Psychological characteristics of religious delusions.

Robel Iyassu,Elizabeth Kuipers,Paul Bebbington,David Fowler,Suzanne Jolley,Philippa Garety,Graham Dunn,Daniel Freeman,Amy Hardy,Helen Waller,Richard Emsley

doi:10.1007/s00127-013-0811-y

Abstract

PurposeReligious delusions are common and are considered to be particularly difficult to treat. In this study we investigated what psychological processes may underlie the reported treatment resistance. In particular, we focused on the perceptual, cognitive, affective and behavioural mechanisms held to maintain delusions in cognitive models of psychosis, as these form the key treatment targets in cognitive behavioural therapy. We compared religious delusions to delusions with other content.MethodsComprehensive measures of symptoms and psychological processes were completed by 383 adult participants with delusions and a schizophrenia spectrum diagnosis, drawn from two large studies of cognitive behavioural therapy for psychosis.ResultsBinary logistic regression showed that religious delusions were associated with higher levels of grandiosity (OR 7.5; 95 % CI 3.9–14.1), passivity experiences, having internal evidence for their delusion (anomalous experiences or mood states), and being willing to consider alternatives to their delusion (95 % CI for ORs 1.1–8.6). Levels of negative symptoms were lower. No differences were found in delusional conviction, insight or attitudes towards treatment.ConclusionsLevels of positive symptoms, particularly anomalous experiences and grandiosity, were high, and may contribute to symptom persistence. However, contrary to previous reports, we found no evidence that people with religious delusions would be less likely to engage in any form of help. Higher levels of flexibility may make them particularly amenable to cognitive behavioural approaches, but particular care should be taken to preserve self-esteem and valued aspects of beliefs and experiences.

Highlights

Delusions are a cardinal feature of psychotic illness, present in around three quarters of people with a schizophrenia spectrum diagnosis [1, 2]
Comprehensive measures of symptoms and psychological processes were completed by 383 adult participants with delusions and a schizophrenia spectrum diagnosis, drawn from two large studies of cognitive behavioural therapy for psychosis
Binary logistic regression showed that religious delusions were associated with higher levels of grandiosity

Summary

Introduction

Delusions are a cardinal feature of psychotic illness, present in around three quarters of people with a schizophrenia spectrum diagnosis [1, 2]. To be classified as a religious delusion, the belief must be idiosyncratic, rather than accepted within a particular culture or subculture [7]. Believing oneself to be inhabited by the warring spirits of multiple interspatial deities, would be considered to be a religious delusion. Acceptable religious beliefs are cited as an important coping strategy for many people with schizophrenia, and may contribute to lower symptom severity in both severe and enduring mental illnesses [8, 9] and common mental disorders [10, 11]. In contrast, have routinely been linked to poorer prognosis for people with psychotic disorders [12]

Results

Discussion

Conclusion