Grandiose delusions

Grandiose delusions (GD), delusions of grandeur, expansive delusions[1] are a subtype of delusion that occur in patients suffering from a wide range of psychiatric diseases, including two-thirds of patients in manic state of bipolar disorder, half of those with schizophrenia, patients with the grandiose subtype of delusional disorder, and a substantial portion of those with substance abuse disorders.[2][3] GDs are characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful. The delusions are generally fantastic and typically have a religious, science fictional, or supernatural theme. There is a relative lack of research into GD, in contrast to persecutory delusions and auditory hallucinations. About 10% of healthy people experience grandiose thoughts but do not meet full criteria for a diagnosis of GD.[3] .

Grandiose delusions
Grandiose delusions cat lion.pdf
People suffering from grandiose delusions wrongly hold themselves at an extraordinarily high status in their mind.

Symptoms

According to the DSM-IV-TR diagnostic criteria for delusional disorders, grandiose-type symptoms include grossly exaggerated beliefs of:

  • self-worth
  • power[4]
  • knowledge
  • identity
  • exceptional relationship to a divinity or famous person.[5]

For example, a patient who has fictitious beliefs about his or her power or authority may believe himself or herself to be a ruling monarch who deserves to be treated like royalty.[6] There are substantial differences in the degree of grandiosity linked with grandiose delusions in different patients. Some patients believe they are God, the Queen of England, a president's son, a famous rock star, and so on. Others are not as expansive and think they are skilled athletes or great inventors.[7]

Expansive delusions

Expansive delusions may be maintained by auditory hallucinations, which advise the patient that they are significant, or confabulations, when, for example, the patient gives a thorough description of their coronation or marriage to the king. Grandiose and expansive delusions may also be part of fantastic hallucinosis in which all forms of hallucinations occur.[7]

Positive functions

Grandiose delusions frequently serve a very positive function for the person by sustaining or increasing their self-esteem. As a result, it is important to consider what the consequences of removing the grandiose delusion are on self-esteem when trying to modify the grandiose delusion in therapy.[4] In many instances of grandiosity it is suitable to go for a fractional rather than a total modification, which permits those elements of the delusion that are central for self-esteem to be preserved. For example, a person who believes they are a senior secret service agent gains a great sense of self-esteem and purpose from this belief, thus until this sense of self-esteem can be provided from elsewhere, it is best not to attempt modification.[4]

Causes of delusion

There are two alternate causes for developing grandiose delusions:[8]

  • Delusion-as-defense: defense of the mind against lower self-esteem and depression.
  • Emotion-consistent: result of exaggerated emotions.

Diagnosis

Patients with a wide range of mental disorders which disturb brain function experience different kinds of delusions, including grandiose delusions.[9] Grandiose delusions usually occur in patients with syndromes associated with secondary mania, such as Huntington's disease,[10] Parkinson's disease,[11] and Wilson's disease.[12] Secondary mania has also been caused by substances such as L-DOPA and isoniazid which modify the monoaminergic neurotransmitter function.[13] Vitamin B12 deficiency,[14] uremia,[15] hyperthyroidism[16] as well as the carcinoid syndrome[17] have been found to cause secondary mania, and thus grandiose delusions.

In diagnosing delusions, the MacArthur-Maudsley Assessment of Delusions Schedule is used to assess the patient.[18]

Comorbidity

Schizophrenia

Schizophrenia is a mental disorder distinguished by a loss of contact with reality and the occurrence of psychotic behaviors, including hallucinations and delusions (unreal beliefs which endure even when there is contrary evidence).[19] Delusions may include the false and constant idea that the person is being followed or poisoned, or that the person’s thoughts are being broadcast for others to listen to. Delusions in schizophrenia often develop as a response to the individual attempting to explain their hallucinations.[19] Patients who experience recurrent auditory hallucinations can develop the delusion that other people are scheming against them and are dishonest when they say they do not hear the voices that the delusioned person believes that he or she hears.[19]

Specifically, grandiose delusions are frequently found predominantly in paranoid schizophrenia, in which a person has an extremely exaggerated sense of his or her significance, personality, knowledge, or authority. For example, the person may possibly declare to own a major corporation and kindly offer to write a hospital staff member a check for $5 million if they would only help them escape from the hospital.[20] Other common grandiose delusions in schizophrenia include religious delusions such as the belief that one is Jesus Christ.[21]

Bipolar disorder

Bipolar I disorder can lead to severe affective dysregulation, or mood states that sway from exceedingly low (depression) to exceptionally high (mania).[22] In hypomania or mania, some bipolar patients can suffer grandiose delusions. In its most severe manifestation, days without sleep or auditory and other hallucinations and uncontrollable racing thoughts can reinforce these delusions. In mania, this illness not only affects emotions but can also lead to impulsivity and disorganized thinking which can be harnessed to increase their sense of grandiosity. Protecting this delusion can also lead to extreme irritability, paranoia and fear. Sometimes their anxiety can be so over-blown that they believe others are jealous of them and, thus, are undermining their "extraordinary abilities," persecuting them or even scheming to seize what they already have.[23]

The vast majority of bipolar patients rarely experience delusions. Typically, when experiencing or displaying a stage of heightened excitability called mania, they can experience, joy, rage, a flattened state in which life has no meaning and sometimes even a mixed state of intense emotions which can cycle out of control along with thoughts or beliefs that are grandiose in nature. Some of these grandiose thoughts can be the expressed as strong beliefs that the patient is very rich or famous or has super-human abilities, or can even lead to severe suicidal ideations.[24] In the most severe form, in what was formerly labeled as megalomania, the bipolar patient may hear voices which support these grandiose beliefs. In their delusions, they can believe that they are, for example, a king, a creative genius, or can even exterminate the world's poverty because of their extreme generosity.[25]

Anatomical aspects

Grandiose delusions are frequently and almost certainly related to lesions of the frontal lobe. Temporal lobe lesions have been mainly reported in patients with delusions of persecution and of remorse, while frontal and frontotemporal involvement have been described in patients with grandiose delusions, Cotard’s syndrome, and delusional misidentification syndrome.[26]

Treatment

In patients suffering from schizophrenia, grandiose and religious delusions are found to be the least susceptible to cognitive behavioral interventions.[18] Cognitive behavioral intervention is a form of psychological therapy, initially used for depression,[27] but currently used for a variety of different mental disorders, in hope of providing relief from distress and disability.[28] During therapy, grandiose delusions were linked to patients' underlying beliefs by using inference chaining.[27][29] Some examples of interventions performed to improve the patient's state were focus on specific themes, clarification of neologisms, and thought linkage.[29] During thought linkage, the patient is asked repeatedly by the therapist to explain his/her jumps in thought from one subject to a completely different one.[29]

Patients suffering from mental disorders that experience grandiose delusions have been found to have a lower risk of having suicidal thoughts and attempts.[30]

Epidemiology

In researching over 1000 individuals of a vast range of backgrounds, Stompe and colleagues (2006) found that grandiosity remains as the second most common delusion after persecutory delusions.[3] A variation in the occurrence of grandiosity delusions in schizophrenic patients across cultures has also been observed.[31][32] In research done by Appelbaum et al. it has been found that GDs appeared more commonly in patients with bipolar disorder (59%) than in patients with schizophrenia (49%), followed by presence in substance misuse disorder patients (30%) and depressed patients (21%).[3]

A relationship has been claimed between the age of onset of bipolar disorder and the occurrence of GDs. According to Carlson et al. (2000), grandiose delusions appeared in 74% of the patients who were 21 or younger at the time of the onset, while they occurred only in 40% of individuals 30 years or older at the time of the onset.[3]

Prevalence

Research suggests that the severity of the delusions of grandeur is directly related to a higher self-esteem in individuals and inversely related to any individual’s severity of depression and negative self-evaluations.[33] Lucas et al. found that there is no significant gender difference in the establishment of grandiose delusion. However, there is a claim that ‘the particular component of Grandiose delusion’ may be variable across both genders.[3] Also, it has been noted that the presence of GDs in people with at least grammar or high school education was greater than lesser educated persons. Similarly, the presence of grandiose delusions in individuals who are the eldest is greater than in individuals who are the youngest of their siblings.[34]

See also

References

  1. ^ Ray Corsini (2016). The Dictionary of Psychology. Taylor & Francis. p. 985. ISBN 978-1-317-70570-3.
  2. ^ Diagnostic and Statistical Manual of Mental Disorders Fourth edition Text Revision (DSM-IV-TR) American Psychiatric Association (2000)
  3. ^ a b c d e f Knowles, R.; McCarthy-Jones S.; Rowse G. (2011). "Grandiose delusions: A review and theoretical integration of cognitive and affective perspectives". Clinical Psychology Review. 31 (4): 684–696. doi:10.1016/j.cpr.2011.02.009. PMID 21482326.
  4. ^ a b c Nelson, H.E. (2005). Cognitive-Behavioural Therapy with Delusions and Hallucinations: A Practice Manual. Nelson Thornes. p. 339. ISBN 9780748792566. Retrieved 5 August 2012.
  5. ^ Sadock, B. J.; Sadock V.A. (2008). Kaplan and Sadock's Concise Textbook of Clinical Psychiatry. Lippincott Williams & Wilkins. p. 752. ISBN 9780781787468.
  6. ^ Davies, J.L.; Janosik E.H. (1991). Mental Health and Psychiatric Nursing: A Caring Approach. Boston, MA: Jones & Bartlett Learning. p. 760. ISBN 9780867204421.
  7. ^ a b Casey, P.R.; Brendan K. (2007). Fish's Clinical Psychopathology: Signs and Symptoms in Psychiatry. UK: RCPsych Publications. p. 138. ISBN 9781904671329..
  8. ^ Smith, N.; Freeman D.; Kuipers E. (2005). "Grandiose Delusions: An Experimental Investigation of the Delusion as Defense". Journal of Nervous and Mental Disease. 193 (7): 480–487. doi:10.1097/01.nmd.0000168235.60469.cc. PMID 15985843.
  9. ^ Cummings, Jeffrey L. (1985). "Organic delusions: phenomenology, anatomical correlations and review". The British Journal of Psychiatry. 146 (2): 184–197. doi:10.1192/bjp.146.2.184. PMID 3156653. Retrieved 24 July 2012.
  10. ^ McHugh, P.R; Folstein, M.F (1975). "Psychiatric syndromes in Huntington's chorea". Psychiatric Aspectes of Neurological Disease.
  11. ^ Bromberg, W. (1930). "Mental states in chronic encephalitis". Psychiatric Quarterly. 4: 537–566. doi:10.1007/bf01563408.
  12. ^ Pandy, R.S.; Sreenivas, K.N.; Paith N.M.; Swamy H.S. (1981). "Dopamine beta-hydroxylase in a patient with Wilson's disease and mania". The American Journal of Psychiatry. 138 (12): 1628–1629. PMID 7304799.
  13. ^ Lin, J-T Y.; Ziegler, D. (1976). "Psychiatric symptoms with initiation of carbidopa-levodopa treatment". Neurology. 26: 679–700. doi:10.1212/wnl.26.7.699.
  14. ^ Goggans, F.C. (1983). "A case of mania secondary to vitamin B12 deficiency". The American Journal of Psychiatry. 141: 300–301.
  15. ^ Cooper, A.T. (1967). "Hypomanic psychosis precipitated by hemodialysis". Comprehensive Psychiatry. 8 (3): 168–172. doi:10.1016/s0010-440x(67)80020-8. PMID 6046067.
  16. ^ Jefferson, J.W.; Marshall J.R. "Neuropsychiatric Features of Medical Disorders". New York: Plenum :Medical Book Company.
  17. ^ Lehmann, J. (1966). "Mental disturbances followed by stupor in a patient with carcinoidosis". Acta Psychiatrica Scandinavica. 42 (2): 153–161. doi:10.1111/j.1600-0447.1966.tb01921.x. PMID 5958539.
  18. ^ a b Appelbaum, P.S.; Clark Robbins, P.; Roth, L. H. (1999). "Dimensional approach to delusions: Comparison across types and diagnoses". The American Journal of Psychiatry. 156 (12): 1938–1943. PMID 10588408.
  19. ^ a b c Magill's Encyclopedia of Social Science: Psychology. California: Salem Press, Inc. 2003. pp. 718–719.
  20. ^ Noll, R. (2009). The Encyclopedia of Schizophrenia and Other Psychotic Disorders. New York: Facts on File, Inc. p. 122. ISBN 9780816075089.
  21. ^ Hunsley, J.; Mash E.J. (2008). A Guide to Assessment that Work. Oxford University Press. p. 676. ISBN 9780198042457.
  22. ^ Barlow, D.H. (2007). Clinical Handbook of Psychological Disorders: A Step by Step Treatment Manual. New York: Guilford. p. 722. ISBN 9781606237656.
  23. ^ Kantor, M. (2004). Understanding Paranoia: A Guide for Professionals, Families, and Sufferers. West Port: Greenwoord. p. 252. ISBN 9780275981525.
  24. ^ Isaac, G. (2001). Bipolar Not Adhd: Unrecognized Epidemic of Manic Depressive Illness in Children. Lincoln: Writers Club Press. p. 184. ISBN 9781475906493.
  25. ^ Fieve, R. R. (2009). Bipolar Breakthrough: The Essential Guide to Going Beyond Moodswings to Harness Your Highs, Escape the Cycles of Recurrent Depression, and Thrive with Bipolar II. Rodale. p. 288. ISBN 9781605296456.
  26. ^ Tonkonogy, Joseph M.; Tonkonogiĭ T.M.; Puente A.E. (2009). Localization of Clinical Syndromes in Neuropsychology and Neuroscience. New York, NY: Springer Publishing Company. p. 846. ISBN 9780826119681.
  27. ^ a b Beck, A.T.; Rush A.J.; Shaw B.F.; Emergy G (1979). "Cognitive Therapy of Depression". New York, NY. Guilford Press.
  28. ^ Salkovskis, P.M. (1996). Frontiers of Cognitive Therapy. New York: Guillford.
  29. ^ a b c Sensky, T.; et al. (2000). "A randomized controlled trial of Cognitive-Behavioral Therapy for Persistent Symptoms in Schizophrenia resistant to medication". Archives of General Psychiatry. 57 (2): 165–172. doi:10.1001/archpsyc.57.2.165. PMID 10665619.
  30. ^ Oquendo, M.A.; et al. (2000). "Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters". Journal of Affective Disorders. 59: 107–117. doi:10.1016/s0165-0327(99)00129-9.
  31. ^ Stompe, T.; et al. (2007). "Paranoid-hallucinatory syndromes in schizophrenia results of the international study on psychotic symptoms". World Cultural Psychiatry Review: 63–68.
  32. ^ Suhail, K. (2003). "Phenomenology of delusions in Pakistani patients: effect of gender and social class". Psychopathology. 36: 195–199. doi:10.1159/000072789.
  33. ^ Smith, N.; et al. (2006). "Emotion and psychosis: Links between depression, self-esteem, negative schematic beliefs and delusions and hallucinations". Schizophrenia Research. 86 (1): 181–188. doi:10.1016/j.schres.2006.06.018. PMID 16857346.
  34. ^ Lucas, C.J.; et al. (1962). "A social and clinical study of delusions in schizophrenia". The Journal of Mental Science. 108: 747–758. doi:10.1192/bjp.108.457.747.
Dave Harris

Dave Harris (born February 25, 1971) is an American disc jockey, songwriter, and musician.He was born in Glasgow, Kentucky, and hosted the syndicated radio show Retro Rewind in 1999. Harris created Retro Rewind in October 1997. In 1998 Harris briefly took a leave of absence from Retro Rewind to manage the band The Outfield.Harris is also a songwriter, having penned a Top 20 hit on the Billboard magazine adult contemporary charts in April 2005 called "Sunset Blvd".Harris has also lent his songwriting talent to others. He has co-written songs with the likes of Rob Thomas, Jon Secada, Julian Lennon, Michael J. Willett, Rick Springfield, John Waite, Billy Burnette, Scott Grimes, Adam Jensen and Billy Montana.

In 2015, Harris formed The Dave Harris Project (featuring Michael J. Willett on vocals) which released the album Grandiose Delusions.In January 2017 Harris was charged with 27 felony counts involving statutory rape and especially aggravated sexual exploitation of a minor. He was convicted of those charges in April 2018.

David Pratt (assassin)

David Beresford Pratt (1 October 1908 – 1 October 1961) was a South African businessman who shot South African Prime Minister Hendrik Verwoerd in 1960. Verwoerd survived, but was killed six years later by Dimitri Tsafendas.

Delusion

A delusion is firm and fixed belief based on inadequate grounds not amenable to rational argument or evidence to contrary, not in sync with regional, cultural and educational background. As a pathology, it is distinct from a belief based on false or incomplete information, confabulation, dogma, illusion, or some other misleading effects of perception.

They have been found to occur in the context of many pathological states (both general physical and mental) and are of particular diagnostic importance in psychotic disorders including schizophrenia, paraphrenia, manic episodes of bipolar disorder, and psychotic depression.

Delusions of grandeur (disambiguation)

Delusions of grandeur may refer to:

Grandiose delusions

Delusions of Grandeur (Fleming and John album)

Delusions of Grandeur (novel)

Delusions of Grandeur (Srl), a ready-to-wear fashion label based in Italy

Delusions of Grandeur (Circle II Circle album), 2008

Delusions of Grandeur (film), a 1971 French film

Delusions of Grandeur (Sahg album), fourth studio album by the Norwegian band Sahg.

Dunning–Kruger effect

In the field of psychology, the Dunning–Kruger effect is a cognitive bias in which people of low ability have illusory superiority and mistakenly assess their cognitive ability as greater than it is. The cognitive bias of illusory superiority comes from the inability of low-ability people to recognize their lack of ability. Without the self-awareness of metacognition, low-ability people cannot objectively evaluate their competence or incompetence.As described by social psychologists David Dunning and Justin Kruger, the cognitive bias of illusory superiority results from an internal illusion in people of low ability and from an external misperception in people of high ability; that is, "the miscalibration of the incompetent stems from an error about the self, whereas the miscalibration of the highly competent stems from an error about others."

Encephalopathy

Encephalopathy (; from Ancient Greek: ἐνκέφαλος "brain" + πάθος "suffering") means any disorder or disease of the brain, especially chronic degenerative conditions. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of overall brain dysfunction; this syndrome can have many different organic and inorganic causes.

Gigantomania

Gigantomania (from Ancient Greek γίγας gigas, "giant" and μανία mania, "madness") is the production of unusually and superfluously large works.Gigantomania is in varying degrees a feature of the political and cultural lives of prehistoric and ancient civilizations (Megalithic cultures, Ancient Egypt, Ancient Rome, Ancient China, Aztec civilization), several totalitarian regimes (Soviet Union, Nazi Germany, Fascist Italy, People's Republic of China, Democratic People's Republic of Korea), as well as of contemporary capitalist countries (notably for skyscrapers and shopping malls).

God complex

A god complex is an unshakable belief characterized by consistently inflated feelings of personal ability, privilege, or infallibility. A person with a god complex may refuse to admit the possibility of their error or failure, even in the face of irrefutable evidence, intractable problems or difficult or impossible tasks. The person is also highly dogmatic in their views, meaning the person speaks of their personal opinions as though they were unquestionably correct. Someone with a god complex may exhibit no regard for the conventions and demands of society, and may request special consideration or privileges.Jehovah complex is a term used in Jungian analysis to describe a neurosis of egotistical self-inflation. Use included in psychoanalytic contributions to psychohistory and biography, with, for example, Fritz Wittels using the term about Sigmund Freud in his 1924 biography and H. E. Barnes using the term about George Washington and Andrew Jackson.God complex is not a clinical term or diagnosable disorder and does not appear in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The first person to use the term god-complex was Ernest Jones (1913–51). His description, at least in the contents page of Essays in Applied Psycho-Analysis, describes the god complex as belief that one is a god.

Grandiosity

Grandiosity refers to an unrealistic sense of superiority, a sustained view of oneself as better than others that causes the narcissist to view others with disdain or as inferior, as well as to a sense of uniqueness: the belief that few others have anything in common with oneself and that one can only be understood by a few or very special people. It also occurs in reactive attachment disorder.Grandiosity is chiefly associated with narcissistic personality disorder, but also commonly features in manic or hypomanic episodes of bipolar disorder.

Imaginum

Imaginum is a Mexican animated sci-fi-comedy film, produced by Ánima Estudios and released in theaters on August 19, 2005.

It features the voices of Eugenio Derbez and Ilse. The film took a total of 18 months to develop, in contrast to other animated films, which take up to 40 months to develop.The film was later released direct-to-video in the United States on 9 December 2008 in both the English and Spanish languages.The film grossed a total of $7.8 million pesos.

Megalomania (disambiguation)

Megalomania is an obsolete name for narcissistic personality disorder but still in use informally.

Megalomania may also refer to:

Mega Lo Mania, a 1991 multi-platform real-time strategy game by Sensible Software

Megalomania (novel), a 1989 science-fiction novel by the author Ian Wallace

Empire of Megalomania, a term used by Ernest Gellner in describing a stereotypical development of nationalism in 19th century Eastern Europe

Grandiose delusions, a delusion characterized by fantastical beliefs that one is famous, omnipotent, wealthy, or otherwise very powerful.

Mental health of Jesus

The question of whether the historical Jesus was in good mental health has been explored by multiple psychologists, philosophers, historians, and writers. The first to openly question Jesus' sanity was French psychologist Charles Binet-Sanglé, the chief physician of Paris and author of the book La Folie de Jésus. This view finds both supporters and opponents.

Messiah complex

A messiah complex (also known as the Christ complex or savior complex) is a state of mind in which an individual holds a belief that they are destined to become a savior. The term can also refer to a state of mind in which an individual believes that he or she is responsible for saving or assisting others.

The term "messiah complex" is not addressed in the Diagnostic and Statistical Manual of Mental Disorders (DSM), as it is not a clinical term nor diagnosable disorder, however, the symptoms of the disorder closely resemble those found in individuals suffering from delusions of grandeur. This form of delusional belief is most often reported in patients suffering from bipolar disorder and schizophrenia. When a messiah complex is manifested within a religious individual after a visit to Jerusalem, it may be identified as a psychosis known as Jerusalem syndrome.

Paranoid personality disorder

Paranoid personality disorder (PPD) is a mental disorder characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. People with this personality disorder may be hypersensitive, easily insulted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions that may validate their fears or biases. They are eager observers. They think they are in danger and look for signs and threats of that danger, potentially not appreciating other evidence.They tend to be guarded and suspicious and have quite constricted emotional lives. Their reduced capacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience. People with PPD may have a tendency to bear grudges, suspiciousness, tendency to interpret others' actions as hostile, persistent tendency to self-reference, or a tenacious sense of personal right. Patients with this disorder can also have significant comorbidity with other personality disorders (such as schizotypal, schizoid, narcissistic, avoidant and borderline)

Paraphrenia

Paraphrenia (from Ancient Greek: παρά – beside, near + φρήν – intellect, mind) is a mental disorder characterized by an organized system of paranoid delusions with or without hallucinations (the positive symptoms of schizophrenia) and without deterioration of intellect or personality (its negative symptom).This disorder is also distinguished from schizophrenia by a lower hereditary occurrence, less premorbid maladjustment, and a slower rate of progression. Onset of symptoms generally occurs later in life, near the age of 60. The prevalence of the disorder among the elderly is between 0.1% and 4%.Paraphrenia is not included in the DSM-5; psychiatrists often diagnose patients presenting with paraphrenia as having atypical psychoses, delusional disorder, psychoses not otherwise specified, schizoaffective disorders, and persistent persecutory states of older adults. Recently, mental health professionals have also been classifying paraphrenia as very late-onset schizophrenia-like psychosis.In the Russian psychiatric manuals paraphrenia (or paraphrenic syndrome) is the last stage of development of paranoid schizophrenia. "Systematized paraphrenia" (with systematized delusions i. e. delusions with complex logical structure) and "expansive-paranoid paraphrenia" (with expansive/grandiose delusions and persecutory delusions) are the variants of paranoid schizophrenia (F20.0). Sometimes systematized paraphrenia can be seen with delusional disorder (F22.0).

Persecutory delusion

Persecutory delusions are a set of delusional conditions in which the affected persons believe they are being persecuted. Specifically, they have been defined as containing two central elements:

The individual thinks that harm is occurring, or is going to occur.

The individual thinks that the perceived persecutor has the intention to cause harm.According to the DSM-IV-TR, persecutory delusions are the most common form of delusions in paranoid schizophrenia, where the person believes "he or she is being tormented, followed, tricked, spied on, or ridiculed", or that their food is being poisoned. They are also often seen in schizoaffective disorder and, as recognized by DSM-IV-TR, constitute the cardinal feature of the persecutory subtype of delusional disorder, by far the most common. Delusions of persecution may also appear in manic and mixed episodes of bipolar disease, polysubstance abuse, and severe depressive episodes with psychotic features, particularly when associated with bipolar illness.

Raison oblige theory

Raison Oblige Theory offers an alternate explanation of exhibited behaviors widely accepted to be caused by the motive of self-verification (SVT)(William Swann, 1983). The theory addresses instances of apparent self-view confirmation strivings and details an economical description of why these behaviors occur. Focusing on the importance of the self-view and rational thought, (see self-esteem; self concept; self knowledge) Raison oblige theory (ROT) accounts for the evidence supporting SVT including the well documented seemingly mal-adaptive self verifying behaviors.

SVT states that a person is actively motivated to confirm their existing self view regardless of the objective accuracy or valence of that view. In other words, a person wants to confirm their currently held self views above and beyond wanting this information to be accurate or positive. (see self verification for details).

ROT challenges the existence of a motive and offers a plausible explanation which can account for all instances of self-verifying behaviors.

The fundamentals of ROT are that people are obliged by reason to accept information that is congruent with their currently held self views and reject information that is not. The theory challenges a self-verification motive, stating that people do not want to self-verify, they simply convey, through behaviour, cognitions that accurately and honestly reflect their own self views.ROT was developed by Aiden P. Gregg (2006).

Scale for the Assessment of Positive Symptoms

The Scale for the Assessment of Positive Symptoms (SAPS) is a rating scale to measure positive symptoms in schizophrenia. The scale was developed by Nancy Andreasen and was first published in 1984. SAPS is split into 4 domains, and within each domain separate symptoms are rated from 0 (absent) to 5 (severe). The scale is closely linked to the Scale for the Assessment of Negative Symptoms (SANS) which was published a few years earlier.

The Truman Show delusion

The Truman Show delusion, informally known as Truman syndrome, is a type of delusion in which the person believes that their lives are staged reality shows, or that they are being watched on cameras. The term was coined in 2008 by brothers Joel Gold and Ian Gold, a psychiatrist and a neurophilosopher, respectively, after the film The Truman Show.

The Truman Show delusion is not officially recognized nor listed in the Diagnostic and Statistical Manual of the American Psychiatric Association.

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