The Defensive function of persecutory delusions: an investigation using the Implicit Association Test

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    Background: Delusions are first-rank symptoms of schizophrenia. Of all delusional themes, delusions of persecution are the most commonly observed clinically and the most vigorously researched empirically. Bentall et al. claim that persecutory delusions are constructed defensively, for the maintenance of selfesteem. A central prediction of their model is that paranoid individuals will show normal or high self-esteem on overt measures, whereas covert measures will show hidden feelings of low self-esteem. Methods: The present study used a new methodology that has been widely used in investigations of implicit attitudes, the Implicit Association Test (IAT), to assess covert self-esteem and to test the above prediction. Overt self-esteem was assessed using the Rosenberg Self-Esteem Scale and an adjective self-relevance ratings measure. These measures were administered to 10 patients with acute persecutory delusions, 10 patients with persecutory delusions in remission and 19 matched healthy control participants. Results: Patients with acute persecutory delusions were found to have lower covert self-esteem (as assessed using the IAT) than healthy controls and patients with remitted persecutory delusions. On the two measures of overt self-esteem, however, the persecutory deluded group did not differ signifi cantly from the other groups once the effects of comorbid depression had been taken into account. Conclusions: The results of the present study are consistent with a model of persecutory delusions as serving a defensive function. As such, they are consistent with a psychotherapeutic approach to what are perhaps the most frequently observed symptoms of schizophrenia.
    Original languageEnglish
    Number of pages2
    JournalActa Neuropsychiatrica
    Issue number6
    Publication statusPublished - 2006
    EventThe Australasian Society for Psychiatric Research Annual Meeting 2006 - Sydney, NSW
    Duration: 6 Dec 20068 Dec 2006


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