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2013, Social Psychiatry and Psychiatric Epidemiology
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11 pages
1 file
Purpose Religious 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. Methods 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. Results Binary 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. Conclusions Levels 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.
Psychiatry-interpersonal and Biological Processes, 2010
2010
In I. Clarke (Ed.) Psychosis and Spirituality; Exploring the New Frontier. 2001; Routledge.
Journal of Nervous & Mental Disease, 2013
The aim of the present study was to elicit how patients with delusions with religious contents conceptualized or experienced their spirituality and religiousness. Sixty-two patients with present or past religious delusions went through semistructured interviews, which were analyzed using the three coding steps described in the grounded theory. Three major themes were found in religious delusions: ''spiritual identity,'' ''meaning of illness,'' and ''spiritual figures.'' One higher-order concept was found: ''structure of beliefs.'' We identified dynamics that put these personal beliefs into a constant reconstruction through interaction with the world and others (i.e., open dynamics) and conversely structural dynamics that created a complete rupture with the surrounding world and others (i.e., closed structural dynamics); those dynamics may coexist. These analyses may help to identify psychological functions of delusions with religious content and, therefore, to better conceptualize interventions when dealing with it in psychotherapy.
British Journal of Clinical Psychology, 1999
Journal of Religion and Health, 2014
Here, we assessed for the first time the frequency of religious delusions and the effect of treatment on religiosity and the phenomena of religious delusions in a Xhosa schizophrenia population. Religious delusions were present in 42 (70 %) participants, and treatment significantly reduced religiosity (p = 0.02) as well as mean scores for certain phenomena associated with the delusions including changes in both thinking (p = 0.0001) and behaviour (p = 0.0001), as well as affective response to the delusion (p = 0.0001) The high frequency of religious delusions may indicate a higher tolerance for religious delusions in this community. It is therefore important to educate spiritual leaders on mental illness.
Mental Health, Religion & Culture, 2010
This study was conducted to assess the impact of religious affiliations on the phenomenology of delusions and hallucinations. Fifty-three Pakistani Muslim patients with schizophrenia were interviewed using the Present State Examination and Religiosity Index. The results indicated that the more religious patients had greater themes of grandiose ability and identity. These differences were more obvious in groups divided on the
2018
The Relationship Between Religious Practices and Delusional Content of Christians with Schizophrenia
Delusions in Context, 2018
The difficulty of distinguishing between delusions and nonpathological beliefs has taxed some of the greatest minds in psychiatry. This chapter argues that this question cannot be resolved without first having an understanding of what is involved in holding an ordinary belief. Although we should not assume that ordinary-language words such as 'belief' will correspond with a specific psychological mechanism or process, sufficient evidence is available from diverse areas of psychology to reach some conclusions about what happens when someone 'believes' something. Beliefs are propositions about the world that are generated dynamically, often during interactions with other people, and therefore depend on the human capacity for language. Although many beliefs are mundane, it is possible to identify a class of master interpretive systems that includes political ideologies and religious belief systems, which are highly resistant to challenge and capable of generating considerable emotion. These systems seem to depend not only on the ability to generate propositions about the world but also on implicit cognitive processes that are related to fundamental biological and social needs, for example the need to avoid contagion, the need to form close intimate relationships or
There is extensive debate about whether delusions are best considered beliefs. This debate is seldom addressed by clinicians though it bears on how delusions are conceived, managed and treated. Little empirical work exists to address this issue. This study explored whether individuals with first hand experiences of delusions spoke about those ideas in ways that were consistent with their being beliefs. Seventeen individuals identified as experiencing, or having experienced, delusions were recruited for a semi-structured interview. Responses to the interview were read and coded by two raters in terms of criteria relevant to whether a mental state is a belief. The majority of delusions examined here were spoken about as though they were beliefs. Most participants believed other things that were consistent with the delusions, attempted to defend their delusions with evidence, had frequently acted on their delusions and provided reasons for holding them. However, there was some varia- tion in the extent to which this was the case. This study provides tentative support for the claim that some delusions are beliefs.
Schizophrenia Research, 2019
The presence of delusions is considered a key feature of psychosis, but despite the psychopathological centrality of the concept of delusion, its definition and comprehension is a matter of continuing debate. In recent years studies showing that delusions are common in the general population have accumulated and challenged the way we perceive psychotic illness. In this systematic review, we examine the basis of the psychosis continuum-hypothesis, by reviewing a representative section of the original literature that report measures of delusional ideation in the general population, focusing specifically on methodology. Three online databases were systematically searched for relevant studies. After applying criteria of inclusion and exclusion, 17 articles were included for comprehensive review. Estimates of the distribution of delusions in the general population vary substantially, as does the mode of assessment. The methodology relies with few exceptions exclusively on self-report and fully structured interview by lay person. We conclude that measures of delusions in the general population should be interpreted cautiously due to inherent difficulties in methodology. Hypothesizing a continuum of delusion between normality and full-blown psychosis is deemed premature based on the reviewed studies.
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