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1
Collinge, M. R. "The relationship between childhood abuse and delusions : an investigation based on delusional content." Thesis, University College London (University of London), 2006. http://discovery.ucl.ac.uk/1445390/.
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Psychotic illness is associated in the literature with abuse in childhood (Read, van Os, Morrison, & Ross, 2005). This literature is reviewed, focussing on the relationship between childhood abuse and delusions. The review looks to the abuse literature to suggest ways that psychological sequelae of abuse might fit with existing theories of delusions to offer a more comprehensive understanding of their origins. It is argued that current psychological models of delusions do not deal adequately with the impact of childhood abuse. A greater appreciation of this relationship is theoretically important, but also has crucial implications for the accuracy of formulations and the appropriateness of treatment.
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Leafhead, Katherine M. "Delusions and attentional bias." Thesis, Durham University, 1997. http://etheses.dur.ac.uk/5007/.
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A research method for investigating delusional beliefs is outlined by adopting the delusional belief that one is dead (the Cotard delusion) as a model delusion. Detailed analyses of published case reports of the Cotard delusion demonstrate that the term 'syndrome' as it is currently applied to the belief that one is dead is not helpful in terms of our understanding of the delusion. Four new case studies of the Cotard delusion suggest that preoccupation with belief may play a role in the formation and maintenance of delusions. Preoccupation with delusional belief was investigated using a variant of the 'emotional' Stroop paradigm, commonly used in investigating anxiety disorders. Three individuals with the Cotard delusion, and diagnosed as suffering from depression, showed attentional biases toward words related to the theme of death. Two of the individuals had no history of anxiety and showed no bias toward words related to generalised anxiety. It was therefore suggested that the locus of attentional biases in delusions may be preoccupation with delusional belief, rather than anxiety per se. Consistent with this, a patient with fixed grandiose delusional beliefs, diagnosed with schizophrenia, and not suffering from anxiety, showed attentional bias toward words related to his delusional beliefs. Attentional bias failed to be demonstrated in a group of people with delusions arising in the context of schizophrenia, and reasons for this are discussed. Finally, three groups of individuals, who were free form any form of psychopathology, each showed a trend towards longer colour-naming times towards words related to their respective interests, but none of these were significant. It is concluded that attentional biases in delusions serve to reinforce delusional beliefs by constantly focusing die individual's attention onto delusion- relevant material. Implications for further research are discussed.
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Dudley, Robert Edward James. "Reasoning biases and delusions." Thesis, Durham University, 1996. http://etheses.dur.ac.uk/5190/.
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We know little about the formation and maintenance of delusional beliefs. Two main approaches have dominated the scant literature. These seek to account for delusions as primarily disturbances of perception (Maher, 1988) or as differences in reasoning (Garety, 1991). The concern here is with reasoning biases. Garety and Hemsley (1994) have proposed a model in which delusions’ are caused by a "failure to utilise previously acquired information". This leads to people with delusions exhibiting characteristic information processing biases in reasoning (i.e. hastiness and overconfidence). The aim of the present research was to compare the performance on reasoning tasks of people with delusions with that of psychiatric and normal control subjects in order to examine whether these subjects exhibited die proposed characteristics of delusional thought. The reasoning tasks were manipulated in both the form of reasoning (deductive, probabilistic etc.) and in content to examine the effect of reasoning with different types of material (neutral or emotional).The results of the six studies demonstrated both abnormal and normal reasoning by people with delusions. These people were no more confident than control subjects in the certainty of the correctness of their answers (Experiment 2). Nor were people with delusions excessively swayed by information currently present in the environment (Experiments 1 and 5) which is a supposed consequence of the inability to use past experience. However, people with delusions were shown to be hasty in their decisions relative to comparison subjects (Experiment 5). This hastiness was further exaggerated when the material reasoned with was self referent in content (Experiment 6). In addition, people with delusions were significantly poorer at reasoning on one of the most researched paradigms the Wason Selection Task (Experiments 3 and 4). The relevance of these findings for theories of delusions was examined.
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Garety, Philippa A. "Reasoning, rationality and delusions : studies in the concepts, characteristics and rationality of delusions." Thesis, King's College London (University of London), 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.323857.
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Jolliffe, Kim. "Safety behaviours in persecutory delusions." Thesis, University of Southampton, 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.405491.
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Mullen, Richard Steven, and n/a. "Delusions : conceptual and phenomenological aspects." University of Otago. Dunedin School of Medicine, 2006. http://adt.otago.ac.nz./public/adt-NZDU20060705.155942.
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Delusions can be reliably identified in clinical populations. However their definition has been a matter of controversy. Attributes that are commonly used to characterise delusions, such as falsity and excessive conviction, do not generally distinguish them from more ordinary beliefs. The convention that considers delusions as forms of belief obscures many of the important points of distinction from more ordinary beliefs.
Conceptual review of the concept of bizarre delusions suggests that delusions are distinguishable from other forms of belief by virtue of their individual bizarreness. That is, delusions depart from what might be the understandable beliefs or experiences for a given individual. Departure from what is objectively possible or culturally sanctioned or expected are useful, but potentially misleading, proxies for individual bizarreness. Although individual bizarreness may be the key defining feature of delusional phenomena, bizarreness, however conceived, may not usefully distinguish different subtypes of delusion.
The idea that delusions are best considered to be on a continuum with more ordinary beliefs is problematic. The continuum hypothesis depends on overemphasis on falsity and complete conviction as identifying characteristics of delusions. Both continuum and category approaches to delusions have utility that depends on the immediate purpose, but neither approach in itself can be presumed to show the greater verisimilitude.
Overvalued ideas are another group of strongly held beliefs that may be false and idiosyncratic. Their relationship to delusions has been uncertain. It is argued that overvalued ideas and delusions are different kinds of phenomena, as overvalued ideas lack the individual bizarreness of delusions. A comparison of delusions in individuals with schizophrenia, with over-valued ideas in individuals with non-psychotic mental disorders, is reported. Several differences between delusions and over-valued ideas were identified. Over-valued ideas were associated with more gradual onset, greater preoccupation, and more concern about the opinions of others about the belief. Delusions were less plausible in their content and the deluded individuals often accounted for the origin of their delusion by referring to other psychotic experiences such as hallucinations. Conviction and insight were not found to differ across the two groups.
Delusions are experiences that have many of the external characteristics of ordinary human belief. However overemphasis on these similarities results in neglect of important differences, and may lead to clinical error.
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Williams, Lisa Jane. "Psychological processes in persecutory delusions." Thesis, Bangor University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.574420.
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Attributional models of persecutory delusions suggest that paranoia arises when people make excessively external attributions for negative events and excessively internal attributions for positive events (i.e. people blame negative events on other people or circumstances and attribute positive events to themselves). The results from a review of the literature on attributional style in people with persecutory delusions indicated that that the evidence for an externalising bias, and more specifically an externalising-personal bias, for negative events is inconsistent and the evidence for an internalising bias for positive events is minimal. More consistent findings were obtained for external- situational attributions; people with persecutory delusions make fewer attributions of this type for negative events compared with healthy controls. The evidence also tentatively suggests that the attributional style of people with persecutory delusions fluctuates momentarily and with the course of mental illness. These findings are discussed in relation to issues with the reliability of current measures of attributional style. Keywords: paranoid delusions, persecutory delusions, attributional style, explanatory style, review Highlights • The evidence for attributional biases in persecutory delusions is inconsistent. Paranoid people make few external-situational attributions for negative events. Attributional style might be unstable in people with persecutory delusions. • • ATTRIBUTIONAL STYLE AND PERSECUTORY DELUSIONS • The reliability of current measures of attributional style is poor. 3
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Menon, Mahesh. "Cognitive factors in schizophrenic delusions." Thesis, University of Cambridge, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.614728.
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Brett, E. "Childhood sexual abuse and delusions." Thesis, University College London (University of London), 2005. http://discovery.ucl.ac.uk/1446331/.
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There is a considerable body of research demonstrating that childhood sexual abuse (CSA) is associated with widespread short- and long-term psychopathology, and moreover, is connected with the most severe, chronic and life-threatening consequences of a wide range of psychiatric disorders. More specifically, there is a growing body of evidence reporting that CSA is related to psychotic symptoms and diagnoses of schizophrenia, and some authors have found thematic links between the nature of abuse and the content of psychotic symptoms. A wide range of biological, psychological and social factors have been postulated in the literature as mediating or moderating the relationship between childhood abuse and psychotic symptoms in adulthood. Cognitive models of psychosis, and delusions in particular, are increasingly influential. There is ongoing debate as to the nature of the relationship between childhood abuse and psychosis, with some theorists proposing a causal relationship. Despite the consistently demonstrated relationship between child abuse and adult psychopathology, research suggests that the majority of abuse and trauma is unidentified by mental health services in routine clinical practice. Clinical issues related to enquiring about abuse are examined.
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Hamdy, Ronald C., Amber Kinser, Tracey Kendall-Wilson, Audrey Depelteau, Rebecca Copeland, Kathleen Whalen, and J. Culp. "Visual Hallucinations and Paranoid Delusions." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2736.
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Visual well-formed hallucinations, fluctuations in the level of cognition, and alertness and extrapyramidal signs are core features of dementia with Lewy bodies. Some patients realize that what they are seeing or hearing are just hallucinations and learn to accept them. Others, however experience these hallucinations as quite real and cannot be dissuaded from the firm belief that they are. In fact, efforts to dissuade them often serve only to confirm the often associated paranoid delusions and this may lead to a catastrophic ending. Hence, it is best not to contradict the patient. Instead, attempts should be made to distract the patient and change the focus of her or his attention. In this case scenario, we present a 68-year-old man who has been diagnosed with dementia with Lewy bodies. He lives with his daughter. He has visual hallucinations and paranoid delusions that worsen at night: He thinks there are people outside the house plotting to kill him. We discuss what went wrong in the patient/caregiver interaction and how the catastrophic ending could have been avoided or averted.
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Cox, Rochelle Evelyn Psychology Faculty of Science UNSW. "Autobiographical memory during hypnotic identity delusions." Awarded by:University of New South Wales. School of Psychology, 2007. http://handle.unsw.edu.au/1959.4/28047.
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The aim of this thesis was to examine the impact of an identity delusion on autobiographical memory and develop a model of deluded autobiographical memory to guide future research in this area. Given the difficulty of studying identity delusions in isolation from other clinical disorders, this thesis presents six experiments that used hypnosis as a laboratory model of identity delusions. Chapter 1 reviews literature from three distinct areas, including delusions, autobiographical memory, and hypnosis. Chapter 1 reviews a model of the self and autobiographical memory proposed by Conway (2005) and outlines the value of using hypnosis instrumentally to model delusions of self. Chapter 2 presents two experiments that established hypnosis as a suitable paradigm for investigating identity delusions. These experiments examined the parameters of the hypnotic delusion and tested the impact of the delusion on self and autobiographical memory. Chapter 3 presents two experiments that continued to examine the characteristics of autobiographical memory during a hypnotic identity delusion. These experiments indexed the specificity, source, perspective, and qualitative features of autobiographical memories elicited during a suggested identity delusion. Chapter 4 presents two experiments that investigated memory processing during a hypnotic identity delusion. These experiments illustrated the shifting accessibility of autobiographical memories during a hypnotic identity delusion. Finally, Chapter 5 draws the empirical findings together to discuss the value of hypnosis as a technique for modelling identity delusions and the ways in which a hypnotic identity delusion influences autobiographical memory. Importantly, Chapter 5 proposes a model of deluded autobiographical memory that integrates Conway???s (2005) self-memory system with relevant aspects of Langdon and Coltheart???s (2000) two-factor theory of delusions. Using this proposed model as a framework, Chapter 5 discusses the clinical and theoretical implications of the findings from this thesis and suggests future research directions.
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Clews, Kelsey. "Persecutory Delusions and Suicide in Schizophrenia." Thesis, The Chicago School of Professional Psychology, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3688354.
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Suicide is a tragic, complex phenomenon experienced by individuals of all ages, genders and cultures. Given its widespread occurrence, it is important to identify predictive and risk factors in order to develop efficacious prevention and intervention strategies. One factor that has been consistently identified as increasing risk for suicide is being diagnosed with schizophrenia. Persecutory delusions have been most prominently researched in relation to outcome in schizophrenia; however, few studies have investigated the relationship between persecutory delusions and suicide risk for those with this diagnosis. Furthermore, studies that have been conducted are largely quantitative in nature, and therefore are limited by their ability to offer explanations for their results. Understanding quantitative relationships through a theoretical perspective focused on choice and meaning making, such as existential psychology, may increase the specificity and effectiveness of preventative programs and intervention approaches, ultimately leading to more saved lives. This dissertation therefore used archival data from participants in the Chicago Follow-Up Study diagnosed with schizophrenia or schizoaffective disorder to explore the relationship between the course of suicidality and persecutory delusions in schizophrenia through an existential lens. Locus of control and self-esteem were included in the analysis as possible mediating variables. Those with high self-esteem endorsed higher suicidal activity, and those with persecutory delusions endorsed higher suicidal activity and a more external locus of control. Implications of these results suggest both self-esteem and locus of control should be addressed as possible mediating factors in the relationship between persecutory delusions and suicide for those diagnosed with schizophrenia.
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Simpson, Jane. "A cognitive investigation of schizophrenic delusions." Thesis, University of Hertfordshire, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302309.
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Kinderman, Peter. "The self-concept and persecutory delusions." Thesis, University of Liverpool, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.320577.
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Day, Elizabeth 1965. "Delusions of gender : sex, identity and intersubjectivity." Monash University, School of Political and Social Inquiry, 2001. http://arrow.monash.edu.au/hdl/1959.1/8524.
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Colbert, Suzanne. "Delusions, anxiety, reasoning and need for closure." Thesis, King's College London (University of London), 2006. https://kclpure.kcl.ac.uk/portal/en/theses/delusions-anxiety-reasoning-and-need-for-closure(bd25f0b9-281c-4d3b-99bb-651d81007e06).html.
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Paget, Andrew. "Interpersonal beliefs and distress in persecutory delusions." Thesis, University of London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.583256.
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Empirical studies into aspects of belief content that are associated with distress in persecutory delusions have been inconsistent. Typically these studies have focused on the anticipation of threat consistent with the conceptualisation of persecutory delusions as a form of threat belief. Research in the voices literature has focused on the relationship the voice-hearer establishes with their voice. In doing so, it has been demonstrated that specific aspects of interpersonal belief content are associated with distress. The study had two main aims: (1) to explore how people with persecutory delusions perceived the self, others and persecutors across specific dimensions of interpersonal belief, and (2) whether the difference self other and persecutor on dimensions of interpersonal beliefs was associated with emotional and delusional distress. A cross-sectional investigation of 29 individuals currently experiencing persecutory delusions was conducted. A repertory grid methodology was used to explore aspects of belief content between self, other and persecutor, and differences were correlated with emotional and delusional distress measures. The results highlighted a role for malevolence as a key belief dimension in the way people with persecutory delusions view persecutors and others. With regard to distress, there was a key role for how others were viewed compared to the persecutor. When participants saw others and persecutors to be similar in terms of malevolence and omnipotence, this was associated with higher levels of depression and anxiety. The appraisals people with persecutory beliefs make concerning others on interpersonal beliefs appear important in distress. Therefore, interventions that focus on improving relationships with others may facilitate the alleviation of distress.
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Pugh, Katherine. "Responsibility beliefs and deservedness in persecutory delusions." Thesis, University of London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.589461.
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Persecutory delusions are one of the most prevalent psychotic symptoms and research into their causes and consequences is vital. People with 'bad me' paranoia believe they deserve to be persecuted. However, other beliefs associated with this experience have not been identified. Responsibility and overestimation of threat beliefs were traditionally linked with OeD but have also been found in people with unspecified psychosis. The current study examined if there was a difference between responsibility beliefs (separate from overestimation of threat beliefs) in people with persecutory delusions compared to non-clinical controls and previously published data from people with OeD, anxiety disorders and unspecified psychosis. The relationship between responsibility beliefs and deservedness for persecution was also examined. 30 people with persecutory delusions and 29 non-clinical controls were recruited. Both groups completed measures of affect, responsibility and overestimation of threat beliefs. People with persecutory delusions were interviewed about their delusional beliefs and they identified a range of entities who they believed ,. were responsible for the perceived harm. They also had higher responsibility scores than non-clinical controls, people with OeD and people with anxiety disorders. In the persecutory delusions group higher responsibility scores were related to people believing they deserved to be persecuted. However, there was no difference between their responsibility scores and those of people with unspecified psychosis. The results suggest that responsibility beliefs are not specific to OeD but further research is required to establish whether responsibility beliefs have a specific relationship to persecutory delusions or are related to psychosis in general. It is important to assess who people believe is responsible for their persecution as this could identify additional beliefs and experiences that are significant for that individual. Treatments 3 for reducing responsibility beliefs in QeD could be beneficial for people with persecutory delusions and future research is needed to establish this.
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Siddle, Ronald. "Religious beliefs and religious delusions in schizophrenia." Thesis, University of Manchester, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.627989.
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Introduction Studies examining outcome in schizophrenia have either not considered religion as a relevant variable; or else they have failed to disentangle religious delusions from normal religious beliefs. Method. The measures were developed. The psychometric properties of the Religious Life Inventory modified for use in patients with schizophrenia were examined (study 1). A reliable categorisation procedure was developed for separating religious delusions from normal religious beliefs. A cross sectional investigation (study 2) established the prevalence of religious delusions, and categorised them into meaningful categories. Response to treatment and satisfaction with treatment was evaluated (in study 3) using a quasi-experimental approach. Results. The prevalence of religious delusions was 24%. The most common examples were the delusion of being God or Jesus and the interpretation of an auditory hallucination to be the voice of God or the Devil. Religious delusions were most commonly found in religious people, especially those who have had alterations in their level of religiosity in the past and who hallucinated. Those with religious delusions had higher scores on psychotic symptom measures than those who did not have religious delusions on admission. There was no difference between the religiously deluded and not religiously deluded, or religious and not religious patients in their response to routine treatment. Conclusion Religiosity is not a relevant factor in response to routine treatment for patients with schizophrenia.
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Wilkinson, Sam Luis John. "Monothematic delusions and the nature of belief." Thesis, University of Edinburgh, 2013. http://hdl.handle.net/1842/8919.
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In this thesis I argue that our philosophical account of the nature and norms of belief should both inform and be informed by our scientific understanding of monothematic delusions. In Chapter 1, I examine and criticise standard attempts to answer the question “What is delusion?” In particular, I claim that such attempts are misguided because they misunderstand the kind of term that “delusion” is. In Chapter 2, I look at the nature of explanation in psychology and apply it to delusions. In particular I look at the constraints on a successful explanation of a person’s psychological state in terms of brain damage or dysfunction. I then propose, in Chapter 3, a way of understanding how delusions of misidentification arise. In particular, I criticise the standard view that they are formed via inference (in the relevant sense of “inference”) on the basis of anomalous experience. I draw on empirical work on object and individual tracking, on dreams, and on the Frégoli delusion, and argue that inference is not only un-necessary, but is actually often bypassed in humans, for judgments of identification. The result is a non-inferential file-retrieval view. On certain views of belief, this would mean that the Capgras delusion lacks the right functional role to count as a genuine belief. In Chapter 4, I criticise such views of belief, and put forward a “downstream only” view. Roughly, something is a case of believing if and only if it disposes people to act in certain ways. I defend such a view against two serious and influential objections. In Chapter 5, I ask whether this means that the Capgras delusion can therefore safely be called a belief. I argue that there is a risk – even if one accepts the downstream only view of belief – that it still won’t count as a belief, as a result of the subject’s “incoherence” or “agentive inertia.” However, I then distinguish egocentric from encyclopaedic doxastic states. This opens the possibility that one can truly say that the subject has the egocentric belief, “This man is not my father”, but may fail to have the encyclopaedic belief, “My father has been replaced by an impostor”. It also demonstrates that the question “Are delusions beliefs?” has been approached in an unhelpful way by the main participants in the debate. This thesis is important because it shows the extent to which real-world phenomena can inform and be informed by central philosophical notions like belief. More precisely, it shows that the most plausible way of accounting for monothematic delusions involves abandoning both a strong normativism, and a discrete representationalism, about belief.
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Buchanan, Alec. "The phenomenological correlates of acting on delusions." Thesis, University of Edinburgh, 1996. http://hdl.handle.net/1842/21660.
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The study consisted of the examination of the phenomenological correlates of acting on delusions in a sample of 83 newly admitted psychotic subjects who demonstrated at least one non-mood congruent delusion. Subjects were screened to identify such beliefs using the P.S.E. and where several delusions were present one belief was selected for further study. This was termed the Principal Belief. Each subject was then interviewed using a newly designed instrument, the Maudsley Assessment of Delusions Schedule, in order to describe the phenomenology of the Principal Belief. Several areas of phenomenology were examined, namely, the degree of conviction with which the belief was held, the presence or absence of evidence supporting the belief, the affective content of that belief, its systematisation, the level of pre-occupation present and the level of insight demonstrated by the subject. In addition, information was obtained relating to two behavioural variables, one derived from the subject's own description and the other generated from information provided by informants. The phenomenological correlates of action defined in these two ways were then examined. When action was defined on the basis of information provided by informants, no such correlates were identified. It seems most likely that this reflects the lack of validity of the behavioural variable. When action was defined on the basis of information provided by the subjects themselves, several aspects of phenomenology were associated with such action. In particular, the ability to identify evidence supporting the belief, the presence of an affective component to that belief and the presence of a form of insight (a willingness, when challenged, to change the degree of conviction with which the belief was held) showed such an association.
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Flood, Anneline D. C. "Cognitive and emotional processes in persecutory delusions." Thesis, University of East London, 2013. http://roar.uel.ac.uk/3040/.
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Reliable and detailed descriptions of the content and emotions associated with persecutory delusions have been emphasized as important for the foundation of effective theoretical development and clinical practice. Two studies have directly examined these associations in persecutory ideation (Green et al., 2006; Freeman et al., 2001), and found details of content to be associated with depression and anxiety. The aim of this study is to partially replicate and extend previous research by exploring possible associations between specific emotions and content. Six research hypotheses were examined. It is hypothesised that the details of content such as the power of the persecutor as rated by the participant would be associated with depression and anxiety, deservedness would be associated with anger and shame and the participants‟ ability to cope would be associated with shame and depression. Thirty-seven participants experiencing persecutory delusions were recruited from inpatient and outpatient locations within a specific NHS Trust. Five measures that assessed persecutory delusional content and emotional responses were completed. This included a novel assessment tool developed for this study. Results of this study failed to support five of the six research hypotheses as no associations were found between content of persecutory delusions and specific emotions. In fact, it was found that there was a slight trend of the relationship being in the opposite direction to that predicted. Findings of this study have a few implications for contemporary approaches to persecutory delusions. It suggests that there are gaps in our understanding and examination of persecutory delusions. Additionally it could mean that the theories of persecutory delusions which emphasize emotions should be revised.
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Green, Melissa Jayne. "Facial affect processing in delusion-prone and deluded individuals a continuum approach to the study of delusion formation /." Connect to full text, 2001. http://hdl.handle.net/2123/792.
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Thesis (Ph. D.)--University of Sydney, 2002.Includes published papers co-authored by Green. Title from title screen (viewed Apr. 23, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Psychology, Faculty of Science. Degree awarded 2002; thesis submitted 2001. Includes bibliography. Also available in print form.
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Bell, Vaughan. "Delusions and belief formation : a cognitive neuropsychiatric approach." Thesis, Cardiff University, 2006. http://orca.cf.ac.uk/55592/.
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There is no accepted definition of belief and it is likely that the everyday use of the term does not represent a single neuropsychological entity. Nevertheless, cognitive neuropsychiatry is likely to be useful in understanding belief-related phenomena, as it does not necessarily require the focus of study to be a unitary construct. The label 'delusion' is likely to be an umbrella term for a variety of pathologies that lead a person to make an unlikely belief-claim or to have an unlikely belief attributed to them on the basis of their behaviour, in tandem with the person experiencing significant distress and / or causing social stress. Social network analyses and case studies suggested that the traditional psychopathological boundaries of delusion are influenced by socio-cultural developments and that the diagnostic criteria need revising. Despite the central role of anomalous perceptual experience in many delusion formation models, it is unclear whether it is a necessary condition. A new, valid measure of perceptual anomalies, the Cardiff Anomalous Perceptions Scale (CAPS), was developed, and a study of delusional patients suggested that pathological levels of anomalous experience are not necessary for delusion formation. A principal components analysis suggested three factors underlying anomalous experience in the general population: 'clinical psychosis', 'chemosensation' and 'temporal lobe experience'. A study using transcranial magnetic stimulation indicated that disrupting the left lateral temporal cortex in healthy participants can alter processes related to magical thinking, suggesting these areas play a causal role in delusion formation. To investigate the determinants of pragmatically pathological beliefs, as opposed to simply 'magical' ones, participants with religious beliefs (Christians and Pagans) were compared to non-religious controls and delusional patients. Pagans reported similar levels of anomalous experience to psychotic patients, but were no more distressed than the general population, suggesting distress is the more important factor in delusion formation.
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Ashley, Andrew Christopher. "Making sense of persecutory delusions : a qualitative approach." Thesis, University of Birmingham, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.667752.
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Doyle, Darrin Michael. "The Big Baby Crime Spree and Other Delusions." University of Cincinnati / OhioLINK, 2006. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1155575561.
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Swarbrick, Rebecca. "Exploration of self-structure in individuals experiencing paranoid delusions." Thesis, University of Manchester, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.536580.
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Within a symptom framework (e. g. Bentall, 1990), the present research investigated the self-structure of individuals who were actively experiencing paranoid and persecutory delusions. The structural qualities of self-schemata were determined in two experimental groups (15 acutely unwell paranoid patients and 29 non-clinical controls) using a multiple free-sorting task. Participants were asked to endorse pre-selected self-attributes and position their chosen elements into social roles or identities. Linville's unitary index was calculated using Attneave's H algorithm. Separate positive and negative self-complexity indices were also computed following Woolfolk's model, as were levels of differentiation and integration (Rafaeli-Mor et al., 1999). Paranoid individuals displayed reduced unitary and positive self-complexity. Their responses on the negative index mirrored those of controls. The clinical group exhibited less differentiation within endorsed attributes, no overlap of self-descriptive elements and reduced identified social roles. Psychological well-being was inversely related to negative self-complexity and directly associated with positive self-structure. Against predictions, greater self-complexity did not buffer the effects of stress life-events on psychological functioning, with unitary complexity exacerbating levels of anxiety and low self-esteem. A strong inverse trend was observed between negative self-structure and length of present admission. Schizotypy was consistently associated with increased negative self-complexity, indicating a possible vulnerability marker for high-risk populations. Clinical implications include the use of interpersonal therapeutic processes to develop self-reflection skills, the importance of early interventions to prevent the fragmentation and simplification of the self and its internal working models of being, and the potential predictive use of structure to indicate schizotypy. Limitations of the research include a small sample size and under power, lack of appropriate control groups, poor definitional criteria of self-structure and the omission of multi-dimensional phenomenological measures of delusional pathology.
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Earnshaw, Owen. "Recovering the voice of insanity : a phenomenology of delusions." Thesis, Durham University, 2011. http://etheses.dur.ac.uk/3225/.
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This thesis attempts to recover the voice of those termed ‘delusional’ and gives reasons why they should have a place in the ‘conversation of humanity’. It does this by challenging what I identify as a view of language use that I call the ‘monological (as opposed to dialogical) folk-scientific observer’ picture. I argue that it is the poverty of this picture that leads to the idea that delusions are empty speech acts, incomprehensible, or irrational and incorrigible false beliefs. These conceptions of delusions stand in the way of people labelled as ‘delusional’ being considered as competent partners in conversation. In the place of such a picture, I draw analogies with poetical uses of language and outline a view of language as a means of organising experience. The experience of those classified as ‘insane’ is particularly chaotic and an ethical stance to them involves trying to imagine how their words can have sense. The thread that is followed throughout the thesis is that it is reciprocal trust that allows us to remain in a common sense orientation to the world and it is this that breaks down when people start to say things that are considered delusional. Trust provides an epistemic frame that rules out certain possibilities for making sense of the world. A breakdown in trust occurs because of a disruption of the person’s perceptions of salience which prevents the person from being attuned to interpersonal situations. Following on from this depiction of delusions, it follows that re-establishing trust with the sufferer is crucial to overcoming delusions and that the stigma attached to being seen as ‘delusional’ can stand in the way of this. It is argued that the person’s existential stance can be understood as ironic and so an earnestly ironical approach to the person is ethically justified.
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Hutton, Paul. "The role of persecutory self-attacking in persecutory delusions." Thesis, University of Manchester, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.490120.
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Over the past two decades much research has examined the psychological mechanisms involved in persecutory delusions, leading to the development of competing psychological models (Freeman et aI., 2002; Bentall et aI., 2001). Mills, Gilbert, Bellew and McEwan et aI., (2007) suggest an additional perspective on paranoia can be gained by exploring the way human capacities for dealing with threats have evolved. They note paranoid individuals have a heightened sensitivity to threats from others, and when threat is detected this provokes a defence of anger and aggression. Furthermore, and of relevance to the present study, they propose this angry and aggressive way of relating to others can be internalised, leading to emotional distress. Consistent with this theory, they found that students with paranoid beliefs tended to engage in heightened self-attacking of a 'hateful' nature, which seemed to have a 'self-persecutory' function. Using a cross-sectional design and questionnaire methodology the primary objective of the current study is to ascertain whether people with persecutory delusions engage in self-attacking of a hateful and persecutory nature in comparison to people with depression and in comparison to healthy controls. This study also seeks to collate exploratory data enabling the development of hypotheses about the links between self-attacking and (l) emotional distress, (2) an individual's perception of why others may attack them and how this relates to their own self-attacks; (3) perceived deservedness of persecution (Melo, Taylor, & BentalI, in press; Trower & Chadwick, 1995) and (4) recovery style (Drayton, Birchwood, & Trower, 1998). The results suggest that people with persecutory delusions engage in more selfattacking of a persecutory nature than healthy control subjects, less self-reassurance but also less self-corrective self-criticism. Exploratory data is presented suggesting the forms and functions of self-attacking and self-criticism are associated the perceived forms and functions of others-attacking, that hateful self-attacking and selfcriticism are strongly associated with emotional distress in this group, and that treating oneself as inadequate is associated with perceived deservedness of persecution. The results are discussed within the context of the current theoretical understanding of persecutory delusions and in the context of the methodological limitations the current study. Recommendations for future research and the possible clinical implications of the findings are also discussed.
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Fornells-Ambrojo, M. "Can virtual reality be used to understand persecutory delusions?" Thesis, University College London (University of London), 2007. http://discovery.ucl.ac.uk/1444679/.
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Persecutory delusions can be conceptualised as beliefs about the intentions of others. Contemporary models of persecutory delusions have different approaches to understanding interpersonal processes in paranoia. The current paper provides a critical review of the theoretical approaches and the empirical evidence on interpersonal processes across the continuum of paranoia. The three main models of persecutory delusions (Bentall and colleagues' Delusions-as-defence model, Freeman and Colleagues' Threat anticipation model and Trower and Chadwick Interpersonal theory of the self) propose that the social environment is involved in the development of persecutory delusions but they put forward different mechanisms to explain this. The evidence on interpersonal processes is organised in five main areas: interpersonal life events, attachment, schematic beliefs about relationships, social cognition and interpersonal behaviour. The review concludes with a summary of the evidence in relation to the three theoretical approaches, a discussion of methodological issues and the implications for future research.
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Williams, Claire. "Persecutory delusions, schizotypy and disruptions to theory of mind." Thesis, University College London (University of London), 2006. http://discovery.ucl.ac.uk/1446421/.
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Frith (1992) proposed that disruptions to 'theory of mind' (Premack and Woodruff, 1978) or 'mentalising' could explain the signs and symptoms of schizophrenia. For Frith, persecutory delusions represent a disorder in monitoring the thoughts and intentions of others. Following Frith's (1992) model, disruptions to theory of mind have been included in the main cognitive models of persecutory delusions. This review will first outline Frith's neuropsychological model of schizophrenia. It will then summarise the role theory of mind disruptions are given by the main cognitive models of persecutory delusions (Bentall, Corcoran, Howard, Blackwell and Kinderman, 2001 Freeman, Garety, Kuipers, Fowler and Bebbington, 2002) and the cognitive model of positive symptoms (Garety, Kuipers, Fowler, Freeman and Bebbington, 2001). The empirical evidence for such a disruption is then reviewed from studies with a patient population and studies with a non-patient population who vary of the dimension of schizotypy. It is concluded that empirical studies to date have mostly employed traditional theory of mind tests that are designed to assess simple theory of mind deficits such as those seen in autism or the behavioural signs of schizophrenia (Frith, 1992). It is suggested that traditional tests are not able to detect the subtle disruptions to theory of mind related to persecutory delusions. The concepts of 'hyper-ToM' (Abu-Akel and Bailey, 2000) and 'over-mentalising' are discussed and it is suggested that future research should focus on the development of tests which are able to detect 'hyper-ToM' or 'over-mentalising' in patients with persecutory delusions or non-clinical populations who are high on delusional ideation and paranoia.
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Moutoussis, Michael. "Defensive avoidance in paranoid delusions : experimental and computational approaches." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/defensive-avoidance-in-paranoid-delusions-experimental-and-computational-approaches(e36dbfcf-9341-43a0-be41-087f9b22d994).html.
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This abstract summarises the thesis entitled Defensive Avoidance in Paranoid Delusions: Experimental and Computational Approaches, submitted by Michael Moutoussis to The University of Manchester for the degree of Doctor of Philosophy (PhD) in the faculty of Medical and Human Sciences, in 2011.The possible aetiological role of defensive avoidance in paranoia was investigated in this work. First the psychological significance of the Conditioned Avoidance Response (CAR) was reappraised. The CAR activates normal threat-processing mechanisms that may be pathologically over-activated in the anticipation of threats in paranoia. This may apply both to external threats and also to threats to the self-esteem.A temporal-difference computational model of the CAR suggested that a dopamine-independent process may signal that a particular state has led to a worse-than-expected outcome. On the contrary, learning about actions is likely to involve dopamine in signalling both worse-than-expected and better-than-expected outcomes. The psychological mode of action of dopamine blocking drugs may involve dampening (1) the vigour of the avoidance response and (2) the prediction-error signals that drive action learning.Excessive anticipation of negative events might lead to inappropriately perceived high costs of delaying decisions. Efforts to avoid such costs might explain the Jumping-to-Conclusions (JTC) bias found in paranoid patients. Two decision-theoretical models were used to analyse data from the ‘beads-in-a-jar’ task. One model employed an ideal-observer Bayesian approach; a control model made decisions by weighing evidence against a fixed threshold of certainty. We found no support for our ‘high cost’ hypothesis. According to both models the JTC bias was better explained by higher levels of ‘cognitive noise’ (relative to motivation) in paranoid patients. This ‘noise’ appears to limit the ability of paranoid patients to be influenced by cognitively distant possibilities.It was further hypothesised that excessive avoidance of negative aspects of the self may fuel paranoia. This was investigated empirically. Important self-attributes were elicited in paranoid patients and controls. Conscious and non-conscious avoidance were assessed while negative thoughts about the self were presented. Both ‘deserved’ and ‘undeserved’ persecutory beliefs were associated with high avoidance/control strategies in general, but not with increased of avoidance of negative thoughts about the self. On the basis of the present studies the former is therefore considerably more likely than the latter to play an aetiological role in paranoia.This work has introduced novel computational methods, especially useful in the study of ‘hidden’ psychological variables. It supported and deepened some key hypotheses about paranoia and provided consistent evidence against other important aetiological hypotheses. These contributions have substantial implications for research and for some aspects of clinical practice.
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Aschebrock, Yasmin. "Different Realities: Challenging Conventional Ways of Conceptualising Delusions and Hallucinations." Thesis, University of Auckland, 2005. http://hdl.handle.net/2292/916.
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Delusions and hallucinations are typically regarded in contemporary Western societies as signs of serious mental illness - that is, as essentially meaningless surface expressions of a biological process, that are almost invariably distressing and harmful to those experiencing them. However, these conventional ways of conceptualizing delusions and hallucinations are increasingly being contested (by critical psychologists and by some of those who experience these kinds of phenomena). As part of this trend, this thesis highlights the need to move beyond traditional ways of construing delusions and hallucinations and to open up new ways of thinking about them. In Part One, I present analyses from an international survey of 58 mental health practitioners and researchers, which I conducted to investigate their understandings of delusional and hallucinatory content. I explore their views concerning the importance of attending to the content of delusions and hallucinations, and a possible relation between gender and the content of these phenomena. In Part Two, I present analyses of interviews with 11 women who have experienced delusions and hallucinations. I explore the linguistic resources available to those who experience delusions and hallucinations for talking about these kinds of phenomena, and the ways in which they may attempt to make sense of such experiences. I illustrate some of the challenges to traditional ways of conceptualising delusions and hallucinations by drawing upon the accounts of five of the women I interviewed. I aim, in this thesis, to question and disrupt conventional understandings of delusions and hallucinations and to increase the availability of some alternative (marginalised) ways of construing them. I emphasise the need to consider (and critically examine) the potential practical and moral implications of various ways of conceptualising delusions and hallucinations.
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Speechley, William Jonathan. "Dual-stream modulation failure, cognitive biases and delusions in schizophrenia." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42246.
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Recent cognitive research has made important contributions to our understanding of delusions, but there have been few attempts to generate a general model that address both delusion formation and maintenance, with a focus on the mechanisms that may underlie the cognitive characteristics of delusions. This thesis describes studies replicating and extending our understanding of two previously identified cognitive biases, and then outlines the development and initial testing of a new model of delusions.
The Dual-Stream Modulation Failure (DSMF) model suggests that delusions are the result of an imbalance between two streams of reasoning: Stream 1, which is automatic and intuitive, and Stream 2, which is slower and more deliberative. The degree to which each stream is favoured in a given situation may depend on two modulators: conflict and emotion. Cognitive conflict may cause an individual to consider the available evidence more carefully, while emotional salience may favour reflexive, non-deliberative processing. In schizophrenia, conflict modulation failure (CMF) and/or accentuated emotional modulation (AEM) may result in an under-recruitment of Stream 2 processing and over-reliance on Stream 1, increasing the likelihood that erroneous interpretations will form and be maintained.
The first study employs a variation of a classic probabilistic reasoning paradigm to provide new insights into to the jumping-to-conclusions and over-adjustment biases. The second study describes the first multivariate analysis of bias against disconfirmatory evidence (BADE) data using all available information from the task to aid interpretation of the cognitive underpinnings of the evidence integration necessary in the BADE task. The third and fourth studies investigate the DSMF model of delusions using a conditional reasoning paradigm that places content believability in conflict with logical validity. Support is provided for CMF, with the schizophrenia group showing a greater drop in performance and a significantly smaller increase in activity in areas of the brain associated with conflict and deliberative processing for conflict compared to non-conflict stimuli. No evidence was found for AEM, suggesting that future DSMF research may either need to make adjustments to the experimental paradigm or to the model itself.
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So, Sue. "Changes in delusions over time and the role of reasoning." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/changes-in-delusions-over-time-and-the-role-of-reasoning(017d7cac-996f-4f58-8f37-6bf40244b363).html.
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Todd, David. "A phenomenological analysis of delusions in people with Parkingson's disease." Thesis, Lancaster University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.525318.
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Priovolou, Ageliki. "The self-schema in relation to developed delusions in schizophrenia." Thesis, Leeds Beckett University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.425272.
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This study was conducted to investigate the self-schema of paranoid schizophrenics in relation to developed delusions. A sample of 60 patients (30 with delusions of grandeur, and 30 with delusions of persecution) in remission of their symptoms, as well as a control group (61 non-psychotic individuals), completed the Young maladaptive schema questionnaire (Young, 1990), the Beck depression inventory (Beck, Rush, Shaw and Emery, 1979), and the Rosenberg self-esteem scale (Rosenberg, 1965). A pattern of maladaptive self-schemas, with moderate scores in depression and low self-esteem was found, in paranoid schizophrenics. Schizophrenic patients with delusions of persecution had an average of 8.8 maladaptive schemas (the prevalent ones being abandonment, mistrust, selfsacrifice, insufficient self-control, social undesirability and dependence). Schizophrenic patients with delusions of grandeur had an average of 9.0 maladaptive schemas (the prevalent ones being abandonment, mistrust, selfsacrifice, insufficient self-control, unrelenting standards, and entitlement). The different maladaptive schemas found in patients with delusions of grandeur, and those with delusions of persecution, indicate a relationship between the self-schema and delusions, and suggest that self-schema influences the content of the delusions. Delusion formation appears to reflect an interaction between pre-existing beliefs of the self -i.e. personality, emotions and dysfunctional cognitive processes- and the environment. Emotion also appears to play a role in delusion formation by affecting reasoning. A qualita~ive study was also conducted to investigate the acquisition of the maladaptive schemas in this population. Another sample of 20 paranoid schizophrenic patients (10 with delusions of grandeur and 10 with delusions of persecution in remission of their symptoms) as well as a group of 10 nonpsychotic individuals were interviewed. The analysis suggests that patients with delusions of grandeur as children may not have paid enough attention to the environment developing schemas without relevant childhood experiences, while patients with delusions of persecution may have paid too much attention to the environment, as children, claiming childhood experiences without holding the relevant maladaptive schemas. The results indicate that these patients may base their thinking on conceptual processes starting early in life. The findings lead to a proposal of a model to account for the formation of delusions of grandeur and persecution. This in turn leads to proposed modifications of therapeutic procedures regarding paranoid schizophrenic patients.
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So, Ho-Wai. "Change in delusions with treatment and the role of reasoning." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/change-in-delusions-with-treatment-and-the-role-of-reasoning(0a7cf6ce-7a6a-4c07-99ff-1d1dcb235591).html.
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Background: Delusions are characterised by conviction, distress, preoccupation, and disruption. ’Jumping-to-conclusions’ (JTC) and a lack of belief flexibility (BF) have been shown to be associated with delusions. -- The thesis: The overall aim was to investigate psychological processes of change in delusions over time and to examine response to treatment of aspects of delusional experience. Specific questions were: do psychological processes associated with delusions change? And do reasoning biases predict change in delusions? -- Method: Three longitudinal studies were conducted using three separate samples of patients with delusions of at least moderate severity. Studies 1 (N = 40) and 3 (N = 16) involved patients in an acute phase of psychosis, whereas Study 2 participants (N = 273) were in the recovery phase. Study 1 investigated changes in delusional dimensions, JTC and BF over eight weeks of antipsychotic treatment. Study 2 examined the factor structure and longitudinal relationship of conviction, JTC and BF over 12 months. Study 3 assessed moment-by-moment levels of delusional dimensions, BF and aberrant salience over two weeks using experience sampling methodology. -- Results: During the early phase of antipsychotic treatment, all delusional dimensions improved over eight weeks (Study 1), whereas only distress and disruption improved over two weeks (Study 3). BF and conviction were distinct factors (Study 2), and higher flexibility was consistently related to lower conviction. JTC was stable within the study periods, although higher rates of JTC during the acute phase suggest improvement across phases. JTC predisposed to the presence of delusions (Study 2) and was associated with higher and more variable conviction during treatment (Study 3). -- Conclusions: That JTC and BF contribute to the development and maintenance of delusions was largely confirmed using longitudinal data.
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Craig, Jaime. "Persecutory beliefs and social reasoning." Thesis, Bangor University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327460.
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Orem, Diana. "THE INFLUENCE OF EMOTIONAL STIMULI ON COGNITIVE PERFORMANCE IN RELATION TO DELUSION INTENSITY IN SCHIZOPHRENIA." Doctoral diss., University of Central Florida, 2009. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/3787.
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Previous research has suggested that there are multiple psychological processes underlying delusional thought. While it appears that cognitive biases in certain reasoning and attention processes are related to delusion-proneness, the influence of emotion on these processes is not well understood. The overall objective of this study was to investigate the effect of emotional content on performance on tasks thought to measure attentional bias, preferential recall, and probabilistic reasoning in individuals with schizophrenia and demographically matched controls. In order to account for level of delusion-proneness, participants also completed a multidimensional measure of delusional thought. It was hypothesized that individuals with schizophrenia would perform more poorly on both the emotional and neutral versions of these tasks compared to controls. It was also hypothesized that within each group, there would be a statistically significant emotion effect, indicated by a difference in performance on the emotional (compared to neutral) condition of each task. This emotion effect was expected to be larger in the schizophrenia group. Finally, it was hypothesized that the emotion effect would increase as the severity of delusional proneness increased for all participants, regardless of group. As hypothesized, the schizophrenia group performed more poorly on the tasks overall, though expected emotion effects were generally absent. There were no differences in the size of emotion effects between the groups on any of the cognitive tasks administered, and the emotion effect did not appear to increase as severity of delusion-proneness increased. Factors that may have contributed to this pattern of results are discussed. Implications of these findings on theoretical models of delusions and future directions for research in this area are also discussed.Ph.D.
Department of Psychology
Sciences
Psychology PhD
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Fornells, Ambrojo Miriam. "Attributional biases in persecutory delusions : associstions with emotions and social recovery." Thesis, King's College London (University of London), 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435815.
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López, Silva Pablo. "On the architecture of psychosis : thoughts and delusions of thought insertion." Thesis, University of Manchester, 2015. https://www.research.manchester.ac.uk/portal/en/theses/on-the-architecture-of-psychosisthoughts-and-delusions-of-thought-insertion(d5a49b7e-1074-4fcc-bb53-7d56cd8baa87).html.
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In its many manifestations, psychosis leads to a number of clinical and philosophical debates. Despite their practical and conceptual importance, a number of these debates remain unresolved. Appealing to the connection between phenomenological descriptions, empirical evidence, and philosophical analysis, this dissertation is devoted to the careful examination of five of the main debates surrounding the occurrence of delusions of thought insertion, one of the most complex and severe symptoms of psychotic disorders. Roughly speaking, patients suffering from thought insertion report that external agents of different nature have placed certain thoughts into the patients' minds. The introduction to this compilation clarifies the main distinctions underlying the general discussions about delusions and the specific debates surrounding thought insertion. The introduction is followed by a collection of five papers. The first paper tries to explain the way in which subjects self-attribute their own conscious thoughts in terms of agency. The second paper, assuming that delusions are a type of belief, engages with the discussion about the role that experiential abnormalities have in the process of formation of the delusional belief of thought insertion. The third paper examines the role that affective impairments might have in the process of production of thought insertion, an issue that is often overlooked by current dominant approaches to thought insertion. Taken altogether, the first three papers of this collection offer a novel understanding of the aetiology and architecture of thought insertion. The fourth paper examines a much larger discussion that overlaps with the debate about the subjective features of thought insertion. It is argued that cases of thought insertion - in conjunction with other psychotic phenomena - undermine the current self-presenting theory of consciousness, a theory meant to explain the most fundamental subjective character of conscious experiences. Finally, the fifth paper of the compilation engages with a more general discussion about the nature and role that delusions might play in a subject's life. It is argued against the dominant view that there are good reasons to characterize a certain type of monothematic delusions (including some cases of thought insertion) as biologically adaptive.
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Vorontsova, Natasha. "Cognitive factors maintaining persecutory delusions in psychosis : the contribution of depression." Thesis, King's College London (University of London), 2012. https://kclpure.kcl.ac.uk/portal/en/theses/cognitive-factors-maintaining-persecutory-delusions-in-psychosis(51b7c144-b811-4d72-8b82-df06a0d72c79).html.
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Persecutory delusions are one of the most common and distressing symptoms of psychosis. Many studies indicate an association of persecutory delusions with depression. A direct role for depression-related cognitive factors in the maintenance of persecutory delusions has not been systematically examined, despite such processes being implicated in a cognitive model. To determine whether depression in people with persecutory delusions is associated with the same cognitive factors implicated in major depressive disorder, and to examine these factors as predictors of the persistence of persecutory delusions over time. A systematic literature review formed the basis of two linked studies: one cross-sectional and one longitudinal. In the first study, 60 participants with persecutory delusions and schizophrenia spectrum diagnoses were classified into two groups, according to whether or not they met ICD-10 criteria for major depression. Assessments were made of delusions, depression and key cognitive factors from the literature: schematic beliefs, avoidance, rumination, memory specificity and problem solving. The groups’ scores were compared, and the same comparisons were made between 30 participants with non-psychotic depression and 30 non-clinical controls. For the second study, 54 participants with delusions were re¬assessed six months later, and predictors of symptom persistence were examined. 50% of participants with persecutory delusions met diagnostic criteria for major depression. With baseline paranoia levels controlled, higher baseline depression predicted higher paranoia six months later. Negative schematic beliefs about the self and problem solving deficits predicted the persistence of both paranoia and depression over time. Coexisting depression predicts the persistence of persecutory delusions, suggesting a causal association. Trials are warranted of depression-related therapeutic techniques for people with delusions, including those that target negative schematic beliefs about the self. An improved understanding of the mechanisms that maintain paranoid beliefs can enable the development of better treatments.
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Lewis, Heledd Wyn. "A formal comparison of spiritual and psychotic experiences." Thesis, Bangor University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297998.
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Longenecker, Julia Martin. "Clinical correlates of hierarchically modeled perceptions of self & others in psychosis." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47168110.
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Introduction: The connection between self and psychosis has been qualitatively noted for centuries, but left relatively neglected in the field of quantitative psychology research. Some targeted studies have shown that self-concept is different in patients with psychosis than healthy volunteers. Studies of individuals have established a specific relationship between distortions of self and the content of delusions. Recent studies have begun to collect evidence of changes of self in the early stages of psychosis. Research suggests that delusions and self-concept have various shared cognitive mechanisms and neuroanatomy, particularly with respect to persecutory delusions. Changes in self-concept are apparent in persons at ultra high risk for developing psychosis, suggesting that it precedes specific symptomatology and could be at the root of delusion formation. Therefore, we identify where the two domains intersect while overcoming the limitations of past studies such as considering only persecutory delusions, minimally defining self, and including patients with a wide range of diagnoses.
Methods: We consider delusions and self-concept in a patient group, consisting of 22 persons with first-episode schizophrenia spectrum disorders, and a group of 22 healthy volunteers. Delusional ideation is measured through the Peters et al Delusion Inventory (PDI) which derives a total, three subscores- Distress, Preoccupation, Conviction- and seven factor scores based on delusion content. Self-concept is quantified using hierarchical classification (HICLAS) analysis which generates numeric and visual outputs. It is important to specify that self is a deceivingly broad topic of which we will focus on the trait level- that is, which adjectives individuals use to describe their selves and others who are close to them. In addition to PDI and HICLAS evaluations, patients undergo clinical diagnoses and symptom ratings.
Results: While there was no diagnostic group difference in the PDI total or subscores, patients had more delusional ideation with respect to three types of content, as determined by the factor scores. HICLAS did not show group differences. However, patients and controls had different relationships between PDI and HICLAS measures, with patients showing a greater overall connection between the two domains. The specific results are discussed, including two qualitative case studies.
Conclusion: We conclude that the relationship between self-concept and schizophrenia is specific to delusions rather than general symptomatology. Relationships are drawn between the cognitive theories underlying each domain. The findings are important to theoretical understandings of self and delusions. Furthermore, it is hoped that advanced understanding of these topics can likely lead to new, targeted psychotherapeutic treatment approaches.published_or_final_version
Psychiatry
Master
Master of Philosophy
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Al, Nzawi Fatma Mohammed. "Cultural factors influencing content of delusions among schizophrenic patients in Saudi Arabia." Thesis, Brunel University, 2012. http://bura.brunel.ac.uk/handle/2438/7630.
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The present study aimed to investigate the influences of socio-cultural context on content of delusions within schizophrenic patients among three different geographical areas in Saudi Arabia and to estimate the prevalence of schizotypal personality within the non-clinical Saudi population. Methods: 148 patients meeting DSM-IV criteria of schizophrenia were drawn from in-patient sections of mental health hospitals in three areas of study (Riyadh, Jeddah, and the Eastern Province), and 364 participants were recruited for comparison groups from Saudi universities and general medical practices in the same areas. The study utilized the following instruments: Scale for the Assessment of Positive Symptoms (SAPS), Scale for the Assessment of Negative Symptoms (SANS), the MacArthur-Maudsley Delusions Assessment Schedule (MMDAS), the World Health Organization (WHO) Life Events Schedule, the Aetiological Beliefs Questionnaire (ABQ), and the Schizotypal-Personality Questionnaire (SPQ). Results: Firstly: there were significant main effects of residence and sex on the three dependent SPQ scales, and females and Riyadh area residents scored higher on all dependent SPQ scales especially on the cognitive scale. Secondly: persecutory delusions were the most common delusions among schizophrenic patients followed by delusions of being controlled, and the frequency of persecutory delusions was significantly higher in females and in the Riyadh area. Thirdly: only delusions of jealousy were specifically associated with violent behaviours among schizophrenic patients. Finally: ABQ showed that both supernatural and psychological explanations of illness were common among both control and clinical groups. Qualitative analysis of the content of delusions revealed socio-cultural and gender-related issues that were strongly reflected in the themes and content of delusions. Conclusion: Content analysis of delusions in a Saudi schizophrenic sample showed strong effects of the socio-cultural context and stress points such as racism and gender inequality, and gender and regional culture affected both the frequency with which persecutory delusions were observed, and the mean scores of schizotypal personality in a non-clinical sample.
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Young, Heather Frances. "Reasoning in patients with persecutory delusions : comparisons with depressed and normal subjects." Thesis, University of Liverpool, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309945.
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King, David. "Understanding delusions : the role of self-esteem and a consideration of metacognition." Thesis, Open University, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.286933.
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Rossell, Susan Lee. "An experimental study of semantics and affect in schizophrenic patients with delusions." Thesis, King's College London (University of London), 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391363.
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Murphy, Philip. "Understanding decision-making in psychosis : a case series of psychological assessment and formulation of impaired treatment decision-making, and a systematic review and meta-analysis of the Attribution-Self-Representation model of persecutory delusions." Thesis, University of Edinburgh, 2017. http://hdl.handle.net/1842/25835.
Full textAbstract:
Purpose: A systematic review and meta-analysis was conducted to test key predictions of the widely-studied ‘paranoia as defence’ model (more formally known as the ‘attribution–self-representation cycle’) proposed by Bentall, Corcoran, Howard, Blackwood, and Kinderman (2001), as applied to people with psychosis with persecutory delusions. A novel case series was also conducted to examine the feasibility and acceptability of collaborative psychological assessment and formulation of impaired treatment decision-making capacity (TDMC) among patients with psychosis, and produce preliminary data on safety and efficacy. Methods: With regard to the systematic review and meta-analysis, people with psychosis with persecutory delusions were compared to healthy controls, people with depression and people with psychosis without persecutory delusions (and, if specified, grandiose delusions) on a number of outcomes: externalising attributional bias, explicit self-esteem, implicit self-esteem and discrepancy between implicit and explicit self-esteem. Correlations between paranoia severity and each of these outcomes and self-esteem instability were also examined. In regards to the case series, a formulation of impaired TDMC for 5 patient participants was developed and shared with 13 clinician participants. Acceptability, utility, working alliance and safety were assessed through pre and post self-report and interview measures. Results: Sixty-three studies were included in the meta-analysis and systematic review, of which 33, 36, 10, 10 and 4 were used to test hypotheses on externalising attributional bias, explicit self-esteem, implicit self-esteem, implicit-explicit self-esteem discrepancy and selfesteem instability, respectively. Key model-consistent findings included the following: people with psychosis with persecutory delusions had a greater externalising attributional bias compared to all the other groups and a greater implicit-explicit self-esteem discrepancy than people with depression, and paranoia severity was positively correlated with externalising attributional bias and self-esteem instability. Key model-inconsistent findings included the following: people with psychosis with persecutory delusions had lower explicit self-esteem than healthy controls, and paranoia severity was negatively correlated with explicit self-esteem. There were also some model-inconclusive findings. Regarding the case series, 3 of the patient participants collaborated in the development of their formulation. They found the intervention safe and acceptable, following which they provided a much richer understanding of the factors that may impair their TDMC (Cohen’s d = 2.16). Two patient participants only partially adhered to the intervention protocol, but a psychological formulation was still feasible to produce and no adverse effects were reported. Clinician participants provided a much richer understanding of the factors that may impair the patient participants’ TDMC (Cohen’s d = 1.36; 95% CI = 0.63 to 2.07) after the presentation of the case formulations. Increases in knowledge, confidence and positive attitudes regarding supporting the TDMC of patients were observed. They strongly believed that the formulations cohered with their knowledge of the patient participants and were comprehensive and accurate. Conclusions: The findings of the systematic review and meta-analysis support a ‘weak’ version of the paranoia as defence model, which suggests persecutory delusions are only partially effective at protecting low implicit self-esteem from reaching awareness. The findings of the case series suggest that patients with psychosis, and their clinicians, can be engaged in a collaborative psychological assessment and formulation of factors that may impair their TDMC. Initial data from the case series also suggests this process is acceptable, safe and helpful.