Phenomenology of delusions and hallucinations in schizophrenia by religious convictions

This study was conducted to assess the impact of religious affiliations on the phenomenology of delusions and hallucinations. Fifty-three Pakistani Muslim patients with schizophrenia were interviewed using the Present State Examination and Religiosity Index. The results indicated that the more religious patients had greater themes of grandiose ability and identity. These differences were more obvious in groups divided on the basis of practice of Islam. Similar results were obtained in the content of hallucinations. More religious patients were more likely to hear voices of paranormal agents and had visions of the same. The results of this study have strong implications for mental health professionals who, without reinforcing threatening and pathological beliefs of patients, can utilise this knowledge to create and maintain a therapeutic alliance with the patients as well as to more effectively manage the disorder.     

Mood and memory: Mood-congruity effects in absence of mood

Themood-congruity effect refers to facilitated processing of information when the affective valence of this information is congruent with the subject’s mood. In this paper we argue that mood may be a sufficient but not a necessary condition to produce the mood-congruity effect of selective learning. Two experiments are presented in which subjects learned lists of words with neutral, positive, and negative affective valences. In the learning task the subjects were instructed to behave as if they were depressed or happy. The mood-congruity effect was indeed obtained. The effect was stronger with subjects who “predicted” the relationship between mood and affective word valence than with subjects who were unaware of this relationship. The results are not simply attributed to task demands, but are interpreted in terms of a model of cognitive processes and people’s knowledge about mood states.     

Religious beliefs and religious delusions: Response to treatment in schizophrenia

It has been suggested that patients with strong religious beliefs or religious delusions have poor outcome from psychiatric treatment. The aim of the investigation was to establish if the patients’ shorter-term response to psychiatric treatment was affected by these factors. A quasi-experimental design was used, in which patients with schizophrenia were assessed soon after admission to hospital. They were categorised as (1) religious or not religious, (2) experiencing religious delusions or not, using reliable criteria. Patients were given their routine treatment and their symptoms were then re-assessed after four weeks. There was no difference in response to treatment between the religious and non-religious patients. There was no difference between patients who had religious delusions and those who had other types of delusions. Though this study does not settle the debate, it suggests that strong religious beliefs or religious delusions do not adversely affect the patient's response to treatment in the shorter term.     

Need for closure and anxiety in delusions: a longitudinal investigation in early psychosis

This study investigated the role of need for closure (NFC) and anxiety in delusions. The Need For Closure Scale (NFCS) and measures of trait and state anxiety were administered to an early psychosis group with current delusions, a clinical (generalised anxiety disorder--GAD) control group and a non-clinical control group. The battery of questionnaires was repeated at follow-up one year later. The NFCS did not meet criteria for a unidimensional scale and two sub-scales were removed from all further analyses. At baseline the deluded and GAD groups scored significantly higher on the reduced NFCS (NFCS-R) than the control group. Trait anxiety was related to NFCS-R in the GAD and non-clinical control groups, but not in the deluded group. At follow-up all groups scored significantly lower on the NFCS-R, perhaps suggesting a practice effect, although the two clinical groups continued to have higher scores than the non-clinical control group. The recovered and non-recovered deluded groups did not differ on the NFCS-R one year later, unlike in the GAD group where recovered participants had significantly lower scores than the non-recovered. Change scores on the NFCS-R and trait anxiety were correlated at trend level in the GAD and non-clinical control groups, but not in the deluded group. These findings suggest that whilst NFC and trait anxiety are related in non-psychotic groups, NFC may be implicated in the formation of delusions, independently of anxiety, in psychotic individuals.     

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.     

Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence

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.     

Mood effects on attitude judgments: independent effects of mood before and after message elaboration.

This study investigated the independent effects of induced mood on the encoding of persuasive messages and on the assessment of attitude judgments. In Experiment 1, positive or negative mood was induced either before the encoding of a counterattitudinal message or before the assessment of attitude judgments. When mood was induced before message presentation, Ss in a bad mood were more persuaded by strong than by weak arguments, whereas Ss in a good mood were equally persuaded by strong and by weak arguments. When Ss encoded the message in a neutral mood, however, the advantage of strong over weak arguments was more pronounced when Ss were in a good rather than in a bad mood at the time of attitude assessment. In Experiment 2, Ss exposed to a counterattitudinal message composed of either strong or weak arguments formed either a global evaluation or a detailed representation of the message. Positive, negative, or neutral mood was then induced. Ss in a good mood were most likely and Ss in a negative mood least likely to base their reported attitudes on global evaluations.     

Mood and the mundane: relations between daily life events and self-reported mood

Daily mood ratings and corresponding diary entries were studied to determine relations between common events and two independent mood factors--Positive Affect (PA) and Negative Affect (NA)--in a sample of 18 young adults over a 3-month period. In an extension of findings from earlier interindividual studies, PA (enthusiastic, delighted vs. sluggish, drowsy) was found to be associated with a wide range of daily events, whereas fewer correlations were found between these events and NA (distressed, nervous, angry vs. calm, relaxed). The relation between high PA and reported social interactions (particularly physically active social events) was especially robust, and its effects were noted repeatedly; NA was unrelated to social activity. As hypothesized, high NA was associated with physical problems; contrary to expectations, low PA also tended to be correlated with health complaints. Overall, the results reaffirm the importance of assessing NA and PA independently and suggest that PA is an interesting and important dimension that deserves more research attention. Theoretical considerations and clinical implications are discussed.     

"Mood contagion": the automatic transfer of mood between persons

The current studies aimed to find out whether a nonintentional form of mood contagion exists and which mechanisms can account for it. In these experiments participants who expected to be tested for text comprehension listened to an affectively neutral speech that was spoken in a slightly sad or happy voice. The authors found that (a) the emotional expression induced a congruent mood state in the listeners, (b) inferential accounts to emotional sharing were not easily reconciled with the findings, (c) different affective experiences emerged from intentional and nonintentional forms of emotional sharing, and (d) findings suggest that a perception-behavior link (T. L. Chartrand & J. A. Bargh, 1999) can account for these findings, because participants who were required to repeat the philosophical speech spontaneously imitated the target person's vocal expression of emotion.     

The bizarreness effect and individual differences in imaging ability

The bizarreness effect refers to the superior performance in recall of bizarre sentences as compared to common sentences. The subjects studied each target word and in Exp. 1 rated its congruity with its sentence frame. In Exp. 2 they rated the vividness of the image for each sentence frame in which it was included. Four types of sentence frames were provided: bizarre image sentences, bizarre nonimage sentences, common image sentences, and common nonimage sentences. Good imagers and poor imagers were assessed on the Questionnaire Upon Mental Imagery. Both experiments showed that good imagers recalled target words in bizarre image sentences better than target words in common image sentences. A difference between the two sentence types was not observed for poor imagers. The differences between bizarre nonimage sentences and common nonimage sentences were not found for both type of imagers. The results were interpreted as showing that a difference in imaging ability was critical for the occurrence of a bizarreness effect.     

Mood and performance: test of a conceptual model with a focus on depressed mood

Objectives. The present study tested a conceptual model of mood–performance relationships (J. Appl. Sport Psychol. 12 (2000) 16) which proposed that depressed mood would influence the intensity and inter-relationships of other mood responses, and moderate the anger–performance and tension–performance relationships.Design. To promote ecological validity, the model was tested in a field setting using a cross-sectional design.Methods. A sample of 451 schoolchildren [age: mean=12.4 years, standard deviation (SD)=1.3 years] completed the Profile of Mood States — Adolescents (POMS-A; J. Sports Sci. 17 (1999) 861) and stated a performance goal, approximately 10 minutes before a running event. Participants were divided into a depressed mood group (n=273) and a no-depression group (n=178) on the basis of responses to the POMS-A depression subscale.Results. As hypothesised, the depressed mood group reported higher scores for anger, confusion, fatigue and tension, and lower scores for vigour. Inter-correlations among these mood dimensions were stronger in the depressed mood group, who set easier goals and performed less well. Vigour was associated with facilitated performance regardless of depression. Anger was associated with debilitated performance in the depressed mood group and with facilitated performance in the no-depression group. Some support was shown for a moderating effect of depressed mood on the tension–performance relationship. The hypothesised curvilinear anger–performance and tension–performance relationships in the no-depression group did not emerge.Conclusion. The Lane and Terry model was generally, but not totally, supported. Future research should continue to investigate the mechanisms underlying mood–performance relationships.     

Mood regulation in depression: Differential effects of distraction and recall of happy memories on sad mood

Recent research suggests that the recall of positive memories plays an important role in mood regulation. In this study, the authors examined the ability of currently depressed, formerly depressed, and never-depressed participants to regulate sad mood through the recall of positive memories or through distraction. Although improvement in mood was found for all participants in response to distraction, under instructions to recall positive memories, never-depressed participants' moods improved, whereas formerly depressed participants' sad moods remained unchanged. It is important to note that depressed participants exhibited a worsening of their sad moods after recalling positive memories. These results suggest both that depression is associated with an impaired ability to use positive recall to regulate a sad mood and that this impairment continues to be evident following recovery.     

Suicidal behavior among inpatients with schizophrenia and mood disorders in Chengdu, China

This study evaluated the characteristics of suicidal behavior (suicide attempt or suicidal ideation) among 230 consecutively admitted inpatients with schizophrenia and mood disorders in a university hospital in China. The rate of lifetime suicidal behavior was found to be significantly higher in patients with mood disorders (62.4%) than in patients with schizophrenia (38.6%). The rate of suicidal behavior was significantly higher in patients with major depressive disorder (86.8%) than those with bipolar disorders (42.6%). Patients with schizophrenia attempted suicide for the first time earlier in life than the patients with mood disorders. Mood disorder patients, especially those with major depressive disorder, had more and more serious suicide attempts than the patients with schizophrenia.     

Relationships between personality variables and bizarreness effects in free recall

Relationships between 6 personality variables and each of 3 different measures of recall for bizarre and common sentences were examined. The personality variables investigated included measures of sensation seeking, novelty experiencing, desire for novelty, arousal-seeking tendency, social potency, and conservatism. Recall was measured in terms of sentences accessed, target words recovered per accessed sentence, and misplaced target words. The results indicated the typical pattern of bizarreness effects on recall and significant relationships between personality variables and these effects. Arousal seeking and conservatism were positively related to a bizarreness advantage in sentences accessed. Additionally, high social potency was related to the recovery of more details from common than bizarre sentences, and high desire for novelty was related to a greater bizarre misplacement effect. The results are discussed in terms of orienting and defensive responses to bizarreness.     

Mood stability versus mood instability in bipolar disorder: a possible role for emotional mental imagery

A cognitive model of bipolar disorder suggests that mental imagery acts as an emotional amplifier of mood and may be heightened in bipolar disorder. First, we tested whether patients with bipolar disorder would score higher on mental imagery measures than a matched healthy control group. Second, we examined differences in imagery between patients divided into groups according to their level of mood stability. Mood ratings over approximately 6-months, made using a mobile phone messaging system, were used to divide patients into stable or unstable groups. Clinician decisions of mood stability were corroborated with statistical analysis. Results showed (I) compared to healthy controls, patients with bipolar disorder had significantly higher scores for general mental imagery use, more vivid imagery of future events, higher levels of intrusive prospective imagery, and more extreme imagery-based interpretation bias; (II) compared to patients with stable mood, patients with unstable mood had higher levels of intrusive prospective imagery, and this correlated highly with their current levels of anxiety and depression. The findings were consistent with predictions. Further investigation of imagery in bipolar disorder appears warranted as it may highlight processes that contribute to mood instability with relevance for cognitive behaviour therapy.     

Clinician race, situational attributions, and diagnoses of mood versus schizophrenia disorders

This research examined clinicians' consideration of situational factors in diagnostic decisions of mood vs. schizophrenia disorders among psychiatric inpatients from a low-income, African American community. Clinicians completed questionnaires describing their diagnostic decisions. Responses reflecting the usage of situational information were investigated. African American clinicians used situational information more than non-African American clinicians. However, this increased attention to situational information was not uniquely associated with a particular diagnostic decision for African American clinicians. In contrast, consideration of situational attributions by non-African American clinicians did increase the probability of a mood diagnosis. Logistic regression analyses suggested differential application of a diagnostic standard among African American and non-African American clinicians. Implications for enhancing the cultural sensitivity of diagnosis practices are discussed.