DIFFERENCES IN COGNITIVE AND EMOTIONAL PROCESSES BETWEEN PERSECUTORY AND GRANDIOSE DELUSIONS

Course overview

Course Description: This course is based upon material published in the journal Schizophrenia Bulletin and is available as an open access article. Abstract Cognitive models propose that cognitive and emotional processes, in the context of anomalies of experience, lead to and maintain delusions. No large-scale studies have investigated whether persecutory and grandiose delusions reflect differing contributions of reasoning and affective processes. This is complicated by their frequent co-occurrence in schizophrenia. We hypothesized that persecutory and grandiose subtypes would differ significantly in their associations with psychological processes. Methods: Participants were the 301 patients from the Psychological Prevention of Relapse in Psychosis Trial (ISRCTN83557988). Persecutory delusions were present in 192 participants, and grandiose delusions were present in 97, while 58 were rated as having delusions both of persecution and grandiosity. Measures of emotional and reasoning processes, at baseline only, were employed. Results: A bivariate response model was used. Negative self-evaluations and depression and anxiety predicted a significantly increased chance of persecutory delusions whereas grandiose delusions were predicted by less negative self-evaluations and lower anxiety and depression, along with higher positive self and positive other evaluations. Reasoning biases were common in the whole group and in categorically defined subgroups with only persecutory delusions and only grandiose delusions; however, jumping to conclusions, and belief flexibility were significantly different in the 2 groups, the grandiose group having a higher likelihood of showing a reasoning bias than the persecutory group. Conclusion: The significant differences in the processes associated with these 2 delusion subtypes have implications for etiology and for the development of targeted treatment strategies. This course on schizophrenia and symptoms of persecutory and grandiose delusions is designed for professional counselors, social workers, psychologists, nurses, and mental health professionals who do clinical work. This course is appropriate for beginning, intermediate and advanced level practitioners who wish to develop their understanding of persecutory and grandiose delusions. The course material includes a literature review of delusions and symptoms of schizophrenia. It may also be useful for licensed clinicians who require clinical continuing education courses for license renewal. The course is based on a journal article which includes research. As such it contains statistical analysis and data which some clinicians enjoy reading and others do not. One of the benefits of reading research based articles for continuing education is that it allows the practitioner to keep current on the latest findings in their field. Authors: Garety et al. Learning Objectives: This course will provide the practitioner with detailed information regarding the relationship between differences in processes between persecutory and grandiose delusions. Specifically, a professional will: Describe the differences in emotional states between persecutory and grandiose delusions. Identify emotional states associated with grandiose delusions. Identify emotional states associated with paranoid delusions. Citation: Garety, Gittins, Jolley, Bebbington, Dunn, Kuipers, Fowler, and Freeman. (2013). Differences in Cognitive and Emotional Processes Between Persecutory and Grandiose Delusions. Schizophrenia Bulletin vol. 39 no. 3 pp. 629¿639.