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The inferiority complex in paranoia readdressed: A study with the Implicit Association Test
Abstract
It has been theorised that patients with persecutory delusions display a lack of covert self-esteem (formerly termed the 'inferiority complex'), while at the same time displaying normal or even heightened levels of explicit self-esteem. However, the empirical basis for this assumption is inconsistent.
In view of apparent shortcomings of prior studies to assess implicit self-esteem, the Implicit Association Test was utilised to readdress this theory. The Rosenberg scale served as an index of overt self-esteem. A total of 23 schizophrenic patients, 13 of whom showed current symptoms of persecutory delusions, participated in the study; 41 healthy and 14 depressed participants served as controls.
Schizophrenic patients showed decreased levels of both implicit and explicit self-esteem relative to healthy controls. In line with recent studies, patients with current ideas of persecutory delusions displayed greater explicit self-esteem than nonparanoid patients.
The present study lends partial support for the notion that persecutory delusions serve as a defence against low implicit self-esteem, although the explicit self-esteem of these patients is still lower than in normal participants. Apart from abnormalities of attributional style, which have been assumed to convert low into high self-esteem, the assumption that a 'feeling of personal significance' heightens self-esteem in paranoid schizophrenia deserves further consideration.
... To our knowledge, the only studies of implicit self-esteem in psychosis have focused on paranoid delusions, and the reported findings have been varied (Kesting and Lincoln, 2013). Some studies using the Implicit Association Test (IAT) have reported low implicit self-esteem in individuals with paranoia compared with healthy controls (McKay et al., 2007;Moritz et al., 2006), whereas others have reported no differences between the two groups (Kesting et al., 2011;Mackinnon et al., 2011). Valiente et al. (2011) used the affective go/no-go task, a variant of the IAT, and found that paranoid participants associated selfattribute more quickly with negative than positive attributes, indicating an implicit negative self-bias. ...
... The absence of an effect on paranoia was consistent with the lack of association between the paranoia measure and implicit self-esteem at baseline, although this latter observation should be treated with caution because the ESM diary was not well structured for this comparison. Together, these observations cast doubt on whether it is appropriate to interpret the associations between implicit self-esteem and paranoia found in some (McKay et al., 2007;Moritz, et al, 2006;Valiente et al. 2011), but not all (Kesting et al., 2011;MacKinnon, et al, 2011), previous studies as causal. However, the limitations of this proof-of-concept study discussed below probably prevent a definitive judgment on this issue. ...
... The pilot study had a number of other important limitations, which may have impeded our ability to detect effects and which may explain the different results obtained from those studies that have found an association between implicit self-esteem and paranoia (McKay et al. 2007;Moritz et al. 2006;Valiente et al 2011). First, students were selected if they scored above 5 on the PIQ, which was the median score of a larger Spanish undergraduate sample tested by the researchers in an earlier study. ...
... Inferiority complex is an exaggeration of normal inferiority feelings and individuals with inferiority complex display a tendency towards overcompensation and overreaction (Heidbreder 1927). Inferiority complex or lack of self-esteem leads to negative or risk-seeking behaviors in young people (Moritz 2006). Theoretical and correlational analyses have yielded tenuous associations between low self-esteem and socially problematic outcomes or risktaking behaviors like substance abuse, aggression, and poor academic achievement (Dawes 1994). ...
... Inferiority complex is an exaggeration of normal inferiority feelings and individuals with inferiority complex display a tendency towards overcompensation and overreaction (Heidbreder 1927). Inferiority complex or lack of self-esteem leads to negative or risk-seeking behaviors in young people (Moritz 2006). Theoretical and corelational analyses have yielded tenuous associations between low self-esteem and socially problematic outcomes or risk-taking behaviors like substance abuse, aggression, & poor school achievement (Dawes1994; Mecca et al. 1989;Overholser et al. 1995). ...
... In the mental health treatment population, this characteristic is shown in patients with many disorders such as certain types of schizophrenia, mood disorders, and personality disorders. Moritz (2006) found the people suffering from paranoid schizophrenia used their delusions as a defense mechanism against low implicit self-esteem. Alfred Adler identified an inferiority complex as one of the contributing factors to problem child behaviors (Alfred 2013). ...
The purpose of the study was to investigate the psychological well-being, inferiority complex, and interpersonal values of the universities’ students in Bangladesh. The sample consisted of 2150 students (age range 19 to 21 years) from the public and private universities of the Dhaka city, and they were selected conveniently. Psychological Well-being Scale (Huque & Begum 2005), Inferiority Measure Questionnaire (Akramuzzaman, Azizul, & Haque 2011), and Interpersonal Values (Begum & Khanam, 1990) were used for the data collection. Pearson Product Moment Correlation, ANOVA, and t-test were used for interpreting the findings. The findings revealed that the psychological well-being, inferiority complex, support, benevolence, and leadership were significantly varied considering types of university. Psychological well-being was significantly positively correlated with conformity (.311), support (.192), benevolence (.289) and leadership (.197) in the case of the university students. Inferiority complex and interpersonal values were not significantly correlated considering to the types of university students. Psychological well-being was negatively correlated (-.55) with the inferiority complex. Interpersonal values and psychological well-being were significantly positively correlated (.81) of the students in the universities. There was the significant difference in psychological well-being and also leadership between the male and female in the case of the university students. There was no statistically significant difference in inferiority complex, independence, conformity, support, recognition, and benevolence in the respect of gender. The male students had possessed better scores in case of the leadership and psychological well-being compared to their counterpart, which was significant. Psychological well-being and inferiority were significantly varied considering residence of the university students. It was also found that both the residential and non-residential university students had possessed almost the same scores on the independence, conformity, support, recognition, benevolence, and leadership, but the residential students had perceived higher psychological well-being and non-residential students had perceived lower inferiority complex compared to their counterparts. The findings have implications for parents, teachers, mental health professionals, and policymakers.
... that patients with paranoia show more negative explicit selfesteem than controls, 7 findings have been far more inconsistent on implicit self-esteem. Studies including that of Moritz et al. 8 showed a relatively low implicit self-esteem in patients with paranoia, 9,10 while others reported parallel implicit selfesteem to that of controls. 11,12 A recent initiative of the Research Domain Criteria 13 emphasizes a shift in the research framework from investigating illness as a categorically separate entity to investigating symptoms on a dimensional level that span from healthy, to subclinical, to clinical levels. ...
... However, some previous studies reported lower implicit selfesteem in the paranoid patient group compared to the controls. [8][9][10] Mixed results leave the role of implicit self-esteem as yet elusive, but we may cautiously consider that lower implicit self-esteem alone may not directly contribute to the hostile perception or blaming bias that may lead to paranoia and formation of delusions. Third, we found that the interaction between implicit and explicit self-esteem was associated with hostility perception bias in ambiguous situations. ...
Objective:
The current study aimed to examine the association of implicit self-esteem, explicit self-esteem and their interaction with paranoia and attributional bias. The relationship of the size and the direction of the discrepancy between implicit and explicit self-esteem with paranoia and attributional bias was examined.
Methods:
A total of 128 female college students participated. We administered the Implicit Association Test to assess implicit self-esteem, and the Rosenberg Self-Esteem Scale to measure explicit self-esteem. Paranoia Scale was used, and the attributional bias was assessed using the Ambiguous Intentions Hostility Questionnaire.
Results:
Results showed that explicit but not implicit self-esteem was negatively associated with paranoia, blame bias and hostility perception bias in ambiguous situations. The interaction of implicit and explicit self-esteem was associated with hostility perception in ambiguous situations. As for the discrepancy, the size of the discrepancy between implicit and explicit self-esteem was positively associated with hostility perception in ambiguous situations. Moreover, the direction of the discrepancy was specifically relevant: damaged self-esteem (high implicit and low explicit self-esteem) was associated with increased levels of paranoia, blame bias and hostility perception in ambiguous situations.
Conclusion:
These findings provide new insights into the role of the implicit and explicit self-esteem in attributional bias and paranoia and point to damaged self-esteem as a possible vulnerability marker for illogical attribution of blaming others and perceiving hostility in social situations.
... The reasons are complicated and effects negatively for self-worth and also harmful for development (Jing, 2012). Lack of self-esteem, including the inferiority complex, leads to negative or risk-seeking behaviors in young age (Moritz, 2006). ...
... Inferiority complex is a kind of psychological obstacle that occurs usually in puberty and its reasons are complicated and its effects negative and harmful for self-worth (Jing, 2000). Inferiority complex or lack of self-esteem leads to negative or risk seeking behaviors in young people (Moritz, 2006). Theoretical and correlational analyses have yielded tenuous associations between low self-esteem and socially problematic outcomes or risk-taking behaviors like substance abuse, aggression and poor school achievement (Dawes, 1994;Mecca, 1989 andOverholser, 1995). ...
The purpose of the present study was to explore whether there is any relation between insecurity feeling and tolerance level of university students. The Bangla version of Insecurity Questionnaire and Tolerance level scale were used. Results showed that mean of private university students showed more insecurity than public university students; 1st year student had more insecurity than 2nd year to 4th year and Ms students. A significant interaction effect was found between types of university and study year and types of university and types of family and according to insecurity feeling. On the other hand, mean of public university was more than private university; Ms student had more tolerance level than 1st year and 2nd year to 4th year students. A significant interaction effect was found between types of university and study year according to tolerance level. Finally, result also showed significant negative correlation between insecurity and tolerance level.
... The reasons are complicated and effects negatively for self-worth and also harmful for development (Jing, 2012). Lack of self-esteem, including the inferiority complex, leads to negative or risk-seeking behaviors in young age (Moritz, 2006). ...
... Inferiority complex is a kind of psychological obstacle that occurs usually in puberty and its reasons are complicated and its effects negative and harmful for self-worth (Jing, 2000). Inferiority complex or lack of self-esteem leads to negative or risk seeking behaviors in young people (Moritz, 2006). Theoretical and correlational analyses have yielded tenuous associations between low self-esteem and socially problematic outcomes or risk-taking behaviors like substance abuse, aggression and poor school achievement (Dawes, 1994;Mecca, 1989 andOverholser, 1995). ...
The purpose of the study was to investigate interpersonal values, inferiority complex and psychological well-being of teenage students. The sample size of the study was 384 teenage students (male = 200 and female = 184; age range 13-19 years) from different public and private schools and colleges in Chittagong, Bangladesh. Interpersonal Values (Begum & Khanam, 1990), Inferiority Measure Questionnaire (Akramuzzaman, Azizul & Haque, 2011) and Psychological Well-being Scale (Huque & Begum, 2005) were used for data collection. Pearson Product Moment Correlation, ANOVA, and t-test were used for interpreting the findings. The findings revealed that psychological well-being and inferiority complex were negatively correlated (r = -.453); interpersonal values and inferiority complex were also negatively correlated (r = -.717); but interpersonal values and psychological well-being were positively correlated (r = .792). It was also found that male teenage students possessed more interpersonal values and psychological well-being than their counterpart. The findings have implications for parents, teachers, mental health professionals, and policymakers.
... In addition, comparing levels of implicit SE between patients with persecutory delusions and patients without paranoia or healthy controls should provide meaningful evidence for a defensive model. To date, research has yielded contradictory results in clinical populations, with some studies supporting or partially supporting the defensive model (39)(40)(41), and others not (42)(43)(44)(45). However, two of the three studies that assessed discrepancies directly comparing z-scores of implicit SE and explicit SE within groups of paranoid and depressed patients, and healthy controls reported no SE discrepancies in paranoid patients. ...
Background: Self-concepts are being intensively investigated in relation to paranoia, but research has shown some contradictory findings. Studying subclinical phenomena in a non-clinical population should allow for a clearer understanding given that clinical confounding factors are avoided. We explored self-esteem, self-schemas, and implicit/explicit self-esteem discrepancies in 3 non-clinical groups with different psychopathological traits and a control group.
Methods: Participants with elevated trait-paranoia (n=41), depressive symptoms (n=34), a combination of both traits (n=32), and a control group (n=71) were assessed on implicit and explicit self-esteem, self-schemas, depression, and paranoia. A dimensional approach with the total sample (n=208) was also used to complement the information provided by the group approach.
Results: All groups presented similar and positive levels of implicit self-esteem. Trait-paranoia participants had similar levels of explicit self-esteem and self-schemas compared to the control group. However, the group with a combination of trait-paranoia and depressive symptoms showed the lowest levels of positive self-schemas and self-esteem. Furthermore, this group and the control group displayed implicit/explicit self-esteem discrepancies, although in opposite directions and with different implications. The dimensional approach revealed associations of trait-paranoia and depressive symptoms with poor explicit self-esteem and self-schemas, but not with implicit self-esteem.
Conclusions: Trait-paranoia participants showed different self-representations depending on whether depressive symptoms were present or not. The interaction between subclinical neurotic and psychotic traits entailed a worse self-representation that might increase the risk for psychopathology.
... Sebenarnya inferiority complex merupakan hal yang umum terjadi, namun dampak dari inferiority complex inilah yang berbahaya bagi individu, dalam hal ini mahasiswa. Menurut Moritz (2006) inferiority complex pada mahasiswa atau kaum muda dapat mengarah pada perilaku negatif atau berisiko tinggi (membahayakan). Inferiority complex juga dapat memicu frustrasi (Barney, 1949). ...
Students are individuals who are entering adulthood, where at this time, students will explore many things in their life. It is not uncommon for students to experience failures, which, if not handled properly, will lead to an inferiority complex or a situation in which excessive inferiority creates a negative view of themselves. The inferiority complex in students will trigger many distractions, such as stress and frustration that will interfere with their activities and education. This article will focus on discussing understanding the basic concepts of the inferiority complex and also the inferiority complex in students. The method used in this article is a literature study from various sources. This article provides an understanding of the inferiority complex in general and that occurs in students and reduces it not to have a negative impact. Abstrak: Mahasiswa merupakan individu yang sedang berada pada transisi remaja menuju dewasa, di mana pada masa ini mahasiswa akan mengeksplorasi banyak hal dalam hidupnya. Tak jarang mahasiswa mengalami kegagalan, yang jika tidak diatasi dengan baik akan menimbulkan inferiority complex atau keadaan rasa inferior berlebihan yang menimbulkan pandangan negatif tentang diri. Inferiority complex pada mahasiswa akan memicu banyak gangguan seperti stres dan frustrasi yang akan mengganggu kegiatan dan pendidikannya. Artikel ini membahas mengenai pemahaman konsep dasar inferiority complex khususnya pada mahasiswa. Metode yang digunakan dalam artikel ini adalah studi literatur. Artikel ini diharapkan dapat memberikan pemahaman tentang inferiority complex secara umum maupun yang terjadi pada mahasiswa serta bagaimana cara untuk menguranginya agar tidak menimbulkan dampak yang negatif. Katakunci: mahasiswa; remaja; pandangan negatif; rendah diri PENDAHULUAN Manusia mengalami beberapa kali transisi dalam hidupnya. Salah satunya transisi dari masa remaja ke dewasa atau yang biasa disebut masa beranjak dewasa (emerging adulthood). Masa beranjak dewasa terjadi dari usia 18 tahun sampai 25 tahun (Arnett, 2007, hlm. 209, dan masa inilah yang sedang dialami oleh mahasiswa. Masa beranjak dewasa ditandai
... schizophrenia may alternately lead to passive acceptance or to rigid adherence to one idea (Moritz, 2006), such as a paranoid fear regarding medication. ...
Severe mental illness in adults refers to a group of mental health conditions including schizophrenia and schizoaffective, bipolar and major depressive disorders. These conditions are often characterized by recurring symptoms, multiple hospitalizations, and significant disability. The public health concern with these conditions is amplified because many individuals with severe mental illness fail to engage in outpatient treatment. Methods to support greater rates of participation in outpatient treatment are needed. Encouraging participation in medical decision making is viewed as one method to optimize patient empowerment, increase engagement in care and decrease the negative outcomes that often characterize this population. Shared Decision Making (SDM) is a collaborative and structured approach to patient-provider communication viewed as a negotiation between mutual experts with the goal of balancing empirical information with patient values and preferences. This was a cross-sectional mixed methods study examining SDM in a sample of individuals with severe mental illness who have recently been discharged from emergency rooms and inpatient psychiatric facilities. Extant data on decision-making preferences and a variety of clinical, demographic and communication variables were analyzed on 258 individuals with severe mental illness during a baseline visit at a transitional care clinic serving individuals immediately after hospital discharge. The association between clinical, demographic and communication characteristics and patients’ self-reported decision-making preference (active, collaborative, or passive) were examined using chi square and one-way analyses of covariance. In addition, we conducted semi-structured qualitative interviews with 15 individuals with serious mental illness a variety of clinical providers (n = 9). Results from the quantitative analyses indicated that race/ethnicity was significantly associated with the SDM preference group, with African American individuals desiring more active participation in decision making compared to their Hispanic counterparts. Other characteristics were not significantly associated with the patient’s baseline decision-making preferences in this context. Qualitative data were analyzed using latent thematic analysis and six themes were identified including: 1) Differences in the Use of SDM, 2) Consideration of Past Experiences, 3) Decisional Power Preferences, 4) Use of SDM in Psychiatry Versus Other Areas of Medicine, 5) Dignity and Disengagement, and 6) External Forces Impacting SDM. These findings indicate race/ethnicity may be an important factor when using a SDM approach. Implications for clinical practice and research using a SDM approach within this treatment setting are further discussed.
... According to a number of researchers paranoia is a direct reflection of low explicit and implicit self-esteem 24, 25 Cicero 27 notes "One possible explanation is that self-esteem only causes paranoia in people with specific personality traits such as low agreeableness or high neuroticism." Two studies have found low implicit and low explicit self-esteem associated with schizophrenia 28 and persecutory delusions 29 . ...
... According to a number of researchers paranoia is a direct reflection of low explicit and implicit self-esteem 24, 25 Cicero 27 notes "One possible explanation is that self-esteem only causes paranoia in people with specific personality traits such as low agreeableness or high neuroticism." Two studies have found low implicit and low explicit self-esteem associated with schizophrenia 28 and persecutory delusions 29 . ...
The present study investigated the relationship between paranoia and job satisfaction. Paranoia is defined as suspiciousness and the feeling of being threatened even if there is no proof of real threat. Paranoia is a concept that is often ignored in researches in Pakistan and rarely explored in context of any concept related to occupational life. After a detailed literature review, it was hypothesized that paranoia would be negatively correlated to job satisfaction. The sample of the present research consisted of 154 professionals (77 male, 77 female) from different work settings. Paranoia was measured with the Feingstein Paranoia Scale Urdu version 1 (FPSU) and job satisfaction was measured by the Generic Job Satisfaction Scale 2 (GJSS). Statistical analysis though Pearson Product Moment Correlation indicates that there is a strong negative correlation between paranoia and job satisfaction. Recommendations for employers and policy makers, avenues of future researches are discussed.
... Therefore, it is important for physicians to detect insomnia as a sign of suicidal behavior, regardless of which illness a patient may suffer from [40]. Of interest, our study found that inferiority, which is seen as a lack of covert self-esteem [41], was correlated with SI in elderly inpatients. This finding is compatible with that of a study which found that low self-esteem was associated with suicidal intent, independently of the severity of depression [42]. ...
Background:
Worldwide, the elderly are at a greater risk of suicide than other age groups. There is a paucity of research exploring risk factors for suicide in hospitalized elderly patients. Therefore, a study designed to explore the prevalence and characteristic of suicidal ideation (SI), such as QOL (quality of life), a wish to die (WTD), and other factors in elderly inpatients with medical or surgical conditions in Taiwan was warranted.
Methods:
A total of 2199 hospitalized elderly patients over age 65 were enrolled. Demographic data, 5-item Brief Symptom Rating Scale (BSRS-5), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) data were collected. Logistic regression models were used to find the SI-related factors for all participants and to investigate the covariates correlated with WTD in patients with SI. Receiver operating characteristic (ROC) curve analysis was used to find the most important items of the BSRS-5 predictive of SI in this population.
Results:
SI was found in 3.1% (68/2199) of the elderly. The statistically significantly factors associated with SI were: BSRS-5 item 2 (depression) (odds ratio [OR] = 2.15, 95% confidence interval [CI] = 1.56-2.98), item 4 (inferiority) (OR = 1.62, 1.23-2.13), item 5 (insomnia) (OR = 1.52, 1.13-2.05), and physical domain of WHOQOL (OR = 0.84, 0.72-0.99). QOL15 (mobility) (OR = 0.64, 0.46-0.90) and QOL 16 (satisfaction with sleep) (OR = 0.62, 0.44-0.88) were also significantly associated with SI. The status of living alone (OR = 4.44, 1.24-15.87), QOL 26 (absence of negative feeling) (OR = 0.38, 0.15-0.98), and QOL 27 (being respected/accepted) (OR = 0.43, 0.20-0.92) were significantly associated with WTD among inpatients with SI. The ROC curve analysis revealed that depression, inferiority, and insomnia were the most important items in the BSRS-5 significantly associated with SI among the elderly inpatients.
Conclusion:
To provide physical recovery and maintain mental health for physically ill elderly inpatients, setting up a multi-faceted approach targeting the aforementioned determinants of SI and WTD for reducing the risk of suicide attempt, and exploring other factors correlated with suicidal behaviors, are important topics and directions for clinical practice and further research.
... Through the maximum practice of inferiority complexity or practice of lower level consideration of self -esteem, the schizophrenic features will be developed among affected individual. Among Schizophrenic patients, excessive practice of lower level practice of both implicit and explicit self -esteem has empirically observed; inferiority complexity is also associated with the delusion as well as paranoid personality (Moritz, S., Werner, R., Collani, G. V., 2006). Therefore, practice of inferiority complex is an alarming issue for the human development diversion; it is a problem to resist the actual growth of education system as well as development of students; through the effectiveness management of education system and corresponding activities, a system will be able to resist the rapid growth of the practice of inferiority complexity by the school going students. ...
Man is an important creation of the world than other which has the probability to carry forward an effective identity for the ultimate goal. Effective fulfillment of said goal will provide some assistive direction to establish an effective existence in the always changing situation as an operational identity. With the proper exercises of individual essence, an individual will be able to develop an effective existence for the development of human society. Man is a living being needs to examine truth, goodness and beauty for the benefit of own identity as well as for mankind in the world. God is a feeling for lives that represents the essence of ultimate reality in different forms. From the effective practice of said feeling, an individual will be able to direct oneself for the ultimate benefit of world. Positivity is an effective gift of the God to move forward for the effective manifestation of cosmic existence in the society of men. Presence of negativity has been observed in different forms in the society which are not desirable for the actual goal fulfillment of life. Inferiority complex is an effective negative human behaviour which stimulates the approach to nullify the level of confident of an individual. It is an approach to minimise the role of individual potentialities as per the situation determinants. To find out the nature of inferiority practice done by the secondary students, presented survey type study has been designed to describe the actual reality. At the end of the study, it has been observed that locality is an important determinant to differentiate the behavioural pattern in respect to deal with the inferiority policies in the practical situation. Moderate level of practice the inferiority styles of individual perception has been identified in this study as per the strata wise analysis of the corresponding facts.
... Its reasons are complicated and effects negatively for self-worth and also harmful for development (Jing, 2012). Lack of self-esteem including with inferiority complex leads to negative or risk seeking behaviors in young age (Moritz, 2006). Researches have yielded tenuous associations between low self-esteem and risk taking behaviors or socially problematic outcomes like aggression, substance abuse and poor school achievement (Dawes, 1994;Mecca, 1989;Overholser, 1995). ...
The purpose of the study was to investigate interpersonal values, inferiority complex and psychological well-being of teenage students. The sample size of the study was 384 teenage students (male = 200 and female = 184; age range 13-19 years) from different public and private schools and colleges in Chittagong, Bangladesh. Interpersonal Values (Begum & Khanam, 1990), Inferiority Measure Questionnaire (Akramuzzaman, Azizul & Haque, 2011) and Psychological Well-being Scale (Huque & Begum, 2005) were used for data collection. Simple statistical tools, e.g., Mean, SD, Pearson Product Moment Correlation, ANOVA, and t-test were used for interpreting the findings. The findings revealed that psychological well-being and inferiority complex were negatively correlated (r = -.453); interpersonal values and inferiority complex were also negatively correlated (r = -.717); but interpersonal values and psychological well-being were positively correlated (r = .792) in respect of teenage students. It was also found that male teenage students possessed more interpersonal values and psychological well-being than their counterpart. The results of the study would be beneficial for family members, teachers, and policymaker knowing them in the development of teenage students. Additionally, it would be useful for psychological health professionals or counselors to consider the importance of institutional or family relations while dealing with their clients.
... We need the outside validation to acknowledge how good they are." (Miller, November 2013) The term "inferiority complex" was coined to indicate a lack of covert self-esteem (Moritz et al, 2007). Stemming from the psychoanalytic branch of psychology, the idea first appeared among many of Sigmund Freud's works and later in the work of his colleague Carl Jung. ...
The term “inferiority complex” was coined to indicate a lack of covert self-esteem. Stemming from the psychoanalytic branch of psychology, the idea first appeared among many of Sigmund Freud's works and later in the work of his colleague Carl Jung. The feeling of a lack of self-worth, of doubt and uncertainty, is often subconscious, and in some cases is thought to drive afflicted individuals to overcompensate, resulting either in spectacular achievement or extreme asocial behavior. This essay asks the question: Is the Caribbean suffering from a collective inferiority complex as a result of the shared experience of chattel slavery?
For it seems that fifty years after their respective independences from British colonial power, Trinidad & Tobago and Jamaica, the two largest islands in the English-speaking Caribbean, still needed “de white man” to tell them what they should have already known: that there are world-class artistes from the Caribbean.
This essay looks at the Caribbean response to the international success of the Sino-Jamaican pop vocalist Tessanne Chin, and Afro-Trinidadian Soca star, Ian Alvarez, aka “Bunji Garlin”.
... For instance, McKay et al. (2007) found that participants with persecutory delusions had a lower implicit SE than healthy controls, but did not differ significantly on explicit SE once depression was taken into account. Similarly, Moritz et al. (2006) found that individuals with persecutory ideation had higher explicit SE than patients without it, and had lower implicit SE than healthy controls. In a recent study, Nakamura et al. (2015) has shown that a discrepancy between explicit and implicit SE is specific to non-self-blaming paranoia. ...
Adversity has been identified as an important factor in models of psychopathology and can help in understanding persecutory ideation, although potential moderators and mediators for adult psychopathology have not been sufficiently examined. Experiential avoidance (EA) and Self-esteem (SE) are relevant factors to understand how adversity leads to persecutory ideation. This study hypothesized that adversity would be associated with persecutory ideation through heightened EA, and that this association would be strengthened in individuals with a discrepant high SE. Participants with persecutory ideation (n = 52), with depression (n = 35) and healthy controls (n = 51) were assessed with the Trauma History Screen, the Paranoia and Deservedness Scale, and the Beck Depression Inventory. A SE discrepancy index was calculated subtracting the normalized explicit SE score from the normalized implicit SE score (measured by a version of a Go/No-go association task). Our analysis revealed that adversity was associated with higher levels of paranoia and was mediated by EA. In addition, we found that the relationship between adversity and EA was moderated by SE discrepancy. Identification of moderating and mediating variables allows for increased understanding of persecutory ideation and the processes that should be targeted in the course of recovery.
... According to Bentall's (1994) model of paranoia (Moritz, Werner, & von Collani, 2006;Trower & Chadwick, 1995), cognitive biases protect paranoid patients from an awareness of their circumscribed role in the world by restricting access to consciousness of negative or less worthy qualities they possess. When negative self-representations are dominated by threatening events, external personal attributions (blaming others) are elicited to prevent the activation of discrepancies between how the subject realistically views himself or herself ("actual self" representations) and how he or she would like to be (ideal self representations). ...
... Subsequent studies found that paranoid patients attributed negative events to the agency of others (Berry et al., 2015;Kinderman and Bentall, 1997;Kinderman and Bentall, 1996a, b;Martin and Penn, 2002). It has been argued that this bias may serve the implicit purpose of raising a primary low self-esteem (delusion-as-defense theory; Bentall et al., 1994;Lyon et al., 1994;Moritz et al., 2006). ...
Background: Aberrant attributional styles are counted to a set of circumscribed cognitive biases that are implicated in the pathogenesis of (paranoid) psychosis. However, evidence for a specific profile (e.g., an exaggerated self-serving bias, other-blaming bias) has become equivocal over the years. More recently, one-sided (monocausal) attributions have been reported in patients with psychosis.
Methods. We compared a large sample of patients with diagnosed schizophrenia (n = 145) to nonclinical controls (n = 30) on a revised version of the Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R). In this task, participants have to assign probability estimates to each of three potential causes (i.e., myself, others, circumstances) for a specific (negative or positive) event.
Results. Participants with schizophrenia displayed an abolished self-serving bias and showed a significant preference for one-sided/monocausal attributions, which was neither correlated with jumping to conclusions nor overconfidence in errors. School education correlated with less monocausal attributions. We did not find any congruence between attributional styles with core delusional ideas.
Conclusions: Our study corroborates earlier investigations showing that monocausal attributions may play a role in the pathogenesis of psychosis; this bias unlikely represents an epiphenomenon of established biases. Unexpectedly, attributional styles (e.g., external-blaming) did not shape delusional contents. The true prevalence of monocausal attributions in psychosis is perhaps underestimated in the study, as groups were equated on school education, which was correlated with greater monocausal attributions.
... The inner workings of both of these aspects has led Kim Jong-un into a quandary wherein he has to fulfill a position which by definition he does not fit. He is torn and may further suffer from inferiority complexes which would account for the mass executions of KIM JONG-UN: A NEO-ANALYTICAL AND COGNITIVE PERSONALITY ANALYSIS 20 top military officials who understand his father's delicate brinkmanship (Moritz, Werner, and Collani 2006). ...
This study examined the personality of Kim Jong-un, the ruler of North Korea. Owing to the isolated nature of the country in which he resides and the known bias of its media behavioral evidence was derived from multi source reporting. The analysis applied basic neo-analytic and cognitive theories of personality construct to assess underlying and foundational attributes of his personality. The research found that from a neo-analytical viewpoint Kim Jong-un suffers from a fractured psyche leading to internal conflict. Cognitively he was found to display volatile characteristics to others while simultaneously exhibiting actions of an overprotective nature to his immediate family. The study determined that Kim Jong-un holds a personality construct that leads him to exhibit indecisive, short tempered, and insecure attributes. KIM JONG-UN: A NEO-ANALYTICAL AND COGNITIVE PERSONALITY ANALYSIS 2
... This research typically examines discrepancies between self-reported and implicit selfesteem, and compares individuals with persecutory delusions with healthy and/or depressed controls (e.g., MacKinnon, Newman-Taylor, & Stopa, 2011;McKay, Langdon, & Coltheart, 2007;Moritz, Werner, & von Collani, 2006;Kesting, Mehl, Rief, Lindenmeyer, & Lincoln, 2011). Findings have been somewhat mixed however. ...
Background and Objectives: The relationship between self-esteem and paranoia may be influenced by social stress. This study aimed to replicate previous research on the impact of social exclusion on paranoia and self-esteem in a non-clinical sample and to extend this work by examining the effect of exclusion on self-esteem at the ‘implicit’ level.
Methods: Non-clinical participants (N=85) were randomly allocated to the Inclusion or Exclusion condition of a virtual ball-toss game (‘Cyberball’). They completed self-report measures of state paranoia and self-esteem, and two implicit measures of self-esteem – the Implicit Association Task (IAT) and Implicit Relational Assessment Procedure (IRAP) – prior to and after exposure to Cyberball.
Results: Social exclusion increased state paranoia. This effect was moderated by distress associated with trait paranoia. Exclusion was also associated with decreased self-reported self-esteem, as well as reduced implicit self-esteem on the IAT. Changes in self-reported self-esteem were associated with state paranoia at post-Cyberball. The IRAP indicated that reductions in implicit self-esteem may be due to increases in ‘Me-Negative’ and ‘Others-Positive’ biases (rather than reductions in ‘Me-Positive’ bias).
Limitations: The current study involved a non-clinical sample and so findings cannot be generalized to clinical paranoia.
Conclusions: These findings are consistent with previous evidence that paranoia is associated with negative self-evaluations, whereas positive self-evaluations can persist in paranoia. They also provide support for the suggestion that investigations of self-esteem in paranoia should extend beyond global self-esteem and might benefit from a distinction between positive and negative components.
... It is a lowthreshold, low-intensity group intervention (up to 16 sessions lasting ≤ 60 minutes each) which adopts a metacognitive perspective (i.e., "thinking about one's thinking") whose aim is to enhance patient awareness of the cognitive biases underlying the development and maintenance of psychotic symptoms [61]. This approach could be advantageous for patients who cannot distance themselves from their delusions or whose positive symptoms actually foster their self-esteem [62]. The training is delivered by a health care specialist in small groups (3-10) of schizophrenia spectrum patients. ...
Schizophrenia is one of the most disabling conditions in medicine, causing deficits in neurological, psychological and social function. Antipsychotic medications are the first line of treatment and these are effective for many of the symptoms of psychosis. However, disability rates among patients with schizophrenia have changed little over the past century. For this reason, interest in adjunctive non-pharmacological treatments has been growing. Social cognitive dysfunction has been shown to be a persistent feature of this disorder, remaining stable over the course of schizophrenia despite the use of clinically effective psychopharmacological and psychosocial treatment. Social cognition appears to be an independent construct that differs from positive symptoms that is only partially accounted for by negative symptoms and impairment in neurocognition. In recent years, several specific treatment programs have been developed to directly address impairments in this important area. These treatments vary in their approach depending on whether they conceptualize social cognition impairments quantitatively as “deficits” or qualitatively as “dysfunctions”. Dysfunction models view such impairments not as inabilities or restricted abilities, but rather as the result of errors in social cognitive processes of existing abilities. In this context, the aim of this narrative review is to describe the novel psychological interventions developed in recent years whose main aim is to address the underlying social cognitive processes that contribute to the formation of positive symptoms. Importantly, the approach taken by these new therapies stands in contrast to conventional treatments, which target the personal delusional beliefs. All of these new therapies share a focus on the thinking process rather than on the accuracy of thoughts and beliefs (i.e., the content of thinking). Their principal aim is to stimulate and improve the patient's capacity to think about thinking, the metacognitive (or mentalizing) capacity. Metacognitive and mentalizing-based therapies are still in their infancy, but initial results are encouraging, showing that these approaches are both feasible and beneficial in people with schizophrenia.
... The role of (cold) neuropsychological dysfunctions e aggravating but not necessary conditions Neuropsychological deficits increase the chances of false inferences but do not represent a sufficient or even necessary condition for the formation of positive symptoms according to our account. While neuropsychological performance dysfunctions undoubtedly exist in patients with psychosis (for reviews and metaanalyses see Fatouros-Bergman, Cervenka, Flyckt, Edman, & Farde, 2014; Heinrichs & Zakzanis, 1998; Keefe & Harvey, 2012;4 The related idea that delusions serve an "ego defense" function, that is, they guard one's self-esteem or lift it (Bentall et al., 2001;Lincoln, Stahnke, & Moritz, 2014) is currently not well supported (Galbraith & Manktelow, 2015;Mackinnon, Newman-Taylor, & Stopa, 2011), which might be owing to methodological problems (Moritz, Werner, & von Collani, 2006). Schaefer, Giangrande, Weinberger, & Dickinson, 2013) their multicausal origin and their putative specificity are subject to an ongoing debate. ...
Positivsymptome wie Wahn und Halluzinationen stellen definierende Symptome einer (schizophrenen) Psychose dar. In dieser Übersichtsarbeit wird ein 2-stufiges heuristisches Modell für die Entstehung und Aufrechterhaltung psychotischer Positivsymptome vorgelegt. Im Kern der Theorie steht die Hypothese, dass von Psychose betroffene Menschen eine erniedrigte Entscheidungsschwelle aufweisen, die zu einer frühzeitigen Annahme von Hypothesen führt (liberale Akzeptanz). Im Unterschied zu nichtpsychotischen Personen ist die Konfidenz in falsche Urteile bei Betroffenen, als Folge dieser liberalen Akzeptanz, erhöht. Postuliert werden 2 Stufen der Wahnentwicklung. Auf Stufe 1 (Wahnentstehung) ist die subjektive Wahrscheinlichkeit für akzeptierte Hypothesen bei Menschen mit Psychose zunächst vergleichsweise gering. Wahnhafte Ideen sind in diesem Stadium häufig nicht voll entfaltet bzw. fragil und können zwischen 2 sich gegenseitig ausschließenden Ansichten oszillieren («doppelte Buchführung»). Im Zuge der 2. Stufe (Überzeugung, Aufrechterhaltung) verfestigen sich die flüchtigen wahnhaften Ideen zu falschen Überzeugungen aufgrund eines 2-gliedrigen Konsolidierungsprozesses - indem einerseits Gegenbeweise ignoriert und andererseits Belege zugunsten der Leithypothese einen Verarbeitungsvorteil erhalten (Bestätigungstendenz). Alternative Hypothesen rücken in den Hintergrund. Aufrechterhaltend für eine Wahnidee sind vielfältige psychologische Faktoren und Motive, wie die Kongruenz des Wahns mit dem emotionalen Befinden, persönliche Bedeutsamkeit und die temporäre Steigerung des Selbstwertgefühls sowie das Spannen eines Erklärungsrahmens für ein breites Spektrum von Beschwerden zur Reduktion kognitiver Dissonanz. Aus unserer Sicht können viele Formen von Halluzinationen und Erstrangsymptomen (z.B. Gedankeneingebung) ebenfalls durch liberale Akzeptanz erklärt werden. Diese Symptome basieren unseres Erachtens nicht zwingend auf fehlerhaften oder abnormalen Wahrnehmungen, sondern repräsentieren eine Fehlinterpretation von (teilweise) normalen sensorischen Phänomenen, die sich von einem (normalen) «Als-ob»-Gefühl bis hin zu einer wahnhaften Überzeugung steigern. Im Einklang mit dem erläuterten Modell werden Positivsymptome durch Interventionen wie das metakognitive Training (MKT) verringert, die Betroffene dazu anhalten, mehr Informationen zu sammeln und ihre Urteilssicherheit zu reduzieren (Säen von Zweifel). Die antipsychotische Wirkung von Antipsychotika/Neuroleptika wird im Rahmen der Theorie zum Teil durch ihre Eigenschaft erklärt, Zweifel zu induzieren. Die Bedeutung der Emotionsregulation bei der Reduktion von Positivsymptomen wird ebenfalls aufgezeigt, und zukünftige Forschungsrichtungen sowie offene Fragen diskutiert.
... Inability to perform activities like the able-body people could generate feelings of inferiority in persons with dis-ability. The feelings of uncertainty or lack of self-worth may negatively influence self-esteem, self-confidence, and life satisfaction (Schmitt and Allik, 2005;Moritz et al, 2006). However, in the studies of PA in PWPD that have been conducted over the past 10 years, the relationship between the amount of PA and QOL is still not conclusive. ...
Physical activity (PA) can improve health and quality of life (QOL) of healthy people. However, the association between PA and QOL among people with physical disability (PWPD) is inconclusive. This study was conducted to determine the relationships between factors including intensity of PA, activitiy in daily living (ADL), stress, and self-esteem that influences self-reported QOL among PWPD. The relationships were further explored using the in-depth interview method to find out whether the intensity of PA, stress, and self-esteem are related to QOL perception in PWPD. One hundred sixty PWPD aged 18-48 years who studied at a vocational school were enrolled. A mixed method case study was conducted: cross-sectional survey and in-depth interview. Five questionnaires, including the Barthel Index, Perceived Stress Scale (PSS), Rosenberg Self-Esteem Scale (RSES), and Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) were distributed. QOL was measured using the WHOQOL_BREF. Multiple linear regression was used to determine factors for QOL prediction. For in-depth interview, ten persons from each group (poor-to-fair and good QOL) volunteered to explore further about life satisfaction related to physical disability. One hundred forty-six (91%) subjects completed all questionnaires. One hundred fourteen (77%) reported poor-to-fair QOL. QOL was explained by self-esteem and ADL (adjusted R² 34.7%, p < 0.001) after adjusted for age, stress, and PA. Although PA could not explain QOL in PWPD, good QOL reported high activities (28.40 ± 30.20 MET hour/day) compared to poor and fair QOL (17.94 ± 22.06 and 21.70 ± 17.75 MET hour/day). Those who had good QOL reported that they were proud to be independent and did not feel inferior. PA participation among people with disabilities should therefore be encouraged.
... The role of (cold) neuropsychological dysfunctions e aggravating but not necessary conditions Neuropsychological deficits increase the chances of false inferences but do not represent a sufficient or even necessary condition for the formation of positive symptoms according to our account. While neuropsychological performance dysfunctions undoubtedly exist in patients with psychosis (for reviews and metaanalyses see Fatouros-Bergman, Cervenka, Flyckt, Edman, & Farde, 2014; Heinrichs & Zakzanis, 1998; Keefe & Harvey, 2012;4 The related idea that delusions serve an "ego defense" function, that is, they guard one's self-esteem or lift it (Bentall et al., 2001;Lincoln, Stahnke, & Moritz, 2014) is currently not well supported (Galbraith & Manktelow, 2015;Mackinnon, Newman-Taylor, & Stopa, 2011), which might be owing to methodological problems (Moritz, Werner, & von Collani, 2006). Schaefer, Giangrande, Weinberger, & Dickinson, 2013) their multicausal origin and their putative specificity are subject to an ongoing debate. ...
Objectives: We outline a two-stage heuristic account for the pathogenesis of the positive symptoms of psychosis.
Methods: A narrative review on the empirical evidence of the liberal acceptance (LA) account of positive
symptoms is presented.
Hypothesis: At the heart of our theory is the idea that psychosis is characterized by a lowered decision
threshold, which results in the premature acceptance of hypotheses that a nonpsychotic individual
would reject. Once the hypothesis is judged as valid, counterevidence is not sought anymore due to a bias
against disconfirmatory evidence as well as confirmation biases, consolidating the false hypothesis. As a
result of LA, confidence in errors is enhanced relative to controls. Subjective probabilities are initially low
for hypotheses in individuals with delusions, and delusional ideas at stage 1 (belief formation) are often
fragile. In the course of the second stage (belief maintenance), fleeting delusional ideas evolve into fixed
false beliefs, particularly if the delusional idea is congruent with the emotional state and provides
“meaning”. LA may also contribute to hallucinations through a misattribution of (partially) normal
sensory phenomena. Interventions such as metacognitive training that aim to “plant the seeds of doubt”
decrease positive symptoms by encouraging individuals to seek more information and to attenuate
confidence. The effect of antipsychotic medication is explained by its doubt-inducing properties.
Limitations: The model needs to be confirmed by longitudinal designs that allow an examination of
causal relationships. Evidence is currently weak for hallucinations.
Conclusions: The theory may account for positive symptoms in a subgroup of patients. Future directions
are outlined
... Arguably, these kinds of cognitive biases are especially likely to develop against a background of attachment insecurity and victimization. Consistent with this account, paranoid patients show highly unstable selfesteem (Thewissen et al., 2007; and also marked discrepancies between implicit and explicit self-esteem (McKay et al., 2007;Moritz et al., 2006). However, an externalizing attributional bias (the specific tendency to attribute negative events to the actions of others) only seems to be present during acute episodes of paranoia (Janssen et al., 2006) when the individual is also grandiose (Jolley et al., 2006) and believes that persecution is completely undeserved (Janssen et al., 2006). ...
The originators of the stress-vulnerability model of schizophrenia (Zubin & Spring, 1977) assumed that vulnerability to stress could be acquired ‘due to the influence of trauma, specific diseases, perinatal complications, family experiences, adolescent peer interactions, and other life events’. Most genetic and brain researchers, however, have either ignored the psycho-social causes of psychosis or relegated them to the role of triggers or exacerbators of a vulnerability which they assumed to be genetic. Meanwhile brain researchers identified abnormalities in ‘schizophrenics’ without considering what might have happened in their lives to have caused them. The ratio of biological to psycho-social etiology studies, 16 to 1, has become increasingly imbalanced (see Table 13.1).
... Obviously the stigmata of being mentally ill and being hospitalized are serious psychological strains. In addition delusions might serve as a defense strategy against low self-esteem and create alternative meanings of life (Moritz et al. 2006 ). Consequently the improvement of insight into illness without a deterioration of mood and QOL is an important therapeutic outcome in patients with schizophrenia (Cooke et al. 2005 ). ...
Nowadays, the main objective in treating patients with schizophrenia (SZ) is not only to attain and maintain symptomatic remission, in order to reach recovery, but also to avoid relapses and reach a level of personal and social functioning, as well as of quality of life (QoL), as near as possible to that of the general population (Hasan et al. 2013). In that sense, psychosocial functioning and QoL are increasingly recognized as important treatment outcomes in SZ (Juckel and Morosini 2008; Remington et al. 2010; Figueira and Brissos 2011).
... Some studies have reported this kind of overt vs covert self-esteem discrepancy in paranoid patients. [49][50][51] Several limitations of existing studies constrain the extent to which the findings identify cognitive mechanisms that might form a focus for further biological and psychological investigation. First, most studies have investigated only patients with schizophrenia or delusional disorder, the exception being a series of our articles that also reported data from patients with major depression 23,37 and very late-onset schizophrenia-like psychosis. ...
We aimed to identify transdiagnostic psychological processes associated with persecutory delusions. Sixty-eight schizophrenia patients, 47 depressed patients, and 33 controls were assessed for paranoia, positive and negative self-esteem, estimations of the frequency of negative, neutral, and positive events occurring to the self in the past and in the future and similar estimates for events affecting others in the future. Negative self-esteem and expectations of negative events were strongly associated with paranoia in all groups. Currently deluded patients were asked to rate whether their persecution was deserved on an analogue scale. Mean deservedness scores were higher in deluded-depressed patients than deluded-schizophrenia patients, but patients in both groups used the full range of scores. The findings indicate that negative self-esteem and negative expectations independently contribute to paranoia, but do not support a simple categorical distinction between poor-me (persecution undeserved) and bad-me (persecution deserved) patients.
... Like CBT for psychosis (CBTp), MCT shares the goal of targeting psychotic symptoms, but adopts a "back door approach" by dealing with cognitive processes first and then proceeding to the symptom level (particularly the individualized variant MCT +, see below). This more gentle approach is considered advantageous for patients who cannot distance themselves from their delusions or whose positive symptoms actually foster their selfesteem (Moritz, Werner, & von Collani, 2006;Sundag, 2012) and are considered by patients to be valuable (and partly positive) experiences (Klapheck, Nordmeyer, Cronjager, Naber, & Bock, 2012). In accordance with this, recent evidence shows that guided discovery, an effective core technique of CBT, that uncovers incongruities or inconsistencies in patients' conclusions, may reduce the therapeutic alliance (Wittorf et al., 2013). ...
Opinion statement
Metacognitive training (MCT) is a treatment approach aimed at correcting cognitive biases and reducing positive symptoms in nonaffective psychosis. Patients are taught to withhold overconfident and hasty decisions by becoming aware of the fallibility of human cognition and the advantages of balanced and particularly well-founded judgments for (social) decision-making. The present review reports on new findings on cognitive biases in psychosis. While a number of cognitive theories have been corroborated over the years, other assumptions have become more equivocal. We present new studies on the efficacy of MCT, as well as its individualized variant, termed MCT+. Although two recent meta-analyses arrived at somewhat different conclusions, they agree that group MCT exerts a small or small to medium effect. For individualized MCT, the effects are stronger. It seems that patients who fare the best in the group setting are those who already have at least partial insight. If these preconditions are not met, individualized therapy is deemed more beneficial. Dismantling studies are needed to elucidate core mechanisms of change. Recently, the program, which was initially directed at the reduction of positive symptoms only, has been expanded with modules addressing self-esteem and stigma as for many patients these domains represent a high treatment priority.
... 16 Furthermore, MCT also tries to foster self-esteem, as people diagnosed with schizophrenia have low self-esteem compared to healthy controls. 17 The initial version of MCT consists of a manualized group training and contains interventions addressing attributional style, JTC, problems taking perspectives of others, change of beliefs, low self-esteem and exercises to improve memory and to foster correction of beliefs. 13 The modules can be downloaded free of charge from via the following website: http://www.uke.de/mct. ...
Metacognitive training (MCT) is a new, widely used intervention for psychosis. The present meta-analysis examines the efficacy
of MCT in schizophrenia. Fifteen studies comparing effects of MCT on positive symptoms, delusions or acceptance of MCT with
a control group were included in this meta-analysis. These studies comprised a total of 408 patients in the MCT condition
and 399 in the control condition. The moderating effects of masking of outcome assessment, randomization, incomplete outcome
data, use of an active control intervention, and individual vs group MCT were investigated. Possible effects of sensitivity
analyses and publication bias were also examined. The results show a significant overall effect of MCT for positive symptoms
(g = −0.34, 95% CI [−0.53, −0.15]), delusions (g = −0.41, 95% CI [−0.74, −0.07]) and acceptance of the intervention (g = −0.84, 95% CI [−1.37, −0.31]). Using only studies being at low risk for bias regarding randomization, masking and incomplete
outcome data reduced effect sizes for positive symptoms and delusions (g = −0.28, 95% CI [−0.50, −0.06] and g = −0.18, 95% CI [−0.43, 0.06]), respectively. This meta-analysis demonstrates that MCT exerts a small to moderate effect
on delusions and positive symptoms and a large effect on acceptance of the intervention. The effect on delusions is reduced,
but remains significant when potential biases are considered.
... Furthermore, MCT also tries to foster self-esteem, as people diagnosed with schizophrenia have low self-esteem compared to healthy controls (Moritz, Werner, & von Collani, 2006). ...
... Furthermore, MCT also tries to foster self-esteem, as people diagnosed with schizophrenia have low self-esteem compared to healthy controls (Moritz, Werner, & von Collani, 2006). ...
Objectives: Metacognitive training is a new, widely used intervention for psychosis. The present meta-analysis examines the efficacy of metacognitive training in schizophrenia.
Methods: Studies comparing effects of metacognitive training on positive symptoms, delusions or acceptance of metacognitive training with a control group were included in this meta-analysis. The moderating effects of masking of outcome assessment, randomization, incomplete outcome data, use of an active control intervention and individual versus group metacognitive intervention were investigated. Possible effects of sensitivity analyses and publication bias were also examined.
Results: There was a significant overall effect of metacognitive training for positive symptoms (g = -0.34, 95% CI [-0.53, -0.15]), delusions (g = -.41, 95% CI [-0.74, -0.07]) and acceptance of the intervention (g = -0.84, 95% CI [-1.37, -0.31]). Using only studies being at low risk for bias regarding randomization, masking and incomplete outcome data reduced effect sizes for positive symptoms and delusions (g = -0.28, 95% CI [-0.50, -0.06] and g = -0.18, 95% CI [-0.43, 0.06]), respectively. Adjusting for publication bias reduced the effect on positive symptoms to g = -0.29, 95% CI [-0.50, -0.07]. There was no evidence of a publication bias for delusions or acceptance of the intervention.
Conclusions: Metacognitive training exerts a small to moderate effect on delusions and positive symptoms and a large effect on acceptance of the intervention. The effect on delusions is reduced, but remains significant when potential biases are considered.
Key words: Metacognitive training, psychosis, schizophrenia, delusions, acceptance
... Furthermore, MCT also tries to foster self-esteem, as people diagnosed with schizophrenia have low self-esteem compared to healthy controls (Moritz, Werner, & von Collani, 2006). ...
... Delusions are often accompanied by reduced well-being as reflected by low selfesteem (Kesting & Lincoln, 2013), depression (Buckley, Miller, Lehrer, & Castle, 2009) and emotional distress (Ben-Zeev, Morris, Swendsen, & Granholm, 2012). At the same time, at least some patients acknowledge that their symptoms positively impact on self-esteem (Garety, 1992;Moritz, Werner, & von Collani, 2006) which sometimes even results in discontinuation of medication (Moritz et al., 2009;Moritz et al., 2013). This indicates thatcontrary to the traditional psychiatric view that emphasizes the burden of psychotic symptomsfor at least some patients psychotic symptoms are not solely associated with negative emotions and self-evaluations. ...
Background: Persecutory delusions are often associated with low self-esteem, depression and emotional distress. However, some patients acknowledge that their beliefs positively impact on their well-being which has been linked to non-adherence with medication. The present study aimed to investigate the moderators for the relationship of subjective well-being and persecutory delusions.Method: We recruited 43 patients with acute (n = 33) or remitted (n = 10) persecutory delusions and 33 healthy participants. Following a self-esteem measure and the assessment of psychopathology we conducted a semistructured interview with the patients to assess the contents of persecutory delusions (e.g. power of the persecutor).Results: Patients displayed significantly lower global self-esteem than healthy controls. In the acutely deluded sample (n = 33) patients with special abilities had significantly lower scores of depression and emotional distress than patients with normal or lower-than-normal abilities. A feeling of powerlessness towards the persecutor was associated with lower self-esteem and higher depression. Delusions which imparted the patient with special importance and delusions of being desired by someone else were significantly associated with higher levels of self-esteem.Conclusions: We conclude that the content of delusions is important when planning medical and psychological treatment. Clinicians are advised to take the associations between specific convictions and subjective well-being into account.
... investigations (see Steffens Collani, 2006) and in clinical studies to control the effects 309 of psychotherapeutic interventions (Teachman & Woody, 2003). 310 ...
Applying a person-centered approach, three personality types based on the NEO-FFI scales were identified
in a sample of N = 141 participants by means of clustering methods. They were described as a resilient
(low N, high E), a non-desirable (high N, low E, A, and C), and a reserved overcontrolled prototype
(low E and O, high A and C). The prototypes were related to the level of aggressiveness, assessed by
the Buss–Perry Aggression Questionnaire (AQ). Results indicate that the three clusters differ mainly in
their levels of hostility, verbal aggressiveness, and with respect to anger. With respect to total aggressiveness,
the non-desirable prototype displayed the highest and the reserved prototype the lowest AQ scores.
The results are discussed in relation to studies based on a variable-centered approach. Possible implications
for treatment and research are addressed.
... Like CBT for psychosis (CBTp), MCT shares the goal of targeting psychotic symptoms, but adopts a "back door approach" by dealing with cognitive processes first and then proceeding to the symptom level (particularly the individualized variant MCT +, see below). This more gentle approach is considered advantageous for patients who cannot distance themselves from their delusions or whose positive symptoms actually foster their selfesteem (Moritz, Werner, & von Collani, 2006;Sundag, 2012) and are considered by patients to be valuable (and partly positive) experiences (Klapheck, Nordmeyer, Cronjager, Naber, & Bock, 2012). In accordance with this, recent evidence shows that guided discovery, an effective core technique of CBT, that uncovers incongruities or inconsistencies in patients' conclusions, may reduce the therapeutic alliance (Wittorf et al., 2013). ...
... Like CBT for psychosis (CBTp), MCT shares the goal of targeting psychotic symptoms, but adopts a "back door approach" by dealing with cognitive processes first and then proceeding to the symptom level (particularly the individualized variant MCT +, see below). This more gentle approach is considered advantageous for patients who cannot distance themselves from their delusions or whose positive symptoms actually foster their selfesteem (Moritz, Werner, & von Collani, 2006;Sundag, 2012) and are considered by patients to be valuable (and partly positive) experiences (Klapheck, Nordmeyer, Cronjager, Naber, & Bock, 2012). In accordance with this, recent evidence shows that guided discovery, an effective core technique of CBT, that uncovers incongruities or inconsistencies in patients' conclusions, may reduce the therapeutic alliance (Wittorf et al., 2013). ...
p>This thesis examines the role of self-concept in cognitive models of persecutory delusions. It consists of two sections: A literature review and an empirical research paper. The literature review examines the.role of self-concept in the formation and maintenance of persecutory delusions as proposed by the three main cognitive models; the attribution self-representation model, persecutory and punishment types of paranoia, and the threat anticipation cognitive model. Each model makes different predictions about the role of self-concept, in particular self-esteem and self-schemas. The review concludes that, in terms of the current research evidence, there is broad support for the threat anticipation cognitive model of persecutory delusions. However, further research evidence is needed to fully clarify the role of self-concept in persecutory delusions. The empirical study investigates the predictions of the attribution self- representation model in a clinical group of people with persecutory delusions in comparison with a healthy control group. Persecutory delusions are predicted to defend against low implicit self-esteem reaching conscious awareness. For people with persecutory delusions, the model predicts lower levels of implicit self-esteem and equivalent levels of explicit self-esteem when compared with a healthy control group. The results of this study do not support the attribution self-representation model. The findings of this study are discussed in relation to other cognitive models of persecutory delusions and areas for further research are highlighted.</p
Objectives
Though relatively unexplored in clinical populations, aversive personality traits have been shown to impact the expression, the management, and the outcomes of psychotic disorders. This paper seeks to gather and organize existing evidence of the complex interplay linking social ethics, personality and experiences of psychosis through the lens of the so-called Dark Triad personality model, comprising the three multidimensional constructs Machiavellianism, narcissism and psychopathy.
Methods
A semi-systematic review of major literature databases was conducted; search terms aimed at capturing each of the Dark Triad dimensions and their known relations with both clinical (with single-symptom approach) and non-clinical psychotic experiences.
Results
Reviewed studies suggest that all the components of the Dark Triad model present significant clinical implications in the management of psychotic disorders.
Conclusions
Aversive personality traits interact with and modulate the experiences of psychosis. They can be shown to influence the clinical and functional outcomes of psychotic patients. Therefore, further research on this theme seems justified in that it may inform rehabilitative efforts.
The dual-process models explaining cognitive functioning paved the way for handling explicit and implicit dimensions of self-evaluations. In this direction, the focus has been on implicit self-esteem, which is one important element of unconscious self-evaluations. Many methods have been developed in which self-related stimuli are presented to measure implicit self-esteem. Thus, a new variable that can play a critical role in contexts such as personality, interpersonal relationships, and psychopathology has been defined in the literature on self-esteem, which is generally based on findings measured by self-reporting. The present review aims to shed light on the characteristics of implicit self-esteem, its role in psychopathologies, and traditional and second-generation measurement methods in this field. In this context, a review of studies focusing on the role of implicit self-assessment in different areas such as depression, anxiety, psychosis, and personality disorders is presented. Furthermore, the strengths and limitations of measurement methods are discussed. As a result, it has been observed that implicit self-esteem can play a central role in psychopathologies both in terms of its relation to explicit self-esteem and independently from it, however, studies on the subject have revealed inconsistent findings in some areas. Besides, it was determined that measurement methods are not strong enough in terms of psychometric properties and further studies are needed in this regard.
Objective
The present study investigated the ways in which inferiority predicted aggression 6 months later in college students, by considering the role of cognitive reappraisal and expression suppression.
Method
A total of 462 Chinese college students (50.2% male; Mage=19.60, SD=0.807) completed an emotion regulation questionnaire (ERQ), an inferiority questionnaire, and a Chinese college students’ vision of the Buss-Perry Aggression Questionnaire (CC-BPAQ) at two time points.
Results
The results showed that the predictive effect of inferiority (at time 1) on aggression (at time 2) was significant before putting the mediator variables into the model (β = 0.655, p< 0.001). Cognitive reappraisal (at time 2) played a role in mediating between inferiority and aggression (with the indirect effect= 0.023, p < 0.05, 95% CI= 0.007 ~ 0.054). However, the mediating role of the expression suppression (at time 2) was not significant (with the indirect effect= 0.013, p > 0.05, 95% CI= 0.000 ~ 0.035).
Conclusions
Inferiority had direct positive associations with aggression, and this relationship was only mediated by cognitive reappraisal among college students.
Introduction:
The therapeutic approaches of the so-called "third wave" of clinical cognitivism have assumed increasing relevance in recent years alongside cognitive-behavioral therapy in the treatment of psychosis.
Aims:
To evaluate the efficacy of some of the most relevant third wave cognitive-behavioral approaches (metacognitive interventions and therapies based on mindfulness and acceptance) in the treatment of psychosis.
Method:
A systematic research was carried out for systematic reviews and meta-analysis on the efficacy of metacognitive interventions and mindfulness- and acceptance-based therapies in the treatment of psychosis, published from 1 January 2009 to 31 December 2018. The selected studies were evaluated using AMSTAR 2, a valid and reliable tool composed of 16 items to measure the methodological quality of systematic reviews and meta-analysis.
Results:
7 meta-analysis were selected: 4 for metacognitive therapies (3 of low quality, 1 of critically low quality) and 3 for mindfulness- and acceptance-based therapies (1 of medium quality, 2 of low quality).
Discussion and conclusions:
Among metacognitive therapies, metacognitive training has shown promising results on positive symptoms and in particular on the psychopathology of delusions. Mindfulness- and acceptance-based therapies have shown mild to moderate effects on general and positive symptoms as well as some effects on negative symptoms, depressive symptoms, hospitalization rates and length. However, further research is needed to confirm overall the encouraging results of both metacognitive training and mindfulness- and acceptance-based therapies as the small number of randomized controlled trials and the low methodological quality of most meta-analysis realized up to date does not allow to draw yet sufficiently solid conclusions on their efficacy in the treatment of psychosis.
objective:
Biased attribution styles of assigning hostile intention to innocent others and placing the blame were found in schizophrenia. Attribution styles in individuals at ultra-high risk (UHR) for psychosis, however, have been less studied especially for its association with various psychological factors. We investigated whether UHR individuals show increased hostility perception and blaming bias and explored the associations of these biased styles of attribution with the factor structure of multifaceted self-related psychological variables and neurocognitive performances.
Methods:
Fifty-four UHR individuals and 80 healthy controls were assessed by evaluating resilience, self-perception, self-esteem, and aberrant subjective experiences of schizotypy (physical anhedonia, social anhedonia, magical ideation, and perceptual aberration), basic symptoms, and carrying out a comprehensive neurocognitive test battery. Attribution styles were assessed using the Ambiguous Intentions Hostility Questionnaire.
Results:
UHR individuals, compared with normal controls, showed increased hostility perception and blaming bias. Factor analysis of self-related psychological variables and neurocognitive performances in the entire subject population showed a three-factor solution, which was designated as reflective self, pre-reflective self, and neurocognition. Multiple regression analysis in UHR individuals revealed that hostility perception bias was associated with reflective self and composite blame bias was associated with reflective and pre-reflective self.
Conclusion:
This study supports the emergence of attribution biases in the putative 'prodromal' phase of schizophrenia. The associations of biased attribution styles with multifaceted self-related psychological constructs suggest that psychosocial interventions for biased attribution styles in UHR individuals should focus not only on reflective self but also pre-reflective self-related psychological constructs.
Acne excoriée, also known as ˝picker's acne˝, results when acne lesions are compulsively squeezed and scratched resulting in scabs and scars. It is seen most commonly in adolescent girls and has been thought to be associated with underlying depression, anxiety or emotional problems. The inferiority complex might be one of the underlying problems in this dermatological condition. Young women that do not feel good about themselves might have compulsive need to squeeze and scratch their skin and to worsen the severity of acne. Today´s imperative of perfect face and body (often nothing but photography retouching, illusion of perfection) may worsen women´s (and men´s) complexes, such as inferiority complex or complex of being ugly. Complexes are associated with the lack of positive emotions about oneself, therefore are built on the knots of negative emotions and thoughts.
Different lines of research suggest that individuals differ in accessing self-referential information, that is, to know who they are, what they think, want, need, or feel, and that this construct is positively associated with emotion regulation, adaptive functioning, well-being, and meaning in life. We developed a brief scale of five items, the Self-Access Form (SAF) and conducted four studies to approve its validity with respect to markers of adaptive personality functioning and health. Study 1 shows a clear, unidimensional factor structure for the SAF. Self-access correlates positively with adaptive self- and emotion regulation, as well as with psychological and physical health, but does not correlate with private self-consciousness (Study 2). Additionally, self-access is positively related to self-complexity and self-integration as two markers of adaptive self-development (Study 3). It is also inversely related to self-infiltration, that is, the misconception of other individuals’ expectations as own goals (Study 4). We conclude that self-access can validly be measured by a brief scale and positively relates to adaptive functioning and health.
Eine psychologische, verständnisbasierte Auseinandersetzung mit Wahn und Schizophrenie hat erst in jüngster Zeit an wissenschaftlicher Akzeptanz und klinischem Einfluss gewonnen. Für diese verzögerte Entwicklung scheint, wie bereits erwähnt, ein historischer Vorbehalt bezüglich der Durchführbarkeit und des Erfolgs psychotherapeutischer Maßnahmen bei psychotischen Störungen seitens der großen therapeutischen Schulen, u. a. der Psychoanalyse, verantwortlich zu sein (für neuere Entwicklungen siehe jedoch u. a. von Haebler 2015). Unter dem Jaspers’schen Postulat der Unverstehbarkeit von Psychosen und Freuds Annahme der fehlenden Gegenübertragung galten Schizophrenie und Wahn lange Zeit auch unter Psychologen als rein biologisch begründet und damit als »Sache des Arztes bzw. Apothekers«. Diese Vorstellungen sind nicht zuletzt durch zahlreiche Befunde der Grundlagenforschung und erfolgreiche verhaltenstherapeutische Ansätze korrigiert worden.
During the past decades subjective quality of life (hereafter QOL) has been proven to be a valid and useful outcome criterion in patients with schizophrenia besides the assessment of clinical parameters such as symptoms or daily functioning. Important predictors for a favorable outcome in patients with schizophrenia are a shorter duration of untreated psychosis, better premorbid functioning, an early treatment response, a lower level of psychopathology or illness severity, and better daily and social functioning at beginning of treatment (Lambert et al. 2010a). Clinical outcome is further compromised by a high risk of medication nonadherence and service disengagement (Velligan et al. 2009) and of comorbid disorders, especially substance use (Fleischhacker et al. 2008). All these factors directly or indirectly mediate QOL in patients with schizophrenia.
Background
Recovery in mental health is a relatively new concept, but it is becoming more accepted that people can recover from psychosis. Recovery-orientated services are recommended for adult mental health, but with little evidence base to support this.
Objectives
To facilitate understanding and promotion of recovery in psychosis and bipolar disorder (BD), in a manner that is empowering and acceptable to service users.
Method
There were six linked projects using qualitative and quantitative methodologies: (1) developing and piloting a service user-defined measure of recovery; (2) a Delphi study to determine levels of consensus around the concept of recovery; (3) examination of the psychological factors associated with recovery and how these fluctuate over time; (4) development and evaluation of cognitive–behavioural approaches to guided self-help including a patient preference trial (PPT); (5) development and evaluation of cognitive–behavioural therapy (CBT) for understanding and preventing suicide in psychosis including a randomised controlled trial (RCT); and (6) development and evaluation of a cognitive–behavioural approach to recovery in recent onset BD, including a RCT of recovery-focused cognitive–behavioural therapy (RfCBT). Service user involvement was central to the programme.
Results
Measurement of service user-defined recovery from psychosis (using the Subjective Experience of Psychosis Scale) and BD (using the Bipolar Recovery Questionnaire) was shown to be feasible and valid. The consensus study revealed a high level of agreement among service users for defining recovery, factors that help or hinder recovery and items which demonstrate recovery. Negative emotions, self-esteem and hope predicted recovery judgements, both cross-sectionally and longitudinally, whereas positive symptoms had an indirect effect. In the PPT, 89 participants entered the study, three were randomised, 57 were retained in the trial until 15-month follow-up (64%). At follow-up there was no overall treatment effect on the primary outcome (Questionnaire about the Process of Recovery total; p = 0.82). In the suicide prevention RCT, 49 were randomised and 35 were retained at 6-month follow-up (71%). There were significant improvements in suicidal ideation [Adult Suicidal Ideation Questionnaire; treatment effect = –12.3, 95% confidence interval (CI) –24.3 to –0.14], Suicide Probability Scale (SPS; treatment effect = –7.0, 95% CI –15.5 to 0) and hopelessness (subscale of the SPS; treatment effect = –3.8, 95% CI –7.3 to –0.5) at follow-up. In the RCT for BD, 67 participants were randomised and 45 were retained at the 12-month follow-up (67%). Recovery score significantly improved in comparison with treatment as usual (TAU) at follow-up (310.87, 95% CI 75.00 to 546.74). At 15-month follow-up, 32 participants had experienced a relapse of either depression or mania (20 TAU vs. 12 RfCBT). The difference in time to recurrence was significant (estimated hazard ratio 0.38, 95% CI 0.18 to 0.78; p < 0.006).
Conclusions
This research programme has improved our understanding of recovery in psychosis and BD. Key findings indicate that measurement of recovery is feasible and valid. It would be feasible to scale up the RCTs to assess effectiveness of our therapeutic approaches in larger full trials, and two of the studies (CBT for suicide prevention in psychosis and recovery in BD) found significant benefits on their primary outcomes despite limited statistical power, suggesting definitive trials are warranted.
Funding
The National Institute for Health Research Programme Grants for Applied Research programme.
Positive symptoms in psychotic disorders such as delusions and hallucinations develop on the basis of the interaction of biological vulnerability, cognitive biases and unfavourable social environmental conditions. This overview presents results from the field of experimental neuropsychology. They allow a better understanding of the mechanisms underlying core symptoms of psychotic patients. We focus on the symptoms of delusions, hallucinations and formal thought disorder. Comprehensive cognitive psychological models based on the results of such studies guide current attempts of ameliorating positive symptoms by cognitive-behavioural interventions.
P.S. Churchland & P.M. Churchland What are Beliefs? R. Langdon & E. Connaughton The Neuropsychology of Belief Formation. R. Patterson & A.K. Barbey A Cognitive Neuroscience Framework for Causal Reasoning. E.B. Falk & M.D. Lieberman The Neural Bases of Attitudes, Evaluation, and Behavior Change. E. de Visser & F. Krueger Interpersonal Trust as a Dynamic Belief. R. de Oliveira-Souza, R. Zahn & J. Moll The Neural Bases of Moral Belief Systems. U. Wagner & H. Walter Neuroscientific Approaches to 'Mens Rea' Assessment. L. Moretti, I. Cristofori, G. Zamboni & A. Sirigu The Neural Structure of Political Belief. J. Bulbulia & U. Schjoedt, The Neural Basis of Religion. V. Bell & P.W. Halligan The Neural Basis of Abnormal Personal Belief. F. Krueger & J. Grafman I Believe to My Soul.
Zusammenfassung: Für die deutschsprachige Fassung der Rosenberg-Skala zum Selbstwertgefühl von Ferring und Filipp (1996) wird eine Teilrevision vorgeschlagen. Ein Item der bisherigen Skalenversion stellte sich in eigenen Analysen als psychometrisch unzulänglich heraus und weist eine mangelnde inhalt-liche Validität auf. Dadurch ist möglicherweise die Vergleichbarkeit mit der Originalversion und mit Adaptationen der Rosenberg-Skala in anderen Sprachen nicht gewährleistet. Die vorgeschlagene Teilre-vision der Skala versucht, diese Mängel zu beheben und erweist sich in zwei unabhängigen Untersuchun-gen als Verbesserung der bisherigen Skala auf Itemebene. Außerdem werden hier erstmals vollständige Kennwerte für alle Skalenitems mitgeteilt. Abstract: A partial revision is proposed for the German version of Rosenberg's general self-esteem scale published by Ferring und Filipp (1996). According to our results, one item of the previous scale adaptation turned out to be psychometrically weak and – in our opinion – is lacking content validity. Therefore, the comparability with the original version and with adaptations of the Rosenberg-scale in other languages might be critical. The partially revised scale tries to eliminate these shortcomings and shows improved item statistics in two independent samples. In addition, complete statistics are presented for all scale items.
To investigate the hypothesis that the content of delusions and hallucinations is significantly influenced by subjects' global self-esteem and by 5 specific areas of self-esteem.
The delusions and hallucinations of 40 psychotic patients were assessed by 2 independent raters for content indicative of positive or negative self-esteem and for the extent to which the delusional content would be self-enhancing (or diminishing) and comforting (or discomforting) to the subject. These ratings were correlated with the results of self-esteem inventories completed by the subjects.
The content of delusions reflects both global self-esteem and self-regard.
This study demonstrates that 2 specific personality factors, global self-esteem and self-regard, are reflected in the content of delusions and influence whether those delusions are experienced as comfortable (or uncomfortable) and enhancing (or diminishing). Delusional content is therefore consistent with patients' views of themselves, and this may partially account for the persistence of delusions.
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.
The self-discrepancies of paranoid patients, depressed patients, and nonpatients were examined using a modified version of Higgins's Selves Questionnaire (E. T. Higgins, 1987). Nonpatients showed high consistencies between all domains of the self-concept, whereas depressed patients showed marked self-discrepancies. Paranoid patients alone displayed a high degree of consistency between self-perceptions and self-guides together with discrepancies between self-perceptions and the believed perceptions of parents about the self. Paranoid patients also believed that their parents had more negative views of them than did other participants. These findings are consistent with R. P. Bentall, P. Kinderman, and S. Kaney's (1994) model, which assumes that persecutory delusions are a product of attributional processes serving to maintain a positive explicit self-concept.
Causal attributions for positive and negative hypothetical social events made by paranoid patients, depressed patients, and nonpatient participants were examined via a novel measure of causal locus, the Internal, Personal and Situational Attributions Questionnaire. Depressed patients tended to attribute negative social events to internal (self-blaming) causes. Nonpatient participants and patients with delusions of persecution tended to avoid such self-blame. However, whereas nonpatient participants tended to choose situational or circumstantial external attributions, paranoid patients tended to choose external attributions that located blame in other individuals. These findings support R. P. Bentall, P. Kinderman, and S. Kaney's (1994) defensive attributional model of persecutory delusions, suggest some modifications to that model, and have implications for the understanding of the relationship between causal attributions and social and self-perception.
The major cognitive theories of persecutory delusion formation and maintenance are critically examined in this article.
The authors present a comprehensive review of the literature, citing results of relevant functional neuroimaging and neural network studies.
People with persecutory delusions selectively attend to threatening information, jump to conclusions on the basis of insufficient information, attribute negative events to external personal causes, and have difficulty in envisaging others' intentions, motivations, or states of mind. Presence of the "reality distortion" cluster of psychotic symptoms correlates with cerebral blood flow in the left lateral prefrontal cortex, ventral striatum, superior temporal gyrus, and parahippocampal region. Social cognitive processing (selective attention to threat, attribution of causation or mental states) in normal subjects involves similar areas. Neural network models of persecutory delusions highlight the importance of disordered neuromodulation in their formation and of disordered neuroplasticity in their maintenance.
Further studies examining the interaction of these cognitive processes, cross-sectionally and longitudinally, at cognitive psychological, neural network, and functional neuroanatomical levels are warranted to establish a comprehensive cognitive neuropsychiatric model of the persecutory delusion.
Two experiments were conducted to investigate the psychometric properties of an Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998) that was adapted to measure implicit attitudes towards homosexuality. In a first experiment, the validity of the Homosexuality-IAT was tested using a known group approach. Implicit and explicit attitudes were assessed in heterosexual and homosexual men and women (N = 101). The results provided compelling evidence for the convergent and discriminant validity of the Homosexuality-IAT as a measure of implicit attitudes. No evidence was found for two alternative explanations of IAT effects (familiarity with stimulus material and stereotype knowledge). The internal consistency of IAT scores was satisfactory (alpha s > .80), but retest correlations were lower. In a second experiment (N = 79) it was shown that uninformed participants were able to fake positive explicit but not implicit attitudes. Discrepancies between implicit and explicit attitudes towards homosexuality could be partially accounted for by individual differences in the motivation to control prejudiced behavior, thus providing independent evidence for the validity of the implicit attitude measure. Neither explicit nor implicit attitudes could be changed by persuasive messages. The results of both experiments are interpreted as evidence for a single construct account of implicit and explicit attitudes towards homosexuality.
In reporting Implicit Association Test (IAT) results, researchers have most often used scoring conventions described in the first publication of the IAT (A.G. Greenwald, D.E. McGhee, & J.L.K. Schwartz, 1998). Demonstration IATs available on the Internet have produced large data sets that were used in the current article to evaluate alternative scoring procedures. Candidate new algorithms were examined in terms of their (a) correlations with parallel self-report measures, (b) resistance to an artifact associated with speed of responding, (c) internal consistency, (d) sensitivity to known influences on IAT measures, and (e) resistance to known procedural influences. The best-performing measure incorporates data from the IAT's practice trials, uses a metric that is calibrated by each respondent's latency variability, and includes a latency penalty for errors. This new algorithm strongly outperforms the earlier (conventional) procedure.
Experiment 1 unexpectedly found sex differences in evaluative gender stereotypes (only men associated male with potency, and only women associated female with warmth). Experiment 2 dramatically reduced sex differences in gender-potency judgments when measures were redesigned to avoid implying that potency was positive (the concepts, strong and weak, were represented by evaluatively matched words - e.g., destroy vs. feeble, loud vs. quiet, and mighty vs. gentle). Experiment 3 tested the hypothesis that these sex differences were in the service of self-esteem, but found no correlation between own-gender-favorable stereotyping and implicit self-esteem. Rather, subjects showed a correlation between linking self to the favorable potency trait and linking own gender to that trait. Experiment 4 confirmed the correlation between implicit self-concept and gender stereotype using the contrast between potency and warmth for the implicit stereotype measure. In concert, results suggest that people ...
In reporting Implicit Association Test (IAT) results, researchers have most often used scoring conventions described in the first publication of the IAT (A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998). Demonstration IATs available on the Internet have produced large data sets that were used in the current article to evaluate alternative scoring procedures. Candidate new algorithms were examined in terms of their (a) correlations with parallel self-report measures, (b) resistance to an artifact associated with speed of responding, (c) internal consistency, (d) sensitivity to known influences on IAT measures, and (e) resistance to known procedural influences. The best-performing measure incorporates data from the IAT's practice trials, uses a metric that is calibrated by each respondent's latency variability, and includes a latency penalty for errors. This new algorithm strongly outperforms the earlier (conventional) procedure.
Acollection of papers forming a comprehensive statement of Adler's system of dynamic psychology; translated from the German by P. Radin. Harvard Book List (edited) 1955 #329 (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Zusammenfassung: Es wird eine Prüfung der internen Struktur einer deutschsprachigen Fassung der Skala zum globalen Selbstwertgefühl nach Rosenberg vorgenommen. Explorative und vor allem konfirmatori-schen Faktorenanalysen zeigen, dass das Konstrukt des globalen Selbstwertes, operationalisiert mittels der Selbstwert-Skala von Rosenberg, als mehrdimensional angenommen werden muss. Es finden sich Belege für ein Modell mit den Komponenten «Selbstabwertung» und «Selbstakzeptanz», letztere unter-teilt in zwei Unterkomponenten. Validitätshinweise für dieses Modell werden präsentiert. Unterschiedlich ausgeprägtes Sprachverständnis der Probanden scheint allerdings nicht für die bivariate Struktur verant-wortlich zu sein. Ein einheitliches Konstrukt «Selbstwertgefühl» kann jedoch zumindest auf der Stufe eines Faktors 2. Ordnung angenommen werden. Schlüsselwörter: Globales Selbstwertgefühl, Rosenberg-Skala, Dimensionalitätsanalyse Summary: The internal structure of a German version of Rosenberg's global self-esteem scale is investigated. Explorative and, in particular, confirmatory factor analyses show that the construct of global self-esteem , as measured by the above scale, has to be assumed as multidimensional, and evidence is given for a model with the components «self-deprecation» and «self-acceptance», the latter subdivided into two sub-components. Hints for the validity of this model are presented. The level of verbal comprehension of the participants, however, does not seem to be responsible for the bivariate structure. A unitary construct of global self-esteem can be assumed on the level of a second-order factor.
Objective. A number of cognitive biases have been identified relevant to persecutory thought (e.g. exaggerated self-serving bias). Moreover, findings of increased depressed mood in conjunction with high levels of self-esteem have contributed to theories of persecutory ideation (e.g. Bentall, Kinderman, Kaney, 1994). Using a nonclinical sample, the present study sought to expand upon previous research by examining the linear relationship between persecutory ideation and multiple clinical and social cognitive variables.Design. A cross-sectional design was used. Correlational and multiple regression analyses were conducted.Method. One hundred and ninety-three undergraduate students were administered a battery of questionnaires which assessed the following domains: Paranoid ideation, depression, social anxiety, self-monitoring, attributional style and self-esteem.Results. Higher levels of paranoid ideation were significantly associated with greater depressed mood, social anxiety and avoidance, evaluation apprehension, self-monitoring and lower self-esteem. There were no significant associations between paranoid ideation and attributional biases.Conclusions. These findings suggest that mood, anxiety and perceptions of the self are related to paranoid ideation in a nonclinical sample. These findings are tempered, however, by studying a nonclinical sample and the self-report measures of paranoid ideation that might be assessing multiple aspects of paranoid thought (e.g. ideas of reference).
Heretofore, no research has shown that meaningful variability on the Implicit Association Test (IAT) relates to intergroup discrimination or to explicit measures of prejudice. In the current study, White undergraduates interacted separately with White and Black experimenters, and their behavior during these social interactions was assessed by trained judges and by the experimenters themselves. The participants also completed explicit measures of racial prejudice and a race IAT. As predicted, those who revealed stronger negative attitudes toward Blacks (vs Whites) on the IAT had more negative social interactions with a Black (vs a White) experimenter and reported relatively more negative Black prejudices on explicit measures. The implications of these results for the IAT and its relations to intergroup discrimination and to explicit measures of attitudes are discussed.
True delusions have been conventionally regarded as primary or psychologically irreducible (Jaspers 1913/1959) and thus only explicable in organic terms. While Jaspers acknowledged the existence of secondary delusions, which may be understood in the light of related affect, other experiences, or hallucinations, these were of lesser theoretical importance than true delusions, in which he found a change in "the totality of understandable connections." Anglo-American psychiatry, in espousing Jaspers and rejecting psychoanalysis, has in consequence concentrated on the form and not the sense of delusions.
“Extreme psychotic states offer a human parable … patients see into the depths which do not belong so much to their illness as themselves as individuals with their own historical truth … in psychotic reality we find an abundance of content representing fundamental problems in philosophy …. The philosopher in us cannot but be fascinated by this extraordinary reality and to feel its challenge.” (Jaspers, 1963)
“I think you ought to leave your head to the College of Surgeons to ascertain what wonderful impressionable substance it contains instead of brains” (G. B. Shaw to a correspondent, 1926).
The Attributional Style Questionnaire was given to three groups of 15 adult patients: a group of paranoid patients who were not depressed, a group of depressed patients who were not paranoid, and a group of patients who were both paranoid and depressed. As predicted, the paranoid patients manifested an attributional style opposite to that of the depressed patients: that is, they tended to attribute good events to themselves and bad events to others or to chance, whereas the depressed patients tended to attribute bad events to themselves and good events to others or to chance. These findings confirm those of Kaney & Bentall (1989). The patients who were both paranoid and depressed fell in between the two other groups with respect to their attributions of good events but did not differ from the paranoid group in their attributions of bad events. In addition, differences among groups were manifest with respect to self-esteem, delusional content and suicidal ideation. The implications of these findings for therapy are discussed.
An implicit association test (IAT) measures differential association of 2 target concepts with an attribute. The 2 concepts appear in a 2-choice task (2-choice task (e.g., flower vs. insect names), and the attribute in a 2nd task (e.g., pleasant vs. unpleasant words for an evaluation attribute). When instructions oblige highly associated categories (e.g., flower + pleasant) to share a response key, performance is faster than when less associated categories (e.g., insect & pleasant) share a key. This performance difference implicitly measures differential association of the 2 concepts with the attribute. In 3 experiments, the IAT was sensitive to (a) near-universal evaluative differences (e.g., flower vs. insect), (b) expected individual differences in evaluative associations (Japanese + pleasant vs. Korean + pleasant for Japanese vs. Korean subjects), and (c) consciously disavowed evaluative differences (Black + pleasant vs. White + pleasant for self-described unprejudiced White subjects).
There has been a resurgence of interest in the view that persecutory delusions serve a function of defending self-esteem. An alternative account of levels of self-esteem in individuals with persecutory delusions is that they result from processes similar to those studied in people with depression (i.e. from the occurrence of a range of life experiences and how the individual interprets and copes with them). This study aimed to examine both hypotheses together for the first time, and, as the literature indicates that delusions may not share a common cause, attention was given to the possibility of the presence of subgroups.
Data were examined cross-sectionally and longitudinally from a randomized controlled trial of cognitive behaviour therapy for 60 people with drug-resistant psychosis.
The study is based on the initial assessment of all participants on self-esteem, delusional conviction and a large number of demographic, clinical and cognitive measures. Longitudinal analyses were also carried out, and are reported separately for those who received the therapy intervention and those in the control group.
Almost three-quarters of participants with persecutory delusions reported low self-esteem. Changes over time in total self-esteem correlated with changes in measures of mood and social functioning, but not conviction in persecutory delusions. The individuals who initially had normal levels of self-esteem displayed a different pattern of results from the majority of participants.
Low self-esteem in people with drug-resistant persecutory delusions is common and, in most cases, can best be understood in terms of normal emotional processes. There was evidence that the majority of persecutory delusions do not fit either strong or weak formulations of the delusion-as-defence explanation and that there may be subgroups with differing aetiologies. These results need to be replicated, and extended to groups in which symptoms are not resistant to medication.
The Mini-International Neuropsychiatric Interview (M.I.N.I.) is a short structured diagnostic interview, developed jointly by psychiatrists and clinicians in the United States and Europe, for DSM-IV and ICD-10 psychiatric disorders. With an administration time of approximately 15 minutes, it was designed to meet the need for a short but accurate structured psychiatric interview for multicenter clinical trials and epidemiology studies and to be used as a first step in outcome tracking in nonresearch clinical settings. The authors describe the development of the M.I.N.I. and its family of interviews: the M.I.N.I.-Screen, the M.I.N.I.-Plus, and the M.I.N.I.-Kid. They report on validation of the M.I.N.I. in relation to the Structured Clinical Interview for DSM-III-R, Patient Version, the Composite International Diagnostic Interview, and expert professional opinion, and they comment on potential applications for this interview.
To review critically the evidence for three contemporary theories of delusions.
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.
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.
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.
Experiment 1 used the Implicit Association Test (IAT; A. G. Greenwald, D. E. McGhee, & J. L. K. Schwartz, 1998) to measure self-esteem by assessing automatic associations of self with positive or negative valence. Confirmatory factor analysis (CFA) showed that two IAT measures defined a factor that was distinct from, but weakly correlated with, a factor defined by standard explicit (self-report) measures of self-esteem. Experiment 2 tested known-groups validity of two IAT gender self-concept measures. Compared with well-established explicit measures, the IAT measures revealed triple the difference in measured masculinity-femininity between men and women. Again, CFA revealed construct divergence between implicit and explicit measures. Experiment 3 assessed the self-esteem IAT's validity in predicting cognitive reactions to success and failure. High implicit self-esteem was associated in the predicted fashion with buffering against adverse effects of failure on two of four measures.
In recent years, several techniques have been developed to measure implicit social cognition. Despite their increased use, little attention has been devoted to their reliability and validity. This article undertakes a direct assessment of the interitem consistency, stability, and convergent validity of some implicit attitude measures. Attitudes toward blacks and whites were measured on four separate occasions, each 2 weeks apart, using three relatively implicit measures (response-window evaluative priming, the Implicit Association Test, and the response-window Implicit Association Test) and one explicit measure (Modern Racism Scale). After correcting for interitem inconsistency with latent variable analyses, we found that (a) stability indices improved and (b) implicit measures were substantially correlated with each other, forming a single latent factor. The psychometric properties of response-latency implicit measures have greater integrity than recently suggested.
Based on the assumption that binary classification tasks are often processed asymmetrically (figure-ground asymmetries), two experiments showed that association alone cannot account for effects observed in the Implicit Association Test (IAT). Experiment 1 (N = 16) replicated a standard version of the IAT effect using old vs. young names as target categories and good and bad words as attribute categories. However, reliable compatibility effects were also found for a modified version of the task in which neutral words vs. nonwords instead of good vs. bad words were used as attribute categories. In Experiment 2 (N = 8), a reversed IAT effect was observed after the figure-ground asymmetry in the target dimension had been inverted by a previous go/nogo detection task in which participants searched for exemplars of the category "young." The experiments support the hypothesis that figure-ground asymmetries produce compatibility effects in the IAT and suggest that IAT effects do not rely exclusively on evaluative associations between the target and attribute categories.
A number of cognitive biases have been identified relevant to persecutory thought (e.g. exaggerated self-serving bias). Moreover, findings of increased depressed mood in conjunction with high levels of self-esteem have contributed to theories of persecutory ideation (e.g. Bentall, Kinderman, Kaney, 1994). Using a nonclinical sample, the present study sought to expand upon previous research by examining the linear relationship between persecutory ideation and multiple clinical and social cognitive variables.
A cross-sectional design was used. Correlational and multiple regression analyses were conducted.
One hundred and ninety-three undergraduate students were administered a battery of questionnaires which assessed the following domains: Paranoid ideation, depression, social anxiety, self-monitoring, attributional style and self-esteem.
Higher levels of paranoid ideation were significantly associated with greater depressed mood, social anxiety and avoidance, evaluation apprehension, self-monitoring and lower self-esteem. There were no significant associations between paranoid ideation and attributional biases.
These findings suggest that mood, anxiety and perceptions of the self are related to paranoid ideation in a nonclinical sample. These findings are tempered, however, by studying a nonclinical sample and the self-report measures of paranoid ideation that might be assessing multiple aspects of paranoid thought (e.g. ideas of reference).
Persecutory (paranoid) delusions are a frequently observed clinical phenomenon. In recent years, an increasing volume of research has attempted to explain these types of beliefs in terms of psychological mechanisms. Theories have emphasized early experience, perceptual abnormalities, motivational factors, and information-processing deficits. In this article we review relevant findings, including our own studies of the role of causal attributions and theory of mind deficits. We propose a new integrative model that builds on this work. The core of the model is an account of the way that causal attributions influence self-representations, which in turn influence future attributions: the attribution--self-representation cycle. We argue 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. These abnormalities are amenable to investigation by functional neuroimaging, and recent studies have implicated specific areas of neuroactivation. However, these findings do not necessarily suggest that paranoid delusions are entirely biological in origin, and there is evidence that adverse early experience may play a role in determining the development of a cognitive vulnerability to paranoid thinking.
In two experiments, the use of a self-other Implicit Association Test (IAT) as a measure of implicit self-esteem was examined. In Study 1, participants completed two self-other IATs: one in which the other was unspecified and one in which the other was specified to be a close friend. Esteem-IAT scores were significantly higher for the unspecified other-IAT (d = .82), indicating that the content of the other has a considerable influence on the over-all esteem-IAT scores. Study 2 provided a conceptual replication of these results and provided some initial evidence that the valence of an unspecified other is negative. Across both studies, the nature of the mental representation of the self, as measured by an esteem-IAT, changed as a function of the mental representation of the other. The crucial role of the other-associations in the esteem-IAT calls into question its use and interpretation as a measure of self-esteem.
A. Karpinski (2004) recently criticized Implicit Association Test (IAT) measures of self-esteem, arguing that their measurements of self-associations are compromised by their contrasting self with a putatively extremely negative second category, the nonspecific other. The present data show, to the contrary, that the nonspecific other category in the self-esteem IAT is near neutral in valence. Validity of the self-esteem IAT is most appropriately assessed by examining its correlations with conceptually related measures. That has been done in several previous studies that are reviewed here. The nonspecific other category is only one of several choices for representing the concept of other in self-esteem IATs. Choice of the appropriate other category to contrast with self in self-esteem IATs should be guided by the needs of the research question being addressed.
The Brief Psychiatric Rating Scale (BPRS): Recent developments in ascertainment and scaling Clarifying the role of other'' category in the self-esteem IAT Delusional belief systems and meaning in life: A preferred reality?
- J E Overall
- D R Gorham
- G Roberts
Overall, J. E., & Gorham, D. R. (1988). The Brief Psychiatric Rating Scale (BPRS): Recent developments in ascertainment and scaling. Psychopharmacology Bulletin, 24, 97±99. Pinter, B., & Greenwald, A. G. (2005). Clarifying the role of other'' category in the self-esteem IAT. Experimental Psychology, 52, 74±79. Roberts, G. (1991). Delusional belief systems and meaning in life: A preferred reality? British Journal of Psychiatry, 159(Suppl. 14), 19±28.
Persecutory delusions: A review and theoretical integration Cognitive neuropsychiatric models of persecutory delusions Delusions and self-esteem Explicit self-esteem, implicit self-esteem and depression Attributional style in paranoid vs. depressed patients
- R P Bentall
- R Corcoran
- R Howard
- N Blackwood
- P Kinderman
- ±1192 Blackwood
- N J Howard
- R J Bentall
- R P Murray
- R M Bowins
- B Shugar
Bentall, R. P., Corcoran, R., Howard, R., Blackwood, N., & Kinderman, P. (2001). Persecutory delusions: A review and theoretical integration. Clinical Psychology Review, 21, 1143±1192. Blackwood, N. J., Howard, R. J., Bentall, R. P., & Murray, R. M. (2001). Cognitive neuropsychiatric models of persecutory delusions. American Journal of Psychiatry, 158, 527±539. Bowins, B., & Shugar, G. (1998). Delusions and self-esteem. Canadian Journal of Psychiatry, 43, 154±158. Cai, H. (2003). Explicit self-esteem, implicit self-esteem and depression. Chinese Mental Health Journal, 17, 331±336. Candido, C. L., & Romney, D. M. (1990). Attributional style in paranoid vs. depressed patients. British Journal of Medical Psychology, 63, 355±363. Cunningham, W. A., Preacher, K. J., & Banaji, M. R. (2001). Implicit attitude measures: Con-sistency, stability, and convergent validity. Psychological Science, 2, 163±170.
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- G Werner R Von Collani