Self-Structure in Persecutory Delusions

Lyn Ellett, Jessica Kingston, Eryna Tarant, Christos Kouimtsidis, Laura Vivarelli, Paul Chadwick

Research output: Contribution to journalArticlepeer-review

Abstract

There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalized (characterized by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes. In Study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n = 27) and a healthy control group (n = 47) were compared on self-structure indices. In Study 2 (n = 27), the clinical group also completed the card sort task before and after randomization to either a 12-week mindfulness-based psychological therapy or treatment-as-usual control. In Study 1, self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects, and had more compartmentalized self-structures compared with controls. In Study 2 there were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalization and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.

Original languageEnglish
JournalBehavior Therapy
Early online date5 Aug 2022
DOIs
Publication statusE-pub ahead of print - 5 Aug 2022

Keywords

  • compartmentalization
  • persecutory delusions
  • schizophrenia
  • self-concept
  • self-structure

ASJC Scopus subject areas

  • Clinical Psychology

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