Paranoia and the defensive attributional style: Deluded and depressed patients' attributions about their own attributions (original) (raw)
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Schizophrenia Bulletin, 2009
Many studies have found that people experiencing persecutory delusions have a marked tendency to use externalpersonal attributions when establishing the causes of negative events. Although nonclinical populations also tend to attribute negative events to external causes, those causes are typically believed to be universal in nature, rather than personal. The central goal of the present study was to investigate whether individuals with remitted persecutory delusions would display this external-personal bias regarding negative events, in comparison to remitted patients whose delusions were not paranoid in nature and to nonpsychiatric controls. Results indicate that currently paranoid patients were significantly more likely than all other groups, including the remitted paranoid group, to use external-personal attributions in negative events. Interestingly, all patient groups also were found to be significantly more likely than the controls to use internal-personal and internal-universal attributions when explaining negative events.
Paranoia, persecutory delusions and attributional biases
An influential model of persecutory delusions put forward by Bentall and colleagues hypothesizes that persecutory-deluded patients avoid the activation of negative self-beliefs by making externalising, personalising attributions for negative events. The first study reported here used a new instrument for the measurement of persecutory ideation, the Paranoid, Persecutory and Delusion-Proneness Questionnaire, to investigate whether attributional biases are associated with subclinical persecutory ideation. The second study extended this investigation by re-examining associations between attributional biases and persecutory delusions. Both studies used the Internal, Personal and Situational Attributions Questionnaire to measure attributional style. No evidence was found for a connection between attributional biases and subclinical persecutory ideation. Furthermore, there was no support for an association between persecutory delusions and an externalising bias, and only marginal support for the hypothesized relationship between persecutory delusions and a personalising bias. These results suggest that the putative link between persecutory ideation and attributional biases only manifests (if at all) when persecutory ideation is of delusional intensity, and that it is confined to a personalising bias. D
Cognitive Therapy and Research, 2007
It has been suggested that an exaggerated self-serving bias may underlie the formation of paranoia. One goal of the present study was to explore whether an abnormality of attributional style is confined to patients with persecutory delusions or extends to currently non-deluded patients. A second goal was to test whether paranoid patients show an external-personal rather than an external-situational attributional style for blame. An attributional styles questionnaire was administered to psychiatric patients diagnosed with schizophrenia (n = 35), depression (n = 18), and anxiety disorders (n = 34), as well as a healthy control group (n = 28). For each event (positive or negative outcome) participants were asked to write down what may have led to this event, and then to endorse the degree to which this event was caused by others/circumstances or themselves. Assessment of the Likert scale ratings demonstrated that while healthy subjects displayed a significant self-serving bias, currently paranoid and non-paranoid schizophrenia patients performed intermediately between healthy participants and depressed patients. Analysis of coded verbal statements indicated that irrespective of event type (positive, negative) patients with persecutory delusions had an even-handed attribution bias, whereas all other groups predominantly regarded themselves as causal. The latter finding indicates that acute paranoia may be associated with a decreased locus of internal control, which may promote the occurrence of certain paranoid beliefs (e.g., feelings of alien control and passivity experiences, respectively).
British Journal of Clinical Psychology, 2006
Objectives. The purpose of this study was to explore whether explicit and implicit attributional styles of delusional patients were associated to their clinical state, and whether attributions biases are specific to delusional psychopathology or also appear in other disorders (i.e. depression). Design and methods. A cross-sectional design was used. The sample consisted of 136 participants (40 acute deluded participants, 25 remitted deluded participants, 35 depressed patients and 36 normal controls). The Internal, Personal and Situational Attributions Questionnaire (IPSAQ) and the Pragmatic Inferential Test (PIT) were used to assess explicit and implicit attributional style, respectively. Results. All participants, with the exception of the depressed patients group, showed an externalizing bias (EB) for negative events. Although both acute and remitted deluded patients showed a similar overall pattern of explicit attributions, the personalizing bias (PB) was significantly greater in the acute group. The magnitude of this bias, which was also found in the depressed patients, was significantly related to the patient's degree of severity, as assessed by the total BPRS score (r ¼ :45, p , :001). The results on the implicit attributions were more equivocal, perhaps due the low reliability of the PIT. Conclusions. Attributional biases seem to be a stable characteristic of delusions. Yet, the PB might be a rather unspecific characteristic that varies with the degree of the severity of psychopathology. The implications of these findings for understanding the role of attributional biases in depression and delusion formation are discussed.
Depressive Symptomatology and Attributional Style in Patients with Schizophrenia
Clinical Schizophrenia & Related Psychoses, 2009
The aim of the study was to evaluate the attributional styles and self-serving bias (SSB) in schizophrenic patients with depressive symptoms (schizophrenia and depressive symptoms [SD]) and without depressive symptoms (schizophrenia nondepressed [SND]), and control subjects (C). Methods: Forty-four outpatients with schizophrenia (twenty-two SD and twenty-two SND) and fifty gender-and age-matched C subjects completed the Attributional Style Questionnaire (ASQ). Attributional styles for positive and negative events were calculated by separately summing the responses for positive and negative items on the ASQ subscales (internality, stability, and globality). Results: For negative events, we found that patients with schizophrenia, independently of levels of depressive symptoms, made more internal, stable, and global attributions than C subjects. For positive events, both C subjects and SND patients made more internal, stable, and global attributions than SD patients. Moreover, C subjects and SND patients scored higher for positive situations than for negative situations. However, there were no differences between attributional styles for positive and negative situations among SD patients. For SSB, C subjects and SND patients had higher scores than SD patients. Conclusions: Among patients with schizophrenia, attributional style for positive events may distinguish between those patients with or without depressive symptoms. Our results highlight the importance of assessing depressive symptoms and attributional style in patients with schizophrenia.
Psychology and Psychotherapy: Theory, Research and Practice, 2004
Research into the nature of attributional reasoning in paranoia has for the most part been restricted to questionnaire‐based approaches. This fails to address the issue of whether a distinctive attributional style underpins the everyday talk of paranoid individuals. This study aimed to investigate whether attributional models of paranoid delusions applied to spontaneous attributions generated in the discourse of 12 paranoid and 12 non‐paranoid speakers. Causal attributions for negative and positive life experiences were extracted from interview transcripts and rated using the Content Analysis of Verbatim Explanations (CAVE) technique. It was found that, as a proportion, paranoids made more attributions for negative events that were of an external‐personal, stable and global nature (as attributional models would predict). They also made significantly more external‐personal attributions for negative events and, in one of two datasets, showed a more external mean CAVE rating for negati...
The self, attributional processes and abnormal beliefs: Towards a model of persecutory delusions
Behaviour Research and Therapy, 1994
In this paper we review a series of recent investigations into cognitive abnormalities associated with persecutory delusions. Studies indicate that persecutory delusions are associated with abnormal attention to threat-related stimuli, an explanatory bias towards attributing negative outcomes to external causes and biases in information processing relating to the self-concept. We propose an integrative model to account for these findings in which it is hypothesized that, in deluded patients, activation of self/ideal discrepancies by threat-related information triggers defensive explanatory biases, which have the function of reducing the self/ideal discrepancies but result in persecutory ideation. We conclude by discussing the implications of this model for the cognitive-behavioural treatment of paranoid delusions.
Poor me versus bad me paranoia and the instability of persecutory ideation
Psychology and Psychotherapy: Theory, Research and Practice, 2006
Objectives. To investigate whether there are two stable types of paranoia, 'poor me' and 'bad me', as described by Trower and Chadwick (1995), and whether beliefs about the deservedness of persecution are associated with psychological measures. Methods. In-patients experiencing persecutory delusions were assigned either to 'poor me' (PM) or 'bad me'(BM) groups, according to their rating of a perceived deservedness scale, which was repeated on subsequent assessments. Participants were assessed for depression (BDI); construction of the self (Self-to-Others Scale); autonomy and sociotropy (PSI); perceived parental behaviour (PBI); attributional style (ASQ) and, meaningful daily events (DEI, devised for the study). A healthy control group was also assessed. Results. Many patients' perceived deservedness of persecution varied across time, so that some patients were PM at one point in time but BM at another. BM paranoia was associated with high levels of depression. PM and BM patients groups both scored higher than the controls on the subscales of Self-to-Others Scale and on the PSI. PM patients exhibited a marked self-serving bias on the ASQ, and reported less parental care on the PSI, compared to the BM patients. Both groups reported less PBI mother care than the controls. BM patients reported more failure events than PM patients or controls. PM patients reported more loss of control events than the than BM patients and controls. Conclusions. PM and BM paranoia may represent separate phases of an unstable phenomenon. The findings are consistent with an attributional account of paranoid thinking. Persecutory (paranoid) delusions, the most common type of delusional system observed in psychiatric practice (Jorgensen & Jensen, 1994), have recently become the focus of attention from psychological researchers. Based on initial observations of an abnormal attributional (explanatory) style in paranoid patients (Kaney & Bentall, 1989), Bentall, Kinderman, and Kaney (1994) argued that delusions of persecution arise when patients attribute negative events to external, global, and stable causes, and that this style of
Attribution style of patients with delusion disorder
Srpski arhiv za celokupno lekarstvo, 2006
Introduction. Attribution style represents a tendency to explain events by our own actions, or actions of forces and causes, persons or surroundings, which are external. Objective. The objective of our study was the analysis of specific way in which patients with delusion disorders ascribe meanings to events. Method. The test group included 30 patients with delusional disorder, of both sexes, aged between 30 and 53, without serious organic or somatic disorders. In order to determine the specific attribution system, through a wider frame of cognitive style, Rorschach?s cognitive techniques was applied. RESULTS An average value of MMSE score amounted to 28.43 and IQ - to 103.86. The data were evaluated by Comprehensive interpretation system of John Exner, and only those parameters were used that were the most indicative for this analysis. Patients with delusional disorder belonged to ambitent experience type, which pointed to inconsistency because the role of emotions varied during th...