Understanding Of Delusions Research Articles

The accepted definition of delusions does not effectively separate clinical from non-clinical phenomena

ABSTRACT The DSM-5 and other psychiatric texts define delusions as fixed beliefs that are unamenable to change. However, many fixed beliefs are considered culturally or socially normative, and may even serve an important function in unifying groups and communities. The clinical definition of delusions does not take into account the potential social function of fixed beliefs, which may be a key factor in distinguishing fixed beliefs that are beneficial from those that are pathological. This article proposes that including a social dimension in our definition and understanding of delusions may facilitate clinical distinctions between normative fixed beliefs and clinically relevant delusions.

The Making of Delusions: From Imagination to Irreality.

In this article I aim to understand meaning construction from a cultural psychological stance and investigate how human beings - both individually and collectively - create norms and beliefs that become guidelines for how we perceive. The real and the imaginary are closely intertwined- sometimes to the extent that one of them is taken for the other. Considering some specific product of the imagination as if it is real amounts to a delusion - the topic of this paper. A person constructs and attributes meaning and associations to objects and people and these constructions have been made by both personal and socially shared ideas. The dilemma seems to be concerning perspectives on truth and what lies prior to the determination of this. The attempt of this article and the autoethnographic research is to comprehend the extent and diversity of delusions. This will be examined in the attempt to investigate and distinguish delusions from everyday life to what can be considered pathological hence scrutinize the borderline of healthy versus maladaptive. This borderline will furthermore be discussed with the basis of symptom criteria from the ICD- and DSM diagnosis systems. This seems to be of big importance when diagnostically comprehend the pathological elements of the delusions in the sense that the judgement could come to determine life situation. These discussions lead to an understanding of delusions as semiotically made when distinguishing between general versus pathological psychological conditions.

Themes of delusions and hallucinations in first‐episode psychosis

The study aims to examine the themes of delusions and hallucinations in a cohort of adolescent and young adult patients (aged 15-26 years) presenting with a first episode of psychosis. Information was collected retrospectively from 143 randomly selected medical files, using a questionnaire. Over 70% of patients were found to have either delusions or hallucinations at initial presentation. Delusions of persecution, reference and second person auditory hallucinations were the most commonly reported psychotic symptoms at initial presentation. Anxiety in the context of developmental life events may influence the presentation of patients in this age group. This patient group may also have a less well-developed system of delusional beliefs compared with older patients with established illness. A better understanding of delusions and hallucinations in a first episode of psychosis may help early identification and engagement of these patients.

Paranoid atmospheres: Psychiatric knowledge and delusional realities

In this paper I investigate the topic of paranoid atmospheres. This subject is especially of interest with respect to persons who are deluded, and also, I will demonstrate, sheds light upon the psychiatrist's "gaze" and knowledge of delusions. In my argument I will follow a path initially outlined by Karl Jaspers (1883-1969): modern psychiatric diagnosis of delusions is a diagnosis of form and not content. Jaspers' emphasis on the form of delusions enables psychiatrists to be self-critical about their professional knowledge and, consequently, prevent the development of dogmatic attitudes. In accord with Jaspers, my argument will focus on the basic structure of delusions and highlight the difference between delusional realities and non-delusional realities, a difference that follows from the possibility of self-criticism of one's own conscious and explicit convictions. I will demonstrate the importance of self-criticism with regard to paranoid atmospheres and also to psychiatric knowledge. In this manner, an understanding of delusions as lived experience will be developed, which argues that an escalation of the influence of delusional convictions, resulting in a profoundly paranoid atmosphere, is most problematic for the deluded person. To acknowledge this insight mirrors the need for a self-critique of psychiatric discourse, encourages an empathic and respectful relationship between professionals and deluded patients, and enables deluded persons to restrict their paranoid atmosphere. It is the main conclusion of my paper that a deluded person cannot do (with respect to his delusional convictions) what a psychiatrist must do (with respect to his psychiatric knowledge and his own existential convictions) in order to prevent a profoundly paranoid atmosphere in their relationship: be self-critical.

Hypnotic Illusions and Clinical Delusions: A Hypnotic Paradigm for Investigating Delusions of Misidentification

In 2 experiments, the authors created a hypnotic analogue of delusions of misidentification and explored their impact on autobiographical memory. In Experiment 1, to establish the paradigm, high and low hypnotizable participants were given a suggestion to become someone similar or dissimilar to themselves. In Experiment 2, to further test the paradigm and to examine autobiographical remembering, highs were given a suggestion to become a same-sex sibling, administered 2 challenges to the temporary delusion, and asked to generate autobiographical memories. For high hypnotizable participants, the suggested delusions of misidentification were compelling and resistant to challenge. During these temporary delusions, participants generated specific autobiographical memories that reflected previously experienced events viewed from the perspective of the suggested identity. These findings highlight the instrumental value of hypnosis to the investigation and understanding of delusions and autobiographical memory.

Dual-stream modulation failure: A novel hypothesis for the formation and maintenance of delusions in schizophrenia

Delusions, a cardinal feature of schizophrenia, are characterized by the development and preservation of false beliefs despite reason and evidence to the contrary. A number of cognitive models have made important contributions to our understanding of delusions, though it remains unclear which core cognitive processes are malfunctioning to enable individuals with delusions to form and maintain erroneous beliefs. We propose a modified dual-stream processing model that provides a viable and testable mechanism that can account for this debilitating symptom. Dual-stream models divide decision-making into two streams: a fast, intuitive and automatic form of processing (Stream 1); and a slower, conscious and deliberative process (Stream 2). Our novel model proposes two key influences on the way these streams interact in everyday decision-making: conflict and emotion. Conflict: in most decision-making scenarios one obvious answer presents itself and the two streams converge onto the same conclusion. However, in instances where there are competing alternative possibilities, an individual often experiences dissonance, or a sense of conflict. The detection of this conflict biases processing towards the more deliberative Stream 2. Emotion: highly emotional states can result in behavior that is reflexive and action-oriented. This may be due to the power of emotionally valenced stimuli to bias reasoning towards Stream 1. We propose that in schizophrenia, an abnormal response to these two influences results in a pathological schism between Stream 1 and Stream 2, enabling erroneous intuitive explanations to coexist with contrary logical explanations of the same event. Specifically, we suggest that delusions are the result of a failure to reconcile the two streams due to both a failure of conflict to bias decision-making towards Stream 2 and an accentuated emotional bias towards Stream 1.

Teorías cognitivas de las creencias delirantes

In this paper we present a review of current cognitive theories of delusion formation. Empirical research on delusions has shown that people with delusional beliefs do show underlying cognitive biases in several tasks which are related to the severity of their pathological beliefs. The main theories discussed in this paper, in their relation to the onset and maintenance of delusions, are related to the following domains: reasoning deficits, attentional biases, causal attributions biases, and theory of mind deficits. Wedefend that these studies are providing a new view of that psychotic symptom as there is an assumption that the reasoning processes implied in the formation of delusions are similar to those found in reasoning in normal people. The implications of this research both on the understanding of delusions and on innovative pathways to psychological intervention are discussed.

Wittgenstein and the limits of empathic understanding in psychopathology

The aim of this paper is three-fold. Firstly, to briefly set out how strategic choices made about theorising about intentionality or content have actions at a distance for accounting for delusion. Secondly, to investigate how successfully a general difficulty facing a broadly interpretative approach to delusions might be eased by the application of any of three Wittgensteinian interpretative tools. Thirdly, to draw a general moral about how the later Wittgenstein gives more reason to be pessimistic than optimistic about the prospects of a philosophical psychopathology aimed at empathic understanding of delusions.

Delusions: A Cognitive Perspective

The understanding of delusions, while historically focused on neuropsychological deficits, can be approached from the same cognitive perspective as that applied to other forms of psychopathology. The cross-sectional analysis of delusional thinking shows several cognitive characteristics: egocentric bias (irrelevant events are construed as self-relevant); externalizing bias (strong internal sensations or symptoms are attributed to external agents); and intentionalizing bias (other people’s behaviors are believed to be based on intentions—usually malevolent—towards the patient). In addition, defective reality testing precludes reevaluation and rejection of erroneous conclusions. Consequently, cognitive distortions such as selective abstraction, overgeneralization, and arbitrary inferences are prevalent. From a developmental perspective, grandiose delusions appear to arise from earlier daydreams of glory, serving as a compensation for feelings of loneliness, inadequacy, and inferiority. The daydreams become increasingly real to the patient until they become overt delusions. Persecutory delusions typically begin as a fear of retaliation or discrimination. Because of attentional bias, these fears receive pseudoconfirmation until they become fully formed beliefs that preempt normal information processing and displace more realistic beliefs.

Clinical social work with clients having delusions of persecution

People with a persecutory orientation to their environment present a treatment challenge for clinical social workers because of their negative orientation to the helping process. Such persons do not typically seek counseling services but may be referred by others who perceive their need for improved coping mechanisms. The purposes of this article are to apply social work's biopsychosocial perspective to an understanding of delusions of persecution and present guidelines for clinical intervention. The author emphasizes the utility of symbolic interactionist theory for formulating interventions.