In design · protocol
Akathisia as active inference
Prediction error can be resolved two ways: revise the model, or act on the world until the sensory evidence matches it. One account treats delusion as a pathology of the first route. That account is still debated and not settled. Akathisia may be a pathology of the second route. It would then be an inner restlessness that carries the felt quality of an error no action can close.
Aripiprazole makes this testable. A D2 partial agonist does not simply lower dopaminergic signalling. It compresses that signalling toward an intermediate set point, so its dependence on endogenous tone is damped but not removed. If dopamine encodes the precision of prediction errors, then partial agonism acts as a precision clamp. I use that term for this idea; the literature does not. The prediction that follows is a loss of context-dependent adjustment, not a shifted baseline.