natl Acad Sci USA 2013;110:20953-20958.
Frith U: Autism: Explaining the Enigma. Oxford, Blackwell, 2003.
Happé F: Autism: cognitive deficit or cognitive style? Trends Cogn Sci 1999;3:216-222.
Happé F, Frith U: The weak coherence account: detail-focused cognitive style in autism spectrum disorders. J Autism Dev Disord 2006;36:5-25.
Mottron L, Dawson M, Soulières I, Hubert B, Burack J: Enhanced perceptual functioning in autism: an update, and eight principles of autistic perception. J Autism Dev Disord 2006;36:27-43.
Murray D, Lesser M, Lawson W: Attention, monotropism and the diagnostic criteria for autism. Autism 2005;9:139-156.
Steel MJG, Gorman R, Flexman JE: Neuropsychiatric testing in an autistic mathematical idiot-savant: evidence for nonverbal abstract capacity. J Am Acad Child Psychiatry 1984;23:704-707.
Rumsey JM: Conceptual problem-solving in highly verbal, nonretarded autistic men. J Autism Dev Disord 1985;15:23-36.
Ozonoff S, Pennington BF, Rogers SJ: Executive function deficits in high-functioning autistic individuals: relationship to theory of mind. J Child Psychol Psychiatry 1991;32:1081-1105.
Hill EL: Executive dysfunction in autism. Trends Cogn Sci 2004;8:26-32.
Happé F: Cognition in autism: one deficit or many; in Bock G, Goode J (eds): Autism: Neural Basis and Treatment Possibilities: Novartis Foundation Symposium 251. Chichester, Wiley, 2003, pp 198-212.
Happé F, Ronald A, Plomin R: Time to give up on a single explanation for autism. Nat Neurosci 2006;9:1218-1220.
Gallagher S, Varga S: Conceptual issues in autism spectrum disorders. Curr Opin Psychiatry 2015;28:1.
Pellicano E, Burr D: When the world becomes “too real”: a Bayesian explanation of autistic perception. Trends Cogn Sci 2012;16:504-510.
Brock J: Alternative Bayesian accounts of autistic perception: comment on Pellicano and Burr. Trends Cogn Sci 2012;16:573-574.
Friston KJ, Lawson R, Frith CD: On hyperpriors and hypopriors: comment on Pellicano and Burr. Trends Cogn Sci 2013;17:1.
van Boxtel JJA, Lu H: A predictive coding perspective on autism spectrum disorders. Front Psychol 2013;4:19.
Van de Cruys S, de-Wit L, Evers K, Boets B, Wagemans J: Weak priors versus overfitting of predictions in autism: reply to Pellicano and Burr (TICS, 2012). Iperception 2013;4:95-97.
Teufel C, Subramaniam N, Fletcher PC: The role of priors in Bayesian models of perception. Front Comput Neurosci 2013;7:25.
Lawson RP, Rees G, Friston KJ: An aberrant precision account of autism. Front Hum Neurosci 2014;8:302.
Van de Cruys S, Evers K, Van der Hallen R, Van Eylen L, Boets B, De-Wit L, et al: Precise minds in uncertain worlds: predictive coding in autism. Psychol Rev 2014;121:649-675.
Sevgi M, Diaconescu AO, Tittgemeyer M, Schilbach L: Social Bayes: using Bayesian modeling to study autistic trait-related differences in social cognition. Biol Psychiatry 2016;80:112-119.
Knill DC, Pouget A: The Bayesian brain: the role of uncertainty in neural coding and computation. Trends Neurosci 2004;27:712-719.
Harris H, Israeli D, Minshew N, Bonneh Y, Heeger DJ, Behrmann M, et al: Perceptual learning in autism: over-specificity and possible remedies. Nat Neurosci 2015;18:1574-1576.
Mumford D: On the computational architecture of the neocortex. The role of cortico-cortical loops. Biol Cybern 1992;66:241-251.
Friston K: A theory of cortical responses. Philos Trans R Soc Lond B Biol Sci 2005;360:815-836.
Friston K: Hierarchical models in the brain. PLoS Comput Biol 2008;4:e1000211.
Clark A: Whatever next? Predictive brains, situated agents, and the future of cognitive science. Behav Brain Sci 2013;36:181-204.
Gomot M, Wicker B: A challenging, unpredictable world for people with autism spectrum disorder. Int J Psychophysiol 2012;83:240-247.
von Helmholtz HLF: Handbuch der physiologischen Optik. Leipzig, Voss, 1867.
James W: The Principles of Psychology. New York, Holt, 1890.
Stock A, Stock C: A short history of ideo- motor action. Psychol Res 2004;68:176-188.
Herbort O, Butz MV: Too good to be true? Ideomotor theory from a computational perspective. Front Psychol 2012;3:494.
Felleman DJ, Van Essen DC: Distributed hierarchical processing in the primate cerebral cortex (review). Cereb Cortex 1991;1:1-47.
Friston K, Kiebel S: Predictive coding under the free-energy principle. Philos Trans R Soc B Biol Sci 2009;364:1211-1221.
Friston KJ, Stephan KE: Free-energy and the brain. Synthese 2007;159:417-458.
Friston KJ, Daunizeau J, Kilner J, Kiebel SJ: Action and behavior: a free-energy formulation. Biol Cybern 2010;102:227-260.
Clark A: The many faces of precision (Replies to commentaries on “Whatever next? Neural prediction, situated agents, and the future of cognitive science”). Front Psychol 2013;4:270.
Feldman H, Friston KJ: Attention, uncertainty, and free-energy. Front Hum Neurosci 2010;4:215.
Shipp S, Adams RA, Friston KJ: Reflections on a granular architecture: predictive coding in the motor cortex. Trends Neurosci 2013;36:706-716.
Moran RJ, Campo P, Symmonds M, Stephan KE, Dolan RJ, Friston KJ: Free energy, precision and learning: the role of cholinergic neuromodulation. J Neurosci 2013;33:8227-8236.
Friston K: The free-energy principle: a rough guide to the brain? Trends Cogn Sci 2009;13:293-301.
Hohwy J: The Predictive Mind. Oxford, Oxford University Press, 2014.
Van de Cruys S, Wagemans J: Putting reward in art: a tentative prediction error account of visual art. Iperception 2011;2:1035-1062.
Joffily M, Coricelli G, FitzGerald T, Galea JM, Adams R: Emotional valence and the free- energy principle. PLoS Comput Biol 2013;9:e1003094.
Baker CL, Saxe RR, Tenenbaum JB: Bayesian theory of mind: modeling joint belief-desire attribution. Proc 32nd Annu Conf Cogn Sci Soc, Boston, 2011.
Koster-Hale J, Saxe R: Theory of mind: a neural prediction problem. Neuron 2013;79:836-848.
Heyes C: What's social about social learning? J Comp Psychol 2012;126:193-202.
Behrens TEJ, Hunt LT, Woolrich MW, Rushworth MFS: Associative learning of social value. Nature 2008;456:245-249.
Apps MAJ, Green R, Ramnani N: Reinforcement learning signals in the anterior cingulate cortex code for others' false beliefs. Neuroimage 2013;64:1-9.
Balsters JH, Apps MAJ, Bolis D, Lehner R, Gallagher L, Wenderoth N: Disrupted prediction errors index social deficits in autism spectrum disorder. Brain 2017;140:235-246.
Kilner JM: More than one pathway to action understanding. Trends Cogn Sci 2011;15:352-357.
Kilner JM, Friston KJ, Frith CD: Predictive coding: an account of the mirror neuron system. Cogn Process 2007;8:159-166.
Hamilton AF, Grafton ST: The motor hierarchy: from kinematics to goals and intentions; in Haggard P, Rosetti Y, Kawato M (eds): Sensorimotor Foundations of Higher Cognition: Attention and Performance. Oxford, Oxford University Press, 2007, pp 381-407.
Becchio C, Manera V, Sartori L, Cavallo A, Castiello U: Grasping intentions: from thought experiments to empirical evidence. Front Hum Neurosci 2012;6:117.
Ansuini C, Cavallo A, Bertone C, Becchio C: Intentions in the brain: the unveiling of Mister Hyde. Neuroscientist 2015;21:126-135.
Huang Y, Rao RPN: Predictive coding. Wiley Interdiscip Rev Cogn Sci 2011;2:580-593.
Rao RPN, Ballard DH: Predictive coding in the visual cortex: a functional interpretation of some extra-classical receptive-field effects. Nat Neurosci 1999;2:79-87.
Happé FG: Studying weak central coherence at low levels: children with autism do not succumb to visual illusions. A research note. J Child Psychol Psychiatry 1996;37:873-877.
Kopp B: A simple hypothesis of executive function. Front Hum Neurosci 2012;6:159.
Miller GA: Plans and the Structure of Behavior. New York, Holt, 1960.
Badre D, D'Esposito M: Functional magnetic resonance imaging evidence for a hierarchical organization of the prefrontal cortex. J Cogn Neurosci 2007;19:2082-2099.
Badre D, D'Esposito M: Is the rostro-caudal axis of the frontal lobe hierarchical? Nat Rev Neurosci 2009;10:659-669.
Quattrocki E, Friston K: Autism, oxytocin and interoception. Neurosci Biobehav Rev 2014;47:410-430.
Gallagher S: The practice of mind: theory, simulation or primary interaction? J Conscious Stud 2001;8:83-108.
Schilbach L, Wohlschlaeger AM, Kraemer NC, Newen A, Shah NJ, Fink GR, et al: Being with virtual others: neural correlates of social interaction. Neuropsychologia 2006;44:718-730.
De Jaegher H, Di Paolo E: Participatory sense-making. Phenom Cogn Sci 2007;6:485-507.
Oullier O, de Guzman GC, Jantzen KJ, Lagarde J, Scott Kelso JA: Social coordination dynamics: measuring human bonding. Soc Neurosci 2008;3:178-192.
Reddy V: How Infants Know Minds. Cambridge, Harvard University Press, 2010.
Hari R, Kujala MV: Brain basis of human social interaction: from concepts to brain imaging. Physiol Rev 2009;89:453-479.
De Jaegher H, Di Paolo E, Gallagher S: Can social interaction constitute social cognition? Trends Cogn Sci 2010;14:441-447.
Schilbach L, Wilms M, Eickhoff SB, Romanzetti S, Tepest R, Bente G, et al: Minds made for sharing: initiating joint attention recruits reward-related neurocircuitry. J Cogn Neurosci 2010;22:2702-2715.
Froese T, Di Paolo EA: The enactive approach. Theoretical sketches from cell to society*. Pragmat Cogn 2011;19:1-36.
Froese T, Fuchs T: The extended body: a case study in the neurophenomenology of social interaction. Phenom Cogn Sci 2012;11:205-235.
Di Paolo E, De Jaegher H: The interactive brain hypothesis. Front Hum Neurosci 2012;6:163.
Konvalinka I, Roepstorff A: The two-brain approach: how can mutually interacting brains teach us something about social interaction? Front Hum Neurosci 2012;6:215.
Dumas G: Towards a two-body neuroscience. Commun Integr Biol 2011;4:349-352.
Dumas G, Martinerie J, Soussignan R, Nadel J: Does the brain know who is at the origin of what in an imitative interaction? Front Hum Neurosci 2012;6:128.
Timmermans B, Schilbach L, Pasquali A, Cleeremans A: Higher order thoughts in action: consciousness as an unconscious re-description process. Philos Trans R Soc Lond B Biol Sci 2012;367:1412-1423.
Schilbach L, Timmermans B, Reddy V, Costall A, Bente G, Schlicht T, et al: Toward a second-person neuroscience. Behav Brain Sci 2013;36:393-414.
Dale R, Fusaroli R, Duran ND, Richardson DC: The self-organization of human interaction. Psychol Learn Motiv Adv Res Theory 2013;59:43-95.
Schilbach L: On the relationship of online and offline social cognition. Front Hum Neurosci 2014;8:278.
Schilbach L: Towards a second-person neuropsychiatry. Philos Trans R Soc London B Biol Sci 2015;371:20150081.
Koike T, Tanabe HC, Sadato N: Hyperscanning neuroimaging technique to reveal the “two-in-one” system in social interactions. Neurosci Res 2015;90:25-32.
Gallagher S: Understanding interpersonal problems in autism: interaction theory as an alternative to theory of mind. Philos Psychiatry Psychol 2004;11:199-217.
Tom Froese: Overview. Dr. Tom Froese. https://froese.wordpress.com/research/overview/ (last accessed September 9, 2017).
Menary R: Introduction to the special issue on 4E cognition. Phenom Cogn Sci 2010;9:459-463.
Ward D, Stapleton M: Es are good: cognition as enacted, embodied, embedded, affective and extended; in Paglieri F (ed): Consciousness in Interaction: The Role of the Natural and Social Environment in Shaping Consciousness. Advances in Consciousness Research. Amsterdam, Benjamins, 2012, vol 86, pp 89-104.
Varela FJ, Thompson E, Rosch E: The Embodied Mind: Cognitive Science and Human Experience. Cambridge, MIT Press, 1991.
Hurley SL: Consciousness in Action. Cambridge, Harvard University Press, 1998.
Thompson E: Mind in Life: Biology, Phenomenology, and the Sciences of Mind. Cambridge, Belknap Press of Harvard University Press, 2007.
Haugeland J: Having Thought: Essays in the Metaphysics of Mind. Cambridge, Harvard University Press, 1998.
Clark A: Being There: Putting Brain, Body, and World Together Again. Cambridge, MIT Press, 1997.
Gallagher S: How the Body Shapes the Mind. Oxford, Oxford University Press, 2005.
Clark A, Chalmers D: The extended mind. Analysis 1998;58:7-19.
Colombetti G: Enactive appraisal. Phenom Cogn Sci 2007;6:527-546.
Ratcliffe M: Existential feeling and psychopathology. Philos Psychiatry Psychol 2009;16:179-194.
Dumas G, de Guzman GC, Tognoli E, Kelso JAS: The human dynamic clamp as a paradigm for social interaction. Proc Natl Acad Sci USA 2014;111:E3726-E3734.
Friston K, Frith C: A duet for one. Conscious Cogn 2015;36:390-405.
Friston KJ, Frith CD: Active inference, communication and hermeneutics. Cortex 2015;68:129-143.
Vittorias J, Petrantonakis P, Bolis D, Tsiligkyri A, Kosmidou V, Hadjileontiadis LJ: NOESIS: an enhanced educational environment for kids with autism spectrum disorders. 8th IEEE International Conference on Advanced Learning Technologies, Santandar, 2008, pp 1019-1020.
Laing RD, Phillipson H, Lee AR: Interpersonal perception; a theory and a method of research. New York, Harper & Row, 1972.
Mathys C, Daunizeau J, Friston KJ, Stephan KE: A Bayesian foundation for individual learning under uncertainty. Front Hum Neurosci 2011;5:39.
Bolis D, Heinzle J, Mathys C, Stephan KE: Inferring Cognitive Traits of Individual Subjects through Gaze Controlled Video Games. Trieste, EUT Edizioni Università di Trieste, 2015.
Pessoa L: On the relationship between emotion and cognition. Nat Rev Neurosci 2008;9:148-158.
Stefanics G, Kremláček J, Czigler I: Visual mismatch negativity: a predictive coding view. Front Hum Neurosci 2014;8:666.
Friston K: Life as we know it. J R Soc Interface 2013;10:20130475.
Kelso JAS: Dynamic Patterns: The Self-Organization of Brain and Behavior. Cambridge, MIT Press, 1995.
Hirsch ED, Kett JF, Trefil JS: The New Dictionary of Cultural Literacy. Boston, Houghton Mifflin Harcourt, 2002.
Toomela A: There can be no cultural-historical psychology without neuropsychology. And vice versa; in Yasnitsky A, van der Veer R, Ferrari M (eds): The Cambridge Handbook of Cultural-Historical Psychology. Cambridge, Cambridge University Press, 2014, pp 313-349.
Adorno TW: An Introduction to Dialectics. Hoboken, John Wiley & Sons, 1958/2017.
Robinson H: Dualism; in Zalta EN (ed): The Stanford Encyclopedia of Philosophy (Fall 2017 Edition). https://plato.stanford.edu/archives/fall2017/entries/dualism/.
O'Connor T, Wong HY: Emergent Properties; in Zalta EN (ed): The Stanford Encyclopedia of Philosophy (Summer 2015 Edition). https://plato.stanford.edu/archives/sum2015/entries/properties-emergent/.
Haken H: Synergetics: an overview. Rep Prog Phys 1989;52:515.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.