Elsevier

Behavior Therapy

Volume 45, Issue 2, March 2014, Pages 273-282
Behavior Therapy

Relationships Among Self, Others, and Persecutors in Individuals With Persecutory Delusions: A Repertory Grid Analysis

https://doi.org/10.1016/j.beth.2013.12.001Get rights and content

Highlights

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    This study examined how individuals with persecutory delusions construe the self, others, and their main persecutor.

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    Study also examined whether differences were associated with emotional distress and conviction in delusions.

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    Persecutors were seen as more malevolent and omnipotent than both the self and others.

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    Beliefs about self as powerful were associated with lower anxiety, depression, and higher self-esteem.

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    Beliefs about persecutors’ omnipotence were found to predict delusion conviction.

Abstract

The purpose of the current study was to examine the way individuals with persecutory delusions construe the self, others, and their main persecutor with reference to the constructs of malevolence and omnipotence, and examine the extent to which these interpersonal beliefs link to distress, self-esteem, and delusion conviction. Repertory grid methodology was used to explore interpersonal beliefs about malevolence and omnipotence in a sample (N = 30) of individuals with current persecutory delusions (mean age 36.4 years; 62% male and 53% White). Participants also completed measures of emotional distress (depression and anxiety) and self-esteem. The findings suggested that persecutors were construed as more omnipotent and malevolent than both the self and others; others in turn were construed as more omnipotent and malevolent than the self. Beliefs about self as powerful were associated with lower anxiety, depression, and higher self-esteem, and beliefs about persecutors’ omnipotence predicted delusion conviction. As with voices, the concepts of power/omnipotence and malevolence/benevolence appear to be important constructs when seeking to understand the relationship between individuals and their perceived persecutors. These findings support working therapeutically with negative schematic beliefs about self, others, and persecutors, which is consistent with a person-based cognitive therapy model of distressing psychosis.

Section snippets

Participants

Participants with persecutory delusions were recruited from inpatient (n = 15) and outpatient (n = 15) services in two London NHS Foundation Trusts. In total, 80 people were approached to take part in the study; 22 did not meet criteria for presence of a current persecutory delusion. Of those eligible for the study, 30 (52%) gave consent. The primary inclusion criteria were diagnosis of a psychotic illness, as identified for the purposes of the research by a consultant psychiatrist in the

Data Analysis

All analyses were conducted using IBM SPSS Statistics version 19.0 (2010). First, to address research question 1 concerning differences among beliefs about self, others in general, and the main persecutor, all 12 bipolar items were analyzed using an individual difference unfolding solution. This is a form of multidimensional scaling, in which distances are calculated between the constructs (malevolence and omnipotence) and elements (self, others, persecutor) across participants, and organized

Clinical and demographic data

Demographic and clinical data are presented in Table 1. Participants were between 23 and 64 years of age, (Mage = 39.6, SD = 11.1), the majority were male (62%), White (55%), unemployed (93%), and with a diagnosis of paranoid schizophrenia (76%). In terms of the clinical characteristics of the sample, mean total scores indicated that the sample reported moderate levels of both depression and anxiety.

Discussion

The present study involving people with current persecutory delusions used repertory grid methodology to examine the construed interpersonal relationships among self, main persecutors, and other people in general. Specifically, these relationships were examined with reference to malevolence and omnipotence, and the extent to which these interpersonal beliefs link to distress, self-esteem, and delusional conviction. Individuals with persecutory delusions construed their persecutors as

Conclusion

The current study offers empirical evidence that people with persecutory delusions construct relationships with their main persecutors and with others characterized by interpersonal beliefs about malevolence and omnipotence. The construct systems revealed how participants felt their views of their persecutors were at least partially upheld by people in general. As is true for relationships with voices (Birchwood & Chadwick, 1997), interpersonal beliefs about malevolence and omnipotence were

Conflict of Interest Statement

The authors declare that there are no conflicts of interest.

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