هذیان های شکنجه و نگرانی فاجعه بار در روان پریشی: توسعه درک پریشانی هذیان و تداوم

In a recent theoretical account of persecutory delusions, it is suggested that anxiety and worry are important factors in paranoid experience [Freeman, D., Garety, P. A., Kuipers, E., Fowler, D., & Bebbington, P. E. (2002). A cognitive model of persecutory delusions. British Journal of Clinical Psychology, 41(4), 331–347]. In emotional disorders worry has been understood in terms of catastrophising. In the current study, the concept of catastrophising is applied for the first time with persecutory delusions. Thirty individuals with current persecutory delusions and 30 non-clinical controls participated in a cross-sectional study. The group with persecutory delusions was also followed up at 3 months to assess predictors of delusion persistence. At its most severe, 21% of individuals with persecutory delusions had clinical worry, 68% had levels of worry comparable with treatment seeking GAD patients. Further, high levels of anxiety, worry and catastrophising were associated with high levels of persecutory delusion distress and with the persistence of delusions over 3 months. If future research replicates these findings, worry reduction interventions for individuals with persecutory delusions may be warranted.

In the last 10 years, advancements have been made in our understanding of cognitive and behavioural factors relevant to delusions and this has been accompanied by advancements in psychological treatment (e.g. Sensky et al., 2000). Nonetheless, at least one-third of individuals with persistent positive symptoms do not demonstrate measurable benefit from interventions such as cognitive behavioural therapy (CBT) and remain distressed by symptoms (Kuipers et al., 1998). One route to improving treatment interventions is to further our understanding of pathways that lead to delusion distress and persistence. In the current study, we focus upon understanding the contribution of anxiety to the experience of persecutory delusions.