Explaining delusions: a cognitive perspective

There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. This review considers those models that explain delusions as a breakdown of normal belief formation (belief-positive models), approaches that explain the pathology only (belief-negative models) and approaches that view delusions as one end of a distribution of anomalous mental phenomena (the continuum view). A cognitive theory that includes the 'pragmatic pathology' of delusions will be able to address both the phenomenology and the treatment of delusion-related distress.     

Religious delusions and filicide: a psychodynamic model

In this article, we present a psychodynamic explanation for the complex crime of filicide motivated by religious delusions. To begin, we provide an overview of filicide, including its typology and epidemiology. Second, we examine the psychoanalytic theories of Heinz Kohut and Otto Kernberg so as to better understand how family-of-origin experiences add to the ways in which psychotic disorders later take shape in filicide cases. Third, we offer an explication of the psychology of religion, including the role that religious defences and religious delusions play in cases involving filicide. Ultimately, we hypothesise that mothers with religious delusions commit acts of filicide due to the dynamic and reciprocal interaction between mental illness, psychological functioning, and the psychological role played by religion. We conclude our article with a case illustration to demonstrate our theoretical model.     

Beyond the comparator model: a multifactorial two-step account of agency

There is an increasing amount of empirical work investigating the sense of agency, i.e. the registration that we are the initiators of our own actions. Many studies try to relate the sense of agency to an internal feed-forward mechanism, called the "comparator model". In this paper, we draw a sharp distinction between a non-conceptual level of feeling of agency and a conceptual level of judgement of agency. By analyzing recent empirical studies, we show that the comparator model is not able to explain either. Rather, we argue for a two-step account: a multifactorial weighting process of different agency indicators accounts for the feeling of agency, which is, in a second step, further processed by conceptual modules to form an attribution judgement. This new framework is then applied to disruptions of agency in schizophrenia, for which the comparator model also fails. Two further extensions are discussed: We show that the comparator model can neither be extended to account for the sense of ownership (which also has to be differentiated into a feeling and a judgement of ownership) nor for the sense of agency for thoughts. Our framework, however, is able to provide a unified account for the sense of agency for both actions and thoughts.     

The self in action: lessons from delusions of control

Patients with delusions of control are abnormally aware of the sensory consequences of their actions and have difficulty with on-line corrections of movement. As a result they do not feel in control of their movements. At the same time they are strongly aware of the action being intentional. This leads them to believe that their actions are being controlled by an external agent. In contrast, the normal mark of the self in action is that we have very little experience of it. Most of the time we are not aware of the sensory consequences of our actions or of the various subtle corrections that we make during the course of goal-directed actions. We know that we are agents and that we are successfully causing the world to change. But as actors we move through the world like shadows glimpsed only occasional from the corner of an eye.     

Psychology and Aging: the first 20 years

This article provides a review of the first 20 years of Psychology and Aging, the American Psychological Association's first and only scholarly journal devoted to the topic of aging. The authors briefly summarize its history, its contributions to the study of aging, and its broader status as a scholarly publication. One theme highlighted in our review is the diversity of content in the journal throughout its history. Another is the strong impact that articles published in the journal have had on both basic and applied topics in aging. Efforts to encompass the breadth of topics and methodologies in aging research while retaining excellent quality remain the exciting but essential challenge for Psychology and Aging.     

Explaining in conversation: Towards an argument model

We examine the proposition that, in ordinary conversation, people are concerned to argue — to justify their claims and to counter potential and actual counter claims. We test out the proposition by analysing explanations in one particular conversation. We attend to the validity claims of what the speakers say, and to the authority with which they say it. Viewed in that light, we find that the majority of what might look like causal attributions turn out to look like argumentative claim-backings. We then go on to flesh out the quasi-pragmatic rules which might help to decide formally whether any given utterance is be er understood as an argument or a causal explanation. These rules revolve around the speaker's apparent intention and the projected relationship between the clauses in what she or he says. All of this takes us a fair way from attribution theory's model of explanation as the reporting of a cause, and we end up with an argumentative model of ordinary explanation.     

Acting on persecutory delusions: the importance of safety seeking

OBJECTIVE: Acting on delusions is a significant clinical issue. The concept of safety behaviours--actions carried out with the intention of reducing perceived threat--provides a new way of understanding acting on delusions. A study was conducted with the aim of examining the prevalence and correlates of safety behaviours related to persecutory delusions. METHOD: One hundred patients with persecutory delusions were assessed for safety behaviours, acting on delusions, anxiety, depression, and psychotic symptoms. Case note data were collected on instances of serious violence or suicide attempts. RESULTS: Ninety-six patients had used safety behaviours in the last month. Greater use of safety behaviours was associated with higher levels of distress. A history of violence or suicide attempts was associated with greater use of safety behaviours. Safety behaviours were significantly associated with acting on delusions, but not with the negative symptoms of psychosis. CONCLUSION: Safety behaviours are a common form of acting on persecutory delusions. These behaviours have the consequence that they are likely to prevent the processing of disconfirmatory evidence and will therefore contribute to delusion persistence.     

Deconstructing delusions: A qualitative study examining the relationship between religious beliefs and religious delusions

Delusions have been conceptualized as forming in response to experience, yet the relationship between religious belief, and beliefs regarded as delusional, has received little research attention. This is despite the high prevalence of delusions featuring religious content. Semi-structured interviews were conducted with seven participants who had been diagnosed as experiencing delusions. Participants from a range of religious backgrounds were asked about their religious experiences and beliefs, family background and experiences of psychosis. These interviews were analysed qualitatively. Whilst religious background affected the content of delusions, the nature of delusions appeared to be influenced by other factors, such as early family experiences, particularly an absent parent and conflict within the family. Individuals often used a religious framework to understand unusual experiences, and there seemed to be a role for the process of identification and wish fulfilment in influencing delusional content. Whilst this research is clearly limited by its exploratory nature, it offers a possible framework of understanding which helps make sense of religious delusions, and suggests approaches which may be helpful in recovery.     

Books: Explaining the Unexplainable

You would do better to say, “Inexpressible and nameless is that which gives my soul agony and sweetness. ” May your virtue be too exalted for the familiarity of names, and if you must speak of her, then do not be ashamed to stammer of her.     

Dermatozoon delusion in hypoparathyroidism--reflections on the genesis of delusions

Firstly two female patients with hypoparathyroidism and basal ganglia calcifications are described who developed after long course of illness delusions of parasitosis. The pathological cerebral changes responsible for delusions of parasitosis are mostly localized in the brain-stem. Regarding the two case histories and the former literature the relationship between peripheral paresthesias and a supposed disturbance of central processing is discussed.     

Explaining consciousness: the hard problem

edited by Jonathan Shear, Bradford/MIT Press 1997. ￡33.95/$40.00 (vii+422 pages) ISBN 0 262 19388 4.     

The case for the comparator model as an explanation of the sense of agency and its breakdowns

I compare Frith and colleagues’ influential comparator account of how the sense of agency is elicited to the multifactorial weighting model advocated by Synofzik and colleagues. I defend the comparator model from the common objection that the actual sensory consequences of action are not needed to elicit the sense of agency. I examine the comparator model’s ability to explain the performance of healthy subjects and those suffering from delusions of alien control on various self-attribution tasks. It transpires that the comparator model needs case-by-case adjustment to deal with problematic data. In response to this, the multifactorial weighting model of Synofzik and colleagues is introduced. Although this model is incomplete, it is more naturally constrained by the cases that are problematic for the comparator model. However, this model may be untestable. I conclude that currently the comparator model approach has stronger support than the multifactorial weighting model approach.     

Connecting neurosis and psychosis: the direct influence of emotion on delusions and hallucinations

Diagnostic classification systems contain a core divide between neurosis and psychosis, leading to their separate study and treatment. The basis for the separation of the disorders is outlined and reassessed. It is argued that the empirical evidence does not support such a sharp distinction between neurosis and psychosis. The frequent occurrence of emotional disorder prior to and accompanying psychosis indicates that neurosis contributes to the development of the positive symptoms of psychosis. Psychological theories and experimental evidence concerning the influence of emotion on the content and form of delusions and hallucinations are therefore reviewed. It is argued that in many cases delusions are a direct representation of emotional concerns, and that emotion contributes to delusion formation and maintenance. The content of hallucinations less often directly expresses the emotional concerns of the individual, but emotion can trigger and contribute to the maintenance of hallucinatory phenomena, although how this occurs is not well understood. It is concluded that study needs to be made of the interaction between psychotic and neurotic processes in the development of delusions and hallucinations, and that neurotic and psychotic disorders may have common maintenance processes.     

"三阶梯"止痛原则临床实践20年

WHO癌痛"三阶梯"止痛原则发布20年来,经过医患双方上亿人次的临床实践,取得了巨大成功.人类对癌性疼痛乃至良性疼痛的认识,从来没有如此深刻;有关止痛的实践也从来没有如此广泛.作者回顾了"三阶梯"原则的产生背景和历史功绩,指出了"三阶梯"原则在实践中丰富和发展的必要性.作者建议,今后我国癌症止痛应"临床勇于实践,用药讲究技巧,工作重点下移".     

Hypnosis and belief: A review of hypnotic delusions

Hypnosis can create temporary, but highly compelling alterations in belief. As such, it can be used to model many aspects of clinical delusions in the laboratory. This approach allows researchers to recreate features of delusions on demand and examine underlying processes with a high level of experimental control. This paper reviews studies that have used hypnosis to model delusions in this way. First, the paper reviews studies that have focused on reproducing the surface features of delusions, such as their high levels of subjective conviction and strong resistance to counter-evidence. Second, the paper reviews studies that have focused on modelling underlying processes of delusions, including anomalous experiences or cognitive deficits that underpin specific delusional beliefs. Finally, the paper evaluates this body of research as a whole. The paper discusses advantages and limitations of using hypnotic models to study delusions and suggests some directions for future research.     

A Statistical Correction to 20 years of Banding

Statistically based banding is often considered a viable method for minimizing adverse impact in test‐based employment decisions. By utilizing the standard error of the difference (SED), scores are equated based on the assumption that there is substantial unreliability in any single observed score. However, based on the derivations of Dudek, the formula commonly used to calculate the standard error of measurement (SEM) – a component that is typically used to calculate the SED – is incorrect. Specifically, utilizing the SEM when calculating the SED produces a band of observed scores around a true score, not a band of true scores around an observed score as would be appropriate for banding. This study compares the differences between banding‐based selection decisions when the appropriate SED formula – which utilizes the standard error of estimate – is and is not applied. Overall, results suggest that utilizing the appropriate formula for calculating the SED produces substantial variations in employment decisions. The potential legal and ethical implications of these discrepancies are discussed.     

The Journal of Consumer Behaviour's first 20 years

We analyzed and compared the Journal of Consumer Behaviour content in its first 20 years of publication. Articles were categorized into seven topics (Internal Factors, External Factors, Decision Process, Social Issues, Internet, Managerial Issues, and Research Methods) with subtopics. Authorship, citations based on Google Scholar, geographic representation of authors, and methodologies employed across the first 20 years were also explored. The results are discussed in terms of their implications for the journal and consumer behaviour. This analysis provides suggestions for future research to be published by the Journal of Consumer Behaviour.