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Self-structure in persecutory delusions

Self-structure in persecutory delusions
Self-structure in persecutory delusions

There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalized (characterized by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes. In Study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n = 27) and a healthy control group (n = 47) were compared on self-structure indices. In Study 2 (n = 27), the clinical group also completed the card sort task before and after randomization to either a 12-week mindfulness-based psychological therapy or treatment-as-usual control. In Study 1, self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects, and had more compartmentalized self-structures compared with controls. In Study 2 there were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalization and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.

compartmentalization, persecutory delusions, schizophrenia, self-concept, self-structure
0005-7894
132-140
Ellett, Lyn
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Kingston, Jessica
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Tarant, Eryna
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Kouimtsidis, Christos
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Vivarelli, Laura
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Chadwick, Paul
13a767ec-4c8d-467b-85df-ca04a8d11a8e
Ellett, Lyn
96482ea6-04b6-4a50-a7ec-ae0a3abc20ca
Kingston, Jessica
0a6d15b9-5390-4996-91c9-ef4be2bde1b7
Tarant, Eryna
d07a702d-0110-4939-be7d-722bad71622b
Kouimtsidis, Christos
b66ec077-99da-4c64-823b-f13c28b1fa41
Vivarelli, Laura
92f9fbac-0669-4941-9a52-6b2bd7a3f220
Chadwick, Paul
13a767ec-4c8d-467b-85df-ca04a8d11a8e

Ellett, Lyn, Kingston, Jessica, Tarant, Eryna, Kouimtsidis, Christos, Vivarelli, Laura and Chadwick, Paul (2023) Self-structure in persecutory delusions. Behavior Therapy, 54 (1), 132-140. (doi:10.1016/j.beth.2022.07.011).

Record type: Article

Abstract

There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalized (characterized by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes. In Study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n = 27) and a healthy control group (n = 47) were compared on self-structure indices. In Study 2 (n = 27), the clinical group also completed the card sort task before and after randomization to either a 12-week mindfulness-based psychological therapy or treatment-as-usual control. In Study 1, self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects, and had more compartmentalized self-structures compared with controls. In Study 2 there were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalization and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.

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Accepted/In Press date: 26 July 2022
e-pub ahead of print date: 5 August 2022
Published date: 4 January 2023
Additional Information: Funding Information: This paper presents independent research funded in part by the National Institute for Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Publisher Copyright: © 2022 Association for Behavioral and Cognitive Therapies
Keywords: compartmentalization, persecutory delusions, schizophrenia, self-concept, self-structure

Identifiers

Local EPrints ID: 473114
URI: http://eprints.soton.ac.uk/id/eprint/473114
ISSN: 0005-7894
PURE UUID: 7e7e09b5-6560-4da0-8049-9121fffcbc76
ORCID for Lyn Ellett: ORCID iD orcid.org/0000-0002-6051-3604

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Date deposited: 10 Jan 2023 18:18
Last modified: 05 Aug 2024 04:01

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Contributors

Author: Lyn Ellett ORCID iD
Author: Jessica Kingston
Author: Eryna Tarant
Author: Christos Kouimtsidis
Author: Laura Vivarelli
Author: Paul Chadwick

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