[Relationship between delusions of grandeur and paranoid delusions in the paranoid syndrome].
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Delusions↗
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A cognitive investigation of schizophrenic delusions.
Delusions have traditionally been regarded as unmodifiable false beliefs. Both Freud (1911) and Jaspers (1968) argue that there is a unidirectional relationship between a delusional belief and consensually validatable realtiy: the delusion structures reality in accordance with the delusion's demand. In contrast, we postulate that there is a bidirectional interaction between the delusion and external events. We believe that external events might modify the rigid belief when there is a dramatic incongruity between specific beliefs and selected events. The following investigation was motivated by a desire to understand more clearly how some overtly delusional patients come to lose their delusions during the course of treatment for schizophrenia. Do delusions simply melt away under the influence of major tranquilizers, or does the delusional patient play some active part in assessing the validity of this belief?
Adult↗
[Delusions of self-justification, innocence, forgiveness and justification in schizophrenia].
Delusions of selfjustification directed towards a denial of imaginary guiltiness are characterized by an activity of delusional speech and behaviour. In delusions of innocence the patients partially acknowledge imaginary guiltiness, their opinions and behaviour are passive. These forms of delusions are encountered in the structure of depressions with delusions, paranoid-depressive, hallucinatory-paranoid, acute delusional and paraphrenic syndromes. Delusions of appeal and justification are frequently seen in the structure of paraphrenic syndromes. These forms of delusions occupy a subordinate position in relation to other forms of psychopathological structures.
Adult↗
The element of the irrational at the beginning and during the course of delusion.
Delusion is described from a phenomenological point of view. Based on the observation of 15 cases of delusion over a period of several years and 3 cases described by Japanese and American authors, I have concluded that delusion cannot be understood from a genetic, psychological or sociological standpoint alone. My aim was to discover symptoms which could not be explained by psychodynamic, sociological or other causes. Such symptoms may be called irrational (incomprehensible) symptoms. Their irrationality is analogous to the same symptoms which are described in their autobiographies by two great mystics about their ecstasy. We can see these symptoms in the accounts of Zen Buddhists. These symptoms represent experience of evidence, pseudohallucination, suffering in delusion, a message to do something, loss of awareness of time and space, the polarity of guilt and blessedness following each other in close succession and the feeling of shame. We will better understand delusion if we bear in mind the irrational factor.
Affective Symptoms↗
Cultural influences on delusion.
The nature and content of delusions were studied among 51 schizophrenic patients. The most common delusions in order of frequency were delusions of persecution, religious, magic, ideas of reference, passivity feelings and grandeur. The beliefs of the head of the family, or his equivalent, did not contribute directly to the content. It was concluded that the general cultural beliefs, rather than the immediate environment, play a dominant role in determining the contents of delusion.
Adolescent↗
Cultural aspects of delusions: a psychiatric study of Egypt.
This paper deals with the cultural elements of the delusions of a sample of Egyptian psychiatric patients. After examination of clinical records, interviewing psychiatrists and reviewing literature, the author reaches the conclusion that the content of the patient's delusion varies directly in relation to his social class. For most of the low class men and women, the delusional symptoms, either megalomaniac or persecutory were fantasied in terms of the cultural religious institutions. Middle and upper class patients, however, much more frequently "secularized" their restitutive narcissistic and self esteem delusions in terms of science and class conception of power.
Adolescent↗
Analysis of structural factors in schizophrenic delusions.
A previous factor analysis of delusional properties, scored from verbatim typescripts of interviews held with 32 schizophrenic patients, had generated four interpretable factors. The present study considered the meaning of these qualitative factors in terms of their relationships to four types of information potentially important to understanding the development or maintenance of delusions--sex gender, intelligence, chronicity, and type of delusion (e.g., persecution, grandeur). The possible contribution of factorial structure to understanding delusional behavior was indicated by the number of relationships found between these factors and the independent variables.
Adult↗
Telepathy in mental illness: deluge or delusion?
The belief that one can read others' minds has long been considered a symptom of psychosis, despite reports in the parapsychological literature of veridical telepathy. All patients admitted to an inpatient psychiatric unit were screened for paranormal beliefs, and those claiming telepathic abilities were tested in a free-response ESP task. Eighteen per cent of the inpatient population claimed telepathic abilities; of the nine patients who completed the task, none performed above chance expectations. Higher frequencies of paranormal experiences than those reported previously in the psychiatric literature were attributed to the context of the study. Schneider's first rank symptoms and a belief in telepathy discriminated schizophrenics more reliably than other paranormal experiences. Possible psychodynamics of delusions of telepathy were discussed in view of the predominance of women and younger men reporting them, as were the possible effects of such research on patients' delusions.
Adolescent↗
Persecutory delusions: a cybernetic model.
The authors propose a cybernetic model for the formation and maintenance of persecutory delusions. During the formation of persecutory ideation, the threat of loss of control over the self or others interacts with predictions of control from others. This interaction may result in feelings of alien control followed by persecutory explanations. Since the persecutory explanations provide the individual with a new goal of resisting others' influence in order to prevent being controlled, they reduce the threat of loss of self-control. This is how persecutory delusions are maintained.
Cybernetics↗
[So-called small-scope delusions].
Analysis of psychopathological traits of the paranoiac syndrome in 60 patients with late schizophrenia permitted to distinguish certan signs which can be allocated to the differentiation of late schizophrenia from other delusional psychoses in the elderly. The following differential signs were underlined: initial symptoms, such as rudimentary cenesthopathia, stable insomnia, etc., preceding the formation of delusions; appearance of episodic exacerbations in the form of short-time acute paranoiac states; a combination of paranoiac delusion with stable phasic affective disorders; unusual possession of delusional patients expressed in bizarre delusional behaviour, etc. Using this example as a model, the necessity of further profound and differentiated psychopathological studies of syndromes distinguished as predilective for old age is indicated.
Delusions↗
[Problem of sexual pathology in alcoholic delusions of jealousy].
The data on sex pathology in alcoholic delusions of jealousy with sado-masochist behaviour are reported. Such behaviour was seen when the patients tried to force their wives to "acknowledge" infidelity. A total amount of 196 patients were studied. Abnormal behaviour was characterized by moral and physical torture of their wives and selftorture. They were mostly expressed at late night hours and were connected with a peculiar satisfaction of the "tormenting voluptuosness" (Lemke-Rennert). There was also a sexual excitation with a dissociation between high necessities and a dropped possibilities in the sexual sphere against the background of lowered potency and other sexual disorders. Moreover, there was a high level of general excitation with a narrowing of consciousness, vegeto-vascular changes, which are described during ciotus and a satisfaction of sexual necessities by perversions. A visualization of images related to jealousy was observed, which lead to an increase of the affective shading in delusions.
Aggression↗
Behaviour therapy as an adjunct to treatment of systematized delusion-a case report.
Systematized delusion can sometimes be very difficult to treat. In the present case of identity confusion in a single girl, operant conditioning technique was employed when physical and other forms of psychological treatment had failed. The patient's system of delusion was dissolved and she remained symptom free 12 months after discharge.
Adult↗
The relationship between paranoid delusions and homosexuality.
Freud predicted that paranoid delusions are motivated by unconscious homosexual impulses. The research conductedto test this hypothesis has been reviewed and it is concluded that the results do not support Freud's position. The results indicate anassociation between homosexual concerns and paranoid delusions but not in the manner that FREUD PREDICTED. For example, clinical studies indicate greater overt and conscious homosexual preoccupation in paranoid psychotics compared to nonparanoid psychotics, a finding not predicted by Freud. While psychological studies have tended to find more support for the Freudian position, several studies have failed to find supporting evidence and others are inconsistent in their results.
Female↗
Delusions of parasitosis. An approach to the problem.
One of the most frustrating problems in clinical dermatology is the patient with a delusion of parasitosis. Over the years, very little realistic and practical advice has been offered to the perplexed dermatologists. We describe an approach that is based on the thesis that dermatologists can and often should treat such patients. By considering each patient as an individual, and by working to build rapport, the dermatologist is in the best position to offer help. We report two illustrative cases and discuss guidelines to treatment.
Aged↗
Paranoid delusions and auditory hallucinations associated with digoxin intoxication.
The 83-year-old woman in this case report developed paranoid delusions and auditory hallucinations in association with toxic serum levels of digoxin, while remaining alert, unagitated, and coherent in thinking. No cardiovascular or metabolic abnormalities were discovered to account for her psychiatric symptoms. Her mental status rapidly returned to normal as serum digoxin declined to therapeutic levels.
Aged↗
Television in the hospital: programming patients' delusions.
Systematic collection of art products from 55 schizophrenic patients provided unexpected documentation of the impact of television on delusion-formation. Patients' drawings and descriptions demonstrate the ease with which they incorporate TV program material in their psychotic experience. It is suggested that clinicians consider television viewing a relevant variable in the design of treatment programs.
Acute Disease↗
A proposed basis for delusion formation within an information-processing model of paranoid development.
A developmental model for paranoid behaviour is proposed within a broader theory of schizophrenic development. The model stipulates that given exposure to sustained aversive maternal control and a maternal communication style which is subtle and devious, the child comes to adapt with approach, stratagem-based behaviours and heightened vigilance for evaluative information (i.e. open adaptive style). The model, already supported empirically at several points, postulates that the delusion serves to organize an overextended and disorganized information-processing system for the person and generates its reinforcement from reduction of the anxiety associated with thought disorganization. The present study tested an aspect of this postulate. It was predicted that late-adolescent males who had an open style of adapting to experienced aversive maternal control would find the organization of disorganized evaluative cues uniquely reinforcing. Subjects were presented with an anagrams task made up of scrambled words which they were told came from a poll of mothers asked to evaluate their college-age sons. This task was followed by the individual tachistoscopic and slightly unfocused presentation of a longer series of words, again described as maternal evaluative terms. The longer series comprised the words used in the anagrams task and an equal number which were not. Reinforcement value of proper ordering of disorganized cues was inferred from the subject's heightened ability to detect previously solved anagram terms, indicating stronger learning of these terms upon prior solution. Males identified as open-style adapters were far more cognizant of words which they had previously ordered than other child-rearing groups, as predicted.
Adolescent↗
Depression, Delusions, and Drug Response.
Depressed patients with delusions were found to be markedly unresponsive to tricyclic drug therapy during an ongoing study of depressed patients. After four weeks of administration of imipramine hydrochloride, only 3 of 13 delusional depressed patients had responded to the drug, but 14 of 21 nondelusional depressed patients had responded. The authors conclude on the basis of these data and those of other researchers that delusional depressed patients should not be treated with tricyclic antidepressants and that current research with depressed patients should be reevaluated in the light of this finding.
Adult↗