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Fixed-False Beliefs
Published in Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman, Understanding and Caring for People with Schizophrenia, 2020
Ragy R. Girgis, Gary Brucato, Jeffrey A. Lieberman
Delusions are among the most common symptoms in schizophrenia and are one of the five main symptoms of schizophrenia, along with hallucinations, disorganized speech, disorganized behavior, and negative symptoms (to meet criteria for schizophrenia, patients must meet at least two of these criteria [one must be delusions, hallucinations, or disorganized speech] for one month with some signs of the disorder for at least six months, unless they receive treatment). There are many different types of delusions. One type of delusion is the persecutory delusion. In this type of delusion, one believes that they are being worked against, targeted, or unfairly treated in some way. A person having persecutory delusions is often described as being “paranoid.” This is perhaps the most common type of delusion experienced by individuals with schizophrenia, though it was not experienced by Joy. An example of a persecutory delusion would be thinking that one is being monitored by cameras that no one can see or that a government agency is planning to assassinate someone when that is not true.
OSCE 16 – Risk of violence
Published in Bhaskar Punukollu, Michael Phelan, Anish Unadkat, MRCPsych Part 1 In a Box, 2019
Bhaskar Punukollu, Michael Phelan, Anish Unadkat
4. Risk assessment – current – Ask whether there are any children and if they have been affected. Has the patient told his wife about any command hallucinations or any cause for his violence? Ask if the patient has described persecutory delusions. Has the patient threatened to be violent towards himself with self-harm or suicide? Ask if the wife can cope with the situation and whether she has or intends to press charges.
Preconditions for Implementing MERIT
Published in Paul H. Lysaker, Reid E. Klion, Recovery, Meaning-Making, and Severe Mental Illness, 2017
Paul H. Lysaker, Reid E. Klion
The fourth precondition is that psychotic experiences can be mutually understood by the therapist and patient. Positive, negative, and cognitive symptoms are often part of severe mental illness and will inevitably be evident during the course of psychotherapy sessions. The therapist’s role is to treat all thoughts and experiences, including delusional material and thought disordered communications, as potentially meaningful, and these should not be ignored or extinguished before an understanding can be established. For instance, the emergence of an odd belief could be understood to have any of a number of potential meanings. From different perspectives, a persecutory delusion might be understood as an expression of fear trigged by an anomalous release of dopamine, a response to a threat to self-esteem, a wish to obliterate inter-subjectivity, a fear of engulfment, an untrusting stance toward others that emerged in the wake of trauma, or distress cued by a therapist intervention. This is consistent with findings that symptoms do not randomly emerge in psychotherapy sessions but can be tied to clear and understandable antecedents within the session (Leonhardt, Kukla et al., in press). This precondition also expects the therapist and patient to be continuously seeking to make meaning and resist the impulse for treatment to become symptom-focused. While a symptom could become the focus of treatment, this would only take place if its shared meaning were first developed (e.g., joint agreement that an automatic thought has become burdensome).
Cannabis withdrawal induced brief psychotic disorder: a case study during the national lockdown secondary to the COVID-19 pandemic
Published in Journal of Addictive Diseases, 2021
Julen Marín, Xabier Pérez de Mendiola, Sergio Fernández, Juan Pablo Chart
Given the intense affective and behavioral impact of persecutory delusions, a voluntary admission to the Psychiatry Unit is made. Treatment with Olanzapine 10 mg/day and Lorazepam 2 mg/12 hours is introduced. During the first two days of hospitalization, the delusions persist. In fact, the patient makes paranoid interpretations of distant memories: “certain past moments in my life are connected with what is happening to me now.” The Brief Psychiatric Rating Scale (BPRS)16 score is 72 at admission. Fortunately, the clinical evolution is favorable. Complete remission of symptoms is achieved after seven days of treatment. During the period that he is hospitalized, he does not manifest problems concerning the medication's tolerability. A complete blood analysis, urinalysis, and cerebral magnetic resonance imaging are done, and no pathological results are found. It should be noted that the urine toxicology test is negative for drugs of misuse, including THC (immunoassay cutoff concentration: 50 ng/ml).
Promoting insight into delusions: Issues and challenges in therapy
Published in International Journal of Psychiatry in Clinical Practice, 2020
In order to maintain the therapeutic boundaries and to conduct therapy sessions, it is important that the therapist maintains a non-colluding and non-confronting approach in the therapy sessions. Maintaining this approach is an intricate task as avoiding one pole may make the therapist vulnerable to be perceived being nearer to the other pole. Maintaining a non-colluding approach, for instance, may make the client feel as if her/his beliefs are being refuted by the therapist. Also, clients with persecutory delusions may start perceiving the therapist as conniving with the persecutors. It is imperative that the therapist deals this issue delicately and conveys the message to the client that it is not important whether or not s/he accepts the client’s beliefs, rather it is important to have discussions about it (Kumar et al. 2013). Further, it is advisable that the therapist reduces any ambiguities in the therapy process that might have been fuelling client’s paranoia towards the therapist (Kuiper et al. 2006).
Neurotechnologies Cannot Seize Thoughts: A Call for Caution in Nomenclature
Published in AJOB Neuroscience, 2019
Katherine E. MacDuffie, Sara Goering
The label used by Meynen also has potential to do harm as a result of its connotations in popular culture. Technologies capable of “mind reading” have long fascinated science-fiction audiences, given their chilling potential to rob an individual of private internal thoughts. Persecutory delusions, the most common type of delusion experienced by people with psychotic disorders (Cannon and Kramer 2012), often involve believing that one’s thoughts are being “apprehended” by another person or device. These types of delusions have increased in frequency in the past century, with specific content reflecting trends in emerging technologies (Cannon and Kramer 2012; Škodlar et al. 2008). These trends in delusion content parallel the growing public concern about the invasiveness of technology in modern life (Valentino-DeVries et al. 2018), which could undermine support of research at the frontiers of brain science. The use of terms like Meynen’s NTA in published works of scholarship may stoke these collective fears, with potential harms for psychiatrically-affected individuals as well as scientific progress. Scholars can be clear about real risks of advances in brain science and neurotechnologies without swaying public opinion toward suspicion and distrust through the use of unnecessarily provocative terms.