The defensive function of persecutory delusions. Evidence from attribution tasks.
01 May 1994-British Journal of Psychiatry (The Royal College of Psychiatrists)-Vol. 164, Iss: 5, pp 637-646
TL;DR: Depressed and normal subjects showed similar causal inferences for both attributional measures, but deluded subjects showed a marked shift in internality, attributing negative outcomes to external causes on the transparent Attributional Style Questionnaire but, on the more opaque Pragmatic Inference Task, showing a cognitive style resembling that of the depressed group.
Abstract: Abnormalities of 'social' reasoning were investigated in patients suffering from persecutory delusions and in matched depressed and normal controls using transparent (obvious) and opaque (unobvious) tests of attributional style. Whereas depressed and normal subjects yielded similar causal inferences for both attributional measures, the deluded subjects showed a marked shift in internality, attributing negative outcomes to external causes on the transparent Attributional Style Questionnaire but, on the more opaque Pragmatic Inference Task, attributing negative outcomes to internal causes and thus showing a cognitive style resembling that of the depressed group. This finding, interpreted in terms of explicit versus implicit judgements, supports the hypothesis that delusions function as a defence against underlying feelings of low self-esteem.
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TL;DR: It is confirmed that the self-serving attributional bias is pervasive in the general population but demonstrates significant variability across age, culture, and psychopathology.
Abstract: Researchers have suggested the presence of a self-serving attributional bias, with people making more internal, stable, and global attributions for positive events than for negative events. This study examined the magnitude, ubiquity, and adaptiveness of this bias. The authors conducted a meta-analysis of 266 studies, yielding 503 independent effect sizes. The average d was 0.96, indicating a large bias. The bias was present in nearly all samples. There were significant age differences, with children and older adults displaying the largest biases. Asian samples displayed significantly smaller biases (d = 0.30) than U.S. (d = 1.05) or Western (d = 0.70) samples. Psychopathology was associated with a significantly attenuated bias (d = 0.48) compared with samples without psychopathology (d = 1.28) and community samples (d = 1.08). The bias was smallest for samples with depression (0.21), anxiety (0.46), and attention-deficit/hyperactivity disorder (0.55). Findings confirm that the self-serving attributional bias is pervasive in the general population but demonstrates significant variability across age, culture, and psychopathology.
1,071 citations
Book•
10 Jun 2004
TL;DR: In this article, the authors proposed an insightful and original approach to understand these disorders, one that focuses on what they have in common, instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia.
Abstract: Cognitive Behavioural Therapy (CBT) has established itself as one of the most effective therapies for treating a wide range of psychological disorders. However, research and treatment in this field typically adopts a DSM driven 'disorder-focused' approach - researchers and clinicians target a specific disorder, try to understand its aetiology and maintenance, and try to develop more effective strategies to treat the disorder. This book proposes an insightful and original approach to understanding these disorders, one that focuses on what they have in common. Instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia, it asks - what do patients with these disorders have in common? It takes each cognitive and behavioural process - attention, memory, reasoning, thought, behaviour, and examines whether it is a transdiagnostic process - i.e., serves to maintain a broad range of psychological disorders. Having shown how these disorders share several important processes, it then describes the practical implications of such an approach to diagnosis and treatment. Importantly it explores why the different psychological disorders can present so differently, despite being maintained by the same cognitive and behavioural processes. It also provides an account of the high rates of comorbidity observed among the different disorders. This book provides a novel review and integration of the empirical literature and gives clinicians and researchers a valuable new theoretical base for assessing and treating psychological disorders. Cognitive Behavioural Therapy (CBT) has established itself as one of the most effective therapies for treating a wide range of psychological disorders. However, research and treatment in this field typically adopts a DSM driven 'disorder-focused' approach - researchers and clinicians target a specific disorder, try to understand its aetiology and maintenance, and try to develop more effective strategies to treat the disorder. This book proposes an insightful and original approach to understanding these disorders, one that focuses on what they have in common. Instead of examining in isolation, for example, obsessive compulsive disorders, insomnia, schizophrenia, it asks - what do patients with these disorders have in common? It takes each cognitive and behavioural process - attention, memory, reasoning, thought, behaviour, and examines whether it is a transdiagnostic process - i.e., serves to maintain a broad range of psychological disorders. Having shown how these disorders share several important processes, it then describes the practical implications of such an approach to diagnosis and treatment. Importantly it explores why the different psychological disorders can present so differently, despite being maintained by the same cognitive and behavioural processes. It also provides an account of the high rates of comorbidity observed among the different disorders. This book provides a novel review and integration of the empirical literature and gives clinicians and researchers a valuable new theoretical base for assessing and treating psychological disorders.
1,046 citations
Cites background or result from "The defensive function of persecuto..."
...…5:39 PM Page 149 with schizophrenia who had delusions and patients with delusional disorder excessively attribute negative events to external rather than internal causes (Kaney and Bentall 1989; Candido and Romney 1990; Lyon et al. 1994; Fear et al. 1996; Sharp et al. 1997; Martin and Penn 2002)....
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...However, this exaggerated self-serving bias was not found in patients with schizophrenia compared to non-patient controls in a number of other studies (Lyon et al. 1994; Fear et al. 1996; Sharp et al. 1997; Kinderman and Bentall 1997b)....
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...…Bentall et al. 2001) suggested that the external attribution for negative events might serve a defensive function, since patients with paranoid schizophrenia implicitly have an internalizing style for negative events but explicitly report an external attributional style (e.g. Lyon et al. 1994)....
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TL;DR: It is argued that biases in this cycle cause negative events to be attributed to external agents and hence contribute to the building of a paranoid world view, and a new integrative model is proposed that builds on this work.
853 citations
Cites background or methods from "The defensive function of persecuto..."
...Lyon et al. (1994) attempted to obtain evidence of covert negative self-representations in paranoid patients by means of the Pragmatic Inference Test (PIT), an implicit attributional style measure disguised as a memory test, which had been developed by Winters and Neale (1985) for this purpose....
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...Havner and Izard (1962) found evidence of unrealistic self-enhancement in paranoid patients, and Lyon, Kaney, and Bentall (1994) reported that paranoids scored normally on Rosenberg’s (1965) self-esteem scale, which measures perceived self-worth....
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TL;DR: A multi-factorial model of delusion formation and maintenance incorporating a data-gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta-representation) is consistent with the current evidence.
Abstract: Purpose. To review critically the evidence for three contemporary theories of delusions.
Methods. The theoretical approaches to delusions proposed by Frith and colleagues (‘theory of mind’ deficits), Garety and colleagues (multi-factorial, but involving probabilistic reasoning biases) and Bentall and colleagues (attributional style and self-discrepancies) are summarised. The findings of empirical papers directly relevant to these proposals are critically reviewed. These papers were identified by computerised literature searches (for the years 1987-1997) and a hand search.
Results. The evidence does not unequivocally support any of the approaches as proposed. However, strong evidence is found to support modifications of Garety and colleagues and Bentall and colleagues theories. Studies have replicated a ‘jumping to conclusions’ data-gathering bias and an externalising attributional bias in people with delusions. There is preliminary evidence for a ‘theory of mind’ deficit, as proposed by Frith, although possibly related to a more general reasoning bias. Evidence for an underlying discrepancy between ideal and actual self-representations is weaker.
Conclusions. A multi-factorial model of delusion formation and maintenance incorporating a data-gathering bias and attributional style, together with other factors (e.g. perceptual processing, meta-representation) is consistent with the current evidence. It is recommended that these findings be incorporated into cognitive therapy approaches. However, there are limitations to existing research. Future studies should incorporate longitudinal designs and first episode studies, and should not neglect the co-morbidity of delusions, including affective processes, or the multi-dimensional nature of delusions.
793 citations
Cites background or methods from "The defensive function of persecuto..."
...In all three studies which examined this, self-esteem scores were inversely related to depression scores (Candido & Romney, 1990 ; Freeman et al., 1998; Lyon et al., 1994)....
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...142 Philippa A. Garety and Daniel Freeman Esteem Inventory (Coopersmith, 1984; used by Candido & Romney, 1990), the Rosenberg Self-Esteem Questionnaire (Rosenberg, 1965; employed by Lyon et al., 1994) and the Self-Concept Questionnaire (Robson, 1989; used by Freeman et al., 1998)....
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...Only one study, that by Lyon et al. (1994) of explicit and implicit attributions, provides clear evidence of a discrepancy with a method which is of high validity (although of attributions rather than directly of self-concepts, as discussed above)....
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...In earlier formulations of their theory, Bentall and colleagues argued that persecutory delusions re ̄ect a defensive, self-serving attributional style which protects the individual against underlying feelings of low self-esteem (e.g. Bentall, 1994; Lyon et al., 1994)....
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...Only two of these studies have found convincing evidence of an implicit low self-esteem (Kinderman, 1994; Lyon et al., 1994), using the Emotional Stroop Task and the Pragmatic Inference Task respectively....
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TL;DR: A multifactorial model of the formation and maintenance of persecutory delusions is presented, which includes the (non-defended) direct roles given to emotion in delusion formation, the detailed consideration of both the content and form of delusions, and the hypotheses concerning the associated emotional distress.
Abstract: A multifactorial model of the formation and maintenance of persecutory delusions is presented. Persecutory delusions are conceptualized as threat beliefs. The beliefs are hypothesized to arise from a search for meaning for internal or external experiences that are unusual, anomalous, or emotionally significant for the individual. The persecutory explanations formed reflect an interaction between psychotic processes, pre-existing beliefs and personality (particularly emotion), and the environment. It is proposed that the delusions are maintained by processes that lead to the receipt of confirmatory evidence and processes that prevent the processing of disconfirmatory evidence. Novel features of the model include the (non-defended) direct roles given to emotion in delusion formation, the detailed consideration of both the content and form of delusions, and the hypotheses concerning the associated emotional distress. The clinical and research implications of the model are outlined.
776 citations
References
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TL;DR: According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause and this cause can be stable or unstable, global or specific, and internal or external.
Abstract: The learned helplessness hypothesis is criticized and reformulated. The old hypothesis, when applied to learned helplessness in humans, has two major problems: (a) It does not distinguish between cases in which outcomes are uncontrollable for all people and cases in which they are uncontrollable only for some people (univervsal vs. personal helplessness), and (b) it does not explain when helplessness is general and when specific, or when chronic and when acute. A reformulation based on a revision of attribution theory is proposed to resolve these inadequacies. According to the reformulation, once people perceive noncontingency, they attribute their helplessness to a cause. This cause can be stable or unstable, global or specific, and internal or external. The attribution chosen influences whether expectation of future helplessness will be chronic or acute, broad or narrow, and whether helplessness will lower self-esteem or not. The implications of this reformulation of human helplessness for the learned helplessness model of depression are outlined.
6,923 citations
Book•
01 Jan 2002
TL;DR: "Dementia Praecox and Paraphrenia" (1919) was the book in which Kraepelin first presented his work on schizophrenia to the English-speaking world, and it was probably the most influential psychiatric text of the entire 20th century, and has now become rare.
Abstract: The German psychiatrist Emil Kraepelin (1856 - 1926) is justly called "the father of modern psychiatry". He was the first to identify dementia praecox (schizophrenia) and manic-depression, and he pioneered the use of drugs to treat mental illness. He was also joint discoverer of Alzheimer's disease - which he named after his collaborator, Dr Alois Alzheimer. Kraepelin presented these and other discoveries in successive editions of his "Psychiatrie: Ein Lehrbuch" (definitive 8th edition also now available from Thoemmes Press). Much of this gigantic textbook can only be read in the original German; but parts of it were translated into English, and they had a very profound influence on the development of world psychiatry for the rest of the 20th century. Although Bleuler's name for the disease "schizophrenia" came to replace Kraepelin's term, Kraepelin's general description of the syndrome and division of it into subforms such as hebephrenia and catatonia has persisted. He succeeded in tying together into a single recognizable diagnostic category a disparate array of symptoms that, before Kraepelin, had not been seen as cohering. Despite myriad later refinements, Kraepelin's description of the syndrome is still the classic presentation; it very much lives on in the "Diagnostic and Statistical Manual" used by present-day psychiatrists. "Dementia Praecox and Paraphrenia" (1919) was the book in which Kraepelin first presented his work on schizophrenia to the English-speaking world. It was probably the most influential psychiatric text of the entire 20th century, and has now become rare. Thoemmes Press is pleased to make this facsimile of the first edition available as a single volume.
2,825 citations
Book•
01 Jan 1993TL;DR: Implicit learning as mentioned in this paper is the process by which knowledge about the ralegoverned complexities of the stimulus environment is acquired independently of conscious attempts to do so, and it can be used implicitly to solve problems and make accurate decisions about novel stimulus circumstances.
Abstract: I examine the phenomenon of implicit learning, the process by which knowledge about the ralegoverned complexities of the stimulus environment is acquired independently of conscious attempts to do so. Our research with the two, seemingly disparate experimental paradigms of synthetic grammar learning and probability learning is reviewed and integrated with other approaches to the general problem of unconscious cognition. The conclusions reached are as follows: (a) Implicit learning produces a tacit knowledge base that is abstract and representative of the structure of the environment; (b) such knowledge is optimally acquired independently of conscious efforts to learn; and (c) it can be used implicitly to solve problems and make accurate decisions about novel stimulus circumstances. Various epistemological issues and related prob1 lems such as intuition, neuroclinical disorders of learning and memory, and the relationship of evolutionary processes to cognitive science are also discussed. Some two decades ago the term implicit learning was first used to characterize how one develops intuitive knowledge about the underlying structure of a complex stimulus environment (Reber, 1965, 1967). In those early writings, I argued that implicit learning is characterized by two critical features: (a) It is an unconscious process and (b) it yields abstract knowledge. Implicit knowledge results from the induction of an abstract representation of the structure that the stimulus environment displays, and this knowledge is acquired in the absence of conscious, reflective strategies to learn. Since then, the evidence in support of this theory has been abundant, and many of the details of the process have been sharpened. This article is an overview of this evidence and an attempt to extend the general concepts to provide some insight into a variety of related processes such as arriving at intuitive judgments, complex decision making, and, in a broad sense, learning about the complex covariations among events that characterize the environment. Put simply, this is an article about learning. It seems curious, given the pattern of psychological investigation of the middle decades of this century, that the topic of learning should be so poorly represented in the contemporary literature in cognitive psychology. The energies of cognitive scientists have been invested largely in the analysis and modeling of existing knowledge rather than in investigations of how it was acquired. For example, in an important recent article on the general topic of unconscious memorial systems, Schacter (1987) never came to grips with the distinction between implicit learning and implicit memory. The latter, the focus of his review, was dealt with historically, characterized, out
2,438 citations
"The defensive function of persecuto..." refers background in this paper
...Considerable evidence exists which suggeststhat explicit judgements and implicit judgements are sustained by different cognitive mechanisms (Reber, 1989;Berry& Broadbent,1988)....
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1,940 citations