用主动推断重构持续性头晕的亲历体验：Frontiers in Psychology 假说与理论文章

HYPOTHESIS AND THEORY article

Front. Psychol.

Sec. Psychology for Clinical Settings

Abstract

We present an active inference account of persistent dizziness predicated on models of enactivism and ecological psychology; including first-hand accounts of the patient’s lived experience. Mechanistically, we consider persistent dizziness to reflect an initial failure of sensory attenuation of vestibular and other sensory prediction errors. This failure becomes self-maintaining if the patient infers—or learns—that unattenuated prediction errors cannot be resolved through action. The ensuing formulation provides an integrative account of the pathophysiology of dizziness and how it underwrites—and is maintained by—affective inference and an altered sense of agency that shapes the experience of the person with dizziness. We foreground the holistic person-centered approach on offer from a clinical perspective, and consider complementary levels of therapeutic intervention under this theoretical framework.

Keywords

active inference, Enactivism / Ecological psychology, Free Energy Principle (FEP), Lived experience, Persistent dizziness, Phenomenology, PPPD, ViolEx model

Received

28 April 2026

Accepted

22 September 2026

Copyright

© 2026 Broberg, Thacker, Friston and Esteves. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence:

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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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