Dimensions of Delusions and Attribution Biases along the Continuum of Psychosis (original) (raw)
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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.
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.
Reasoning, Emotions, and Delusional Conviction in Psychosis
Journal of Abnormal Psychology, 2005
The aim of the study was to elucidate the factors contributing to the severity and persistence of delusional conviction. One hundred participants with current delusions, recruited for a treatment trial of psychological therapy (PRP trial), were assessed at baseline on measures of reasoning, emotions, and dimensions of delusional experience. Reasoning biases (belief inflexibility, jumping to conclusions, and extreme responding) were found to be present in one half of the sample. The hypothesis was confirmed that reasoning biases would be related to delusional conviction. There was evidence that belief inflexibility mediated the relationship between jumping to conclusions and delusional conviction. Emotional states were not associated with the reasoning processes investigated. Anxiety, but not depression, made an independent contribution to delusional conviction.
Delusional Themes Across Affective and Non-Affective Psychoses
Frontiers in psychiatry, 2018
The current debate about the diagnostic significance of delusion revolves around two positions. The neurocognitive position conceives delusion as a non-specific, though polymorphic, symptom. The psychopathological position views features of delusion such as content and structure as having meaningful connections with diagnostic entities. This study aims at contributing to this debate by examining the association between delusional themes and diagnosis in a sample of 830 adult psychotic patients. All diagnoses were made by experienced psychiatrists according to DSM-IV or ICD-10 criteria, and in 348 patients were established with the SCID-I. All patients were administered the Brief Psychiatric Rating Scale (BPRS). In each patient, the presence of somatic delusions and delusions of guilt, grandiosity, and persecution was determined by examining the scores on relevant BPRS items. Delusions of guilt were almost pathognomonic for a psychotic depressive condition (psychotic major depression...
Maintaining Delusional Beliefs to Satisfy and Protect Psychological Needs
Zeitschrift für Psychologie, 2018
Affiliation, control and self-esteem are psychological needs that human beings attempt to satisfy and protect (Epstein, 2003; Grawe, 2002). From a motivational perspective, behaviours, attentional and cognitive biases as well as symptoms can have an instrumental function for need satisfaction and protection (Caspar, 2011). In this opinion paper, we elaborate the idea that the maintenance of delusions could be a motivated process. This approach helps to view the maintenance of delusional beliefs as purposeful, yet mostly nonconscious, and not completely adaptive attempt to satisfy and protect psychological needs. Conclusions for case formulations, therapy planning, and the therapeutic relationship building are drawn within the framework of cognitive-behavioural therapy for psychosis. In addition, limitations of the approach and future research avenues are discussed.
Journal of Abnormal Psychology, 2012
Two reasoning biases, jumping to conclusions (JTC) and belief inflexibility, have been found to be associated with delusions. We examined these biases and their relationship with delusional conviction in a longitudinal cohort of people with schizophrenia-spectrum psychosis. We hypothesized that JTC, lack of belief flexibility, and delusional conviction would form distinct factors, and that JTC and lack of belief flexibility would predict less change in delusional conviction over time. Two hundred seventy-three patients with delusions were assessed over twelve months of a treatment trial . Forty-one percent of the sample had 100% conviction in their delusions, 50% showed a JTC bias, and 50%-75% showed a lack of belief flexibility. Delusional conviction, JTC, and belief flexibility formed distinct factors although conviction was negatively correlated with belief flexibility. Conviction declined slightly over the year in this established psychosis group, whereas the reasoning biases were stable. There was little evidence that reasoning predicted the slight decline in conviction. The degree to which people believe their delusions, their ability to think that they may be mistaken and to consider alternative explanations, and their hastiness in decision making are three distinct processes although belief flexibility and conviction are related. In this established psychosis sample, reasoning biases changed little in response to medication or psychological therapy. Required now is examination of these processes in psychosis groups where there is greater change in delusion conviction, as well as tests of the effects on delusions when these reasoning biases are specifically targeted.
Cognitive factors associated with subclinical delusional ideation in the general population
Psychiatry Research, 2012
Cognitive biases have been found to be associated with delusions in schizophrenia and schizotypy. In the current study, we examined the relationship between subclinical delusional ideation, measured using the Peters Delusions Inventory, and cognitive biases including the bias against disconfirmatory evidence (BADE), 'jumping to conclusions', and need for closure, evaluated using the computerized BADE program, in a sample of 117 healthy, non-psychiatric controls. Our results suggest that subclinical delusional ideation is associated with BADE, greater need for closure, a 'jumping to conclusions' response style, and a tendency to rate absurd and unlikely interpretations of an event as more plausible, which might be indicative of insufficient evidence integration or 'liberal acceptance'. These cognitive biases, which occur in a much milder fashion than seen in typical deluded patient samples, may nonetheless additively play a role in the development of delusional ideation, and suggest common pathways seen in healthy and psychiatric samples.
Current Paranoid Thinking in Patients With Delusions: The Presence of Cognitive-Affective Biases
Schizophrenia Bulletin, 2013
Background: There has been renewed interest in the influence of affect on psychosis. Psychological research on persecutory delusions ascribes a prominent role to cognitive processes related to negative affect: anxiety leads to the anticipation of threat within paranoia; depressive negative ideas about the self create a sense of vulnerability in which paranoid thoughts flourish; and selfconsciousness enhances feelings of the self as a target. The objective of this study was to examine such affective processes in relation to state paranoia in patients with delusions. Methods: 130 patients with delusions in the context of a nonaffective psychosis diagnosis (predominately schizophrenia) were assessed for contemporaneous levels of persecutory ideation on 5 visual analog scales. Measures were taken of anxiety, depression, threat anticipation, interpretation of ambiguity, self-focus, and negative ideas about the self. Results: Of the patients, 85% report paranoid thinking at testing. Symptoms of anxiety and depression were highly prevalent. Current paranoid thinking was associated with anxiety, depression, greater anticipation of threat events, negative interpretations of ambiguous events, a self-focused cognitive style, and negative ideas about the self. Conclusions: The study provides a clear demonstration that a range of emotionrelated cognitive biases, each of which could plausibly maintain delusions, are associated with current paranoid thinking in patients with psychosis. We identified biases both in the contents of cognition and in the processing of information. Links between affect and psychosis are central to the understanding of schizophrenia. We conclude that treatment of emotional dysfunction should lead to reductions in current psychotic experiences.