Persecutory delusions and the conditioned avoidance paradigm: Towards an integration of the psychology and biology of paranoia
- 2 November 2007
- journal article
- review article
- Published by Informa UK Limited in Cognitive Neuropsychiatry
- Vol. 12 (6), 495-510
- https://doi.org/10.1080/13546800701566686
Abstract
Introduction. Theories of delusions often underplay the role of their content. With respect to persecutory delusions, taking threat as fundamental suggests that models of threat-related, aversive learning, such as the Conditioned Avoidance Response (CAR) task, might offer valid insights into the underlying normal and abnormal processes. In this study, we reappraise the psychological significance of the CAR model of antipsychotic drug action; and we relate this to contemporary psychological theories of paranoia. Methods. Review and synthesis of literature. Results. Anticipation and recall of aversive events are abnormally accentuated in paranoia. Safety (avoidance) behaviours may help perpetuate and fix persecutory ideas by preventing their disconfirmation. In addition, patients may explain negative events in a paranoid way instead of making negative self-attributions (i.e., in an attempt to maintain self-esteem). This defensive function only predominates in the overtly psychotic patients. The “safety behaviours” of paranoid patients, their avoidance of negative self-attributions, and the antiparanoid effect of antipsychotic medication all resonate with aspects of the CAR. Conclusions. The CAR appears to activate some normal psychological and biological processes that are pathologically activated in paranoid psychosis. Paranoid psychological defences may be a result of basic aversive learning mechanisms, which are accentuated during acute psychosis.Keywords
This publication has 62 references indexed in Scilit:
- Reasoning under uncertainty: heuristic judgments in patients with persecutory delusions or depressionPsychological Medicine, 2006
- Phenomenological Evidence for Two Types of ParanoiaPsychopathology, 2005
- Attributional lability in depression and paranoiaBritish Journal of Clinical Psychology, 2005
- Opponent interactions between serotonin and dopamineNeural Networks, 2002
- PERSECUTORY DELUSIONS: A REVIEW AND THEORETICAL INTEGRATIONClinical Psychology Review, 2001
- Self-Threat Magnifies the Self-Serving Bias: A Meta-Analytic IntegrationReview of General Psychology, 1999
- Persecutory delusions and recall of threat-related, depression-related, and neutral wordsCognitive Therapy and Research, 1995
- The self, attributional processes and abnormal beliefs: Towards a model of persecutory delusionsBehaviour Research and Therapy, 1994
- Delusions as “Wrong Beliefs”: A Conceptual HistoryThe British Journal of Psychiatry, 1991
- The use of extinction to investigate the nature of neuroleptic-induced avoidance deficitsPsychopharmacology, 1980