ذهن شکاک: روانشناسی هذیان های آزار و شکنجه

At least 10–15% of the general population regularly experience paranoid thoughts and persecutory delusions are a frequent symptom of psychosis. Persecutory ideation is a key topic for study. In this article the empirical literature on psychological processes associated with persecutory thinking in clinical and non-clinical populations is comprehensively reviewed. There is a large direct affective contribution to the experience. In particular, anxiety affects the content, distress and persistence of paranoia. In the majority of cases paranoia does not serve a defensive function, but instead builds on interpersonal concerns conscious to the person. However, affect alone is not sufficient to produce paranoid experiences. There is also evidence that anomalous internal experiences may be important in leading to odd thought content and that a jumping to conclusions reasoning bias is present in individuals with persecutory delusions. Theory of mind functioning has received particular research attention recently but the findings do not support a specific association with paranoia. The threat anticipation cognitive model of persecutory delusions is presented, in which persecutory delusions are hypothesised to arise from an interaction of emotional processes, anomalous experiences and reasoning biases. Ten key future research questions are identified, including the need for researchers to consider factors important to the different dimensions of delusional experience.

We are living in paranoid times, with fears of others attaining a new intensity. Nonetheless, being overly wary of the intentions of others has long been recognised as a problem. In the seventeenth century Francis Bacon (1612), often credited as the founder of the scientific method, commented on the corrosive nature of the experience: ‘Suspicions amongst thoughts are like bats amongst birds, — they ever fly by twilight. Certainly they are to be repressed, or, at the least, well guarded. For they cloud the mind, they lose friends, and they check with business, whereby business cannot go on currently and constantly. They dispose kings to tyranny, husbands to jealousy, wise men to irresolution and melancholy.’ Yet in the last 10 years there has been a rapid development in the understanding of persecutory thinking, assisted by the focus on it as a phenomenon of interest in its own right rather than simply as a symptom of severe mental illness (Bentall, 1990). The argument that will be put forward in this review is that there is now an excellent opportunity to take the starting point of this work of the last 10 years and make dramatic increases in the understanding of persecutory thinking. Explanatory models can become as powerful as those for emotional disorders and lead to more effective psychological interventions for paranoia. But also emphasised are the significant conceptual and methodological limitations of previous work.