Anxiety-based cognitive-behavioral therapy for paranoid beliefs

Abstract

Seven patients with chronic paranoid schizophrenia or schizoaffective disorder, in remission from substance dependence, received 8 sessions of cognitive-behavioral treatment (CBT) aimed at reducing their conviction in paranoid beliefs and associated anxiety (both measured on a 0% to 100% scale). Treatment was modeled on established CBT treatments for anxiety and included psychoeducation, relaxation training, and cognitive restructuring. Starting with neutral situations and gradually addressing paranoid situations, participants were taught to generate and evaluate alternative explanations for events. Participants were assigned diagnoses using the SCID-IV. They were assessed at baseline, posttreatment, and 1-month follow-up using interview, self-report, and cognitive measures. A multiple-baseline-across-subjects design was used. Results indicated clinically significant improvement by 3, mixed results for 1, and no change for 3.