Purpose Religious delusions are common and are considered to be particularly difficult to treat. In this study we investigated what psychological processes may underlie the reported treatment resistance. In particular, we focused on the perceptual, cognitive, affective and behavioural mechanisms held to maintain delusions in cognitive models of psychosis, as these form the key treatment targets in cognitive behavioural therapy. We compared religious delusions to delusions with other content. Methods Comprehensive measures of symptoms and psychological processes were completed by 383 adult participants with delusions and a schizophrenia spectrum diagnosis, drawn from two large studies of cognitive behavioural therapy for psychosis. Results Binary logistic regression showed that religious delusions were associated with higher levels of grandiosity (OR 7.5; 95 % CI 3.9-14.1), passivity experiences, having internal evidence for their delusion (anomalous experiences or mood states), and being willing to consider alternatives to their delusion (95 % CI for ORs 1.1-8.6). Levels of negative symptoms were lower. No differences were found in delusional conviction, insight or attitudes towards treatment. Conclusions Levels of positive symptoms, particularly anomalous experiences and grandiosity, were high, and may contribute to symptom persistence. However, contrary to previous reports, we found no evidence that people with religious delusions would be less likely to engage in any form of help. Higher levels of flexibility may make them particularly amenable to cognitive behavioural approaches, but particular care should be taken to preserve self-esteem and valued aspects of beliefs and experiences.

Some but not all models of obsessive–compulsive disorder (OCD) emphasize the role of dysfunctional beliefs in the etiology and maintenance of this disorder. Clinical observations suggest that some OCD patients have prominent dysfunctional beliefs associated with their obsessions and compulsions, while other patients do not show this pattern. It is possible that dysfunctional beliefs play a role in only a

The purpose of this study is to answer the following question: What are the typical features of abnormal bodily experiences (ABEs) in persons affected by acute first-episode schizophrenia? Our overall objective is to contribute to enhance early diagnosis of schizophrenia, and providing supplementary diagnostic criteria especially for ultra-high risk patients. In a group of 39 patients with firstepisode schizophrenia selected from a sample of 393 psychotic patients, 30 (76.9 %) reported ABEs. By means of a phenomenologicallybased qualitative method of inquiry, we recognized four subtypes of ABEs whose main characteristics are dynamization of bodily boundaries and construction, morbid objectivization/devitalization, dysmorphic experiences and pain-like experiences. These four typologies of ABEs are documented through the patients' first-person self-descriptions, and then operationally defined. Two main properties emerge as tentative eidetic (defining) cores of ABEs in early schizophrenia: dynamization of bodily boundaries and construction, and morbid objectivization/devitalization. Sharpening the diagnostic sensibility for typically schizophrenic ABEs can help improve differential diagnosis between schizophrenia and other disorders entailing other types of anomalies of lived corporeality. Also, studying possible transitions from schizophrenic cenesthopathies to bodily delusions in persons with schizophrenia may refine the concept of bizarre delusions by improving its validity. Furthermore, our knowledge about the pathogenesis of schizophrenia may profit from an in-depth assessment of ABEs and their relationship with an abnormal sense of selfhood, especially in early schizophrenia.

Persecutory (paranoid) delusions are a frequently observed clinical phenomenon. In recent years, an increasing volume of research has attempted to explain these types of beliefs in terms of psychological mechanisms. Theories have emphasized early experience, perceptual abnormalities, motivational factors, and information-processing deficits. In this article we review relevant findings, including our own studies of the role of causal attributions and theory of mind deficits. We propose a new integrative model that builds on this work. The core of the model is an account of the way that causal attributions influence self-representations, which in turn influence future attributions: the attribution-self-representation cycle. We argue that biases in this cycle cause negative events to be attributed to external agents and hence contribute to the building of a paranoid world view. These abnormalities are amenable to investigation by functional neuroimaging, and recent studies have implicated specific areas of neuroactivation. However, these findings do not necessarily suggest that paranoid delusions are entirely biological in origin, and there is evidence that adverse early experience may play a role in determining the development of a cognitive vulnerability to paranoid thinking. D

The case study is based on qualitative data, reflection sheets, and interview and field notes from the Guided Self-Determination training. The patient's new insight developed in a process from resistance to receptiveness and then from doubt to reaching a new system in his thoughts.

Public figures are at relatively high risk of unusual contact initiated by fixated individuals. Prior research on managing the threat presented by public figure stalkers concludes that although direct threats rarely precede attacks, there is usually evidence of pre-planning. Furthermore, some public figure attackers do attempt to communicate with their future intended victim prior to attack. Thus, early warning signs from unusual contact behavior can be a powerful tool in threat assessment and risk management. The current paper offers a systematic concept for managing public figure stalking and constitutes five stages: (i) screening, (ii) first analysis, (iii) passive research, (iv) active research and finally (v) considered management strategy. It is concluded that assessment and management of risk are dynamic procedures, requiring ongoing monitoring and flexibility. Furthermore, although different stalkers will engage in ostensibly similar behavior, their motives and underlying psychopathologies may vary considerably. As such, all interventions require individual construction.

Objective: To provide a systematic review of selected experimental studies of psychosocial treatments of behavioral disturbances in dementia. Psychosocial treatments are defined here as strategies derived from one of three psychologically oriented paradigms (learning theory, unmet needs and altered stress thresholds).

AMPHETAMINE psychosis was first described by YOUNG and SCOVILLE in 1938.l Thereafter, sporadic reports of small series or single cases of amphetamine psychosis appeared in medical literature, but the condition was still considered to be somewhat of a rarity. In 1958, CONNELL'S now classic monograph on the subject was published. In this study in which 42 patients with amphetamine psychosis were studied, CONNELL concluded that "Psychosis associated with amphetamine usage is much more frequent than would be expected from reports in the literature." Furthermore, CONNELL asserted that the clinical features of amphetamine psychosis might be such as to make it "indistinguishable from acute or chronic paranoid schizophrenia."2 This contention was not accepted without controversy. SLATER, reviewing CONNELL'S monograph, pointed out that amphetamine psychosis was characterized by a "brisk emotional reaction, usually in the direction of anxiety"3 whereas schizophrenia was not. BELL also compared the two conditions. IIe concluded that amphetamine psychosis was rather strikingly similar to schizophrenia in its presentation but that these two conditions could be differentiated by the presence of thought disorder which was prominent in schizophrenia and lacking in amphetamine psychosis.4 In 1968, GRIFFITH et al., undertook the first experimental induction of amphetamine psychosis in non-schizophrenic volunteer subjects within a controlled hospital environment." This enabled these workers to make observations on amphetamine psychosis in "pure culture", as it were, uncontaminated by the possibility of concomitant usage of other drugs or by schizophrenia that might have antedated amphetamine ingestion. GRIFFITH et al., administered 10 mg of dextro-amphetamine hourly for as long as was tolerated by their subjects and observed as an outcome, a generally abrupt onset of paranoid delusions, often with cold, detached affect. Their patient volunteers however, "did not exhibit a thought disorder or experience hallucinations". Other investigators had questioned whether anhedonia might constitute a distinction between amphetamine psychosis and schizophrenia.6 * lllhis work wils supported by USPHS Grant MH 04669.

Background: Factors such as poor insight, amotivation, suspiciousness, disorganized speech and attentional problems may interfere with the ability of acutely ill individuals with psychotic disorders to provide a valid account of their symptoms. This study was designed to determine the degree to which history provided by such subjects is consistent with that obtained from other sources. Method: Fifty-five subjects presenting with psychotic disorders were multiply evaluated with a semi structured interview, the Comprehensive Assessment of Symptoms and History (CASH), which includes the Scales for the Assessment of Negative and Positive symptoms (SANS and SAPS). One interviewer assessed the severity of the patient's symptoms in the previous month based solely on information provided by the patient. A second rater made symptom ratings based on information obtained from a ''best informant''. Following this, a consensus rating was established based on an extensive evaluation and review of all sources of information. An item-by-item comparison of the three sets of symptom ratings was then quantified by paired t-tests, simple and multiple correlations. Results: Positive and negative symptoms ratings based on the subjects' report were significantly lower than the corresponding consensus ratings. However, those based on the informants' report did not differ from consensus ratings for negative symptoms. Information obtained from subjects and from informants together accounted for a majority of the variance of the consensus ratings. Conclusions: These findings demonstrate that assessment limited to patients' own reports are likely to underestimate psychopathology in acutely ill patients with psychotic disorders. Obtaining corroborative history from a family member may substantially improve the validity of the assessment of negative symptoms. D

Numerous studies suggest a cognitive bias for threat-related material in delusional ideation. However, few studies have examined this bias using a memory task. We investigated the influence of delusion-proneness on identity and expression memory for angry and happy faces. Participants high and low in delusion-proneness were presented with happy and angry faces and were later asked to recognise the same faces displaying a neutral expression. They also had to remember what the initial expressions of the faces had been. Remember/know/guess judgments were asked for both identity and expression memory. Results showed that delusion-prone participants better recognised the identity of angry faces compared to non-delusional participants. Also, this difference between the two groups was mainly due to a greater number of remember responses in delusion-prone participants. These findings extend previous studies by showing that delusions are associated with a memory bias for threat-related stimuli. r

We report a case of recurrent psychosis, spanning decades, with full inter-episode recovery and minimal functional impairment. While it is difficult to classify this disorder using DSM IV-TR criteria, Leonhard and others have described a 'cycloid psychosis' that correlates well with the phenomenology and course of this case. We believe this may represent a subset within the ICD-10 category of 'acute and transient psychotic disorders'. While this disorder, of unknown incidence, is not well reported in the U.S., it is worthy of further investigation and clinical attention given its generally favorable prognosis and potentially distinct pathophysiology and treatment.

A 70-year-old male patient reported to the Department of Neurology, Dr. Ram Manohar Lohia Hospital in New Delhi for the chief complaint of forgetfulness for the last 8 years with agitated behavior and disinhibited sexuality. For the last five years, the patient started using sexually explicit language, which was out of keeping with his premorbid history. He then started touching and grabbing his wife's genitals in front of family members.Upon further probing, it was found that he forced his wife to have sexual intercourse with him 3–4 times during the night and when he gets the opportunity during the daytime. If she refused, he would become aggressive and violent and beat her severely. He also made sexual advances towards other females around him and passes indecent remarks. He has been observed masturbating by caregivers.A mental status examination revealed that the patient was poorly groomed and unkempt. He had delusions of persecution, reference, and infidelity. Auditory hallucinati ...

Après avoir proposé un cadre théorique permettant d'intégrer les contributions des approches du constructivisme social et de la biologie dans la compréhension des maladies mentales en général et de la maladie dépressive en particulier, les auteurs soulignent le faible nombre de publications mentionnant un lien direct entre les facteurs socio-culturels et la sévérité de la dépression. Par contre, des arguments indirects existent qui sont regroupés en deux entités, les modifications selon les cultures de l'expression clinique (somatisation, idées délirantes) d'une part, le poids des représentations sociales et individuelles de la maladie dépressive et ses conséquences en termes de stigmatisation d'autre part. Ces variations transculturelles modulent le processus de recherche de soins et donc l'évolution de la maladie dans le sens d'une gravité plus importante. Les auteurs font remarquer pour conclure que la proposition initiale pourrait être inversée puisque certains avancent que la place centrale occupée par le diagnostic de dépression est un fait de civilisation, voire le symptôme de la sévérité du malaise de la société occidentale.

Background: Cocaine can induce transient psychotic symptoms. We examined the phenomenology of such cocaine-induced psychosis (CIP) using a modified version of the Scale for Assessment of Positive Symptoms (SAPS), a well-validated instrument for the assessment of schizophrenic psychosis. Methods: We developed a new instrument, the Scale for Assessment of Positive Symptoms for Cocaine-Induced Psychosis (SAPS-CIP), based on the well-validated SAPS. We interviewed 243 unrelated cocaine-dependent adults using both the SAPS-CIP and an instrument for the identification of cocaine-induced paranoia, the Cocaine Experience Questionnaire (CEQ). Results: One hundred and eighty-one (75%) of the subjects endorsed CIP using the CEQ. With the SAPS-CIP, hallucination (HAL) and delusion (DEL) scores correlated strongly, and the DEL domain showed excellent concurrent validity with the CEQ. We observed significant positive correlations, respectively, between severity of HAL and DEL, and lifetime number of episodes of cocaine use, and negative correlations with age at onset of cocaine use. Conclusions: The results suggest that CIP consists of transient delusional and hallucinatory symptoms, which tend to occur together and co-vary in severity. It appears that rating cocaine-induced paranoia alone (e.g., with the CEQ) can identify most subjects experiencing CIP. However, the SAPS-CIP is useful for quantifying the severity of CIP according to operational criteria. Our data provide additional evidence that CIP is a sensitizing response.

Lilliputian hallucinations have been described in patients with delirium, schizophrenia, seizure disorders, visual disturbances, and brain tumors. The authors report two cases of patients with lilliputian hallucinations, one with AIDSdementia complex and the other with dementia following head trauma. This is the first time that lilliputian hallucinations have been described in association with such medical conditions.

Objective: To provide a systematic review of selected experimental studies of psychosocial treatments of behavioral disturbances in dementia. Psychosocial treatments are defined here as strategies derived from one of three psychologically oriented paradigms (learning theory, unmet needs and altered stress thresholds).

Nearly half a century ago B. F. Skinner proposed the hypothesis that human superstitiousness would be equivalent to the 'superstitious' behavior displayed by animals in operant situations involving response-independent reinforcement. Surprisingly, no attempt has ever been made to test this equivalence hypothesis experimentally. In the light of recent evidence for a common neurological basis of both superstitious beliefs held by normal subjects and delusional ideas of psychotic patients, Skinner's hypothesis has become topical again. We present an extension of the hypothesis which assumes dysfunction of the medial temporal lobe, in particular of the hippocampus, to be responsible for conditioned superstitions in animals, for common everyday superstitions, and for schizophrenic delusions. This hypothesis is based on (1) the observation of an enhanced 'superstitious' reactivity in hippocampectomized animals, (2) findings of an increased occurrence of popular superstitions in patients with a temporal-limbic epileptic focus, and (3) morphological and pharmacological evidence for schizophrenic delusions to be causally related to hippocampal damage.

Previous research has highlighted increased risk for schizophrenia in Afro-Caribbeans as well as over-representation in the prison population. This small-scale study examined the relationship between criminality, ethnicity, and psychosis-proneness in a male prison sample. Twenty British Caucasian and 20 Afro-Caribbean prisoners were divided into equal sub-groups of violent and non-violent offenders. Participants completed measures of schizotypy, delusional ideation, and hostility. Afro-Caribbean offenders scored more highly on negative schizotypy and delusional ideation than their Caucasian counterparts. Violent offenders scored more highly on the positive symptoms of schizotypy than nonviolent prisoners. Both ethnicity and violent offending may be relevant factors when considering vulnerability to psychosis in the offending population.

This article posits that the DSM-5 and its psychiatric diagnoses are a monumental artifact of social power rather than a useful system for naming, describing, classifying, or understanding mental disorders. Two biographic documentaries, Crumb and Jupiter's Wife, are examined as alternative information about people with severe mental, behavioral, and emotional disturbances, which ordinarily would be diagnosed as schizophrenia or a related psychotic disorder. In contrast to the disease processes implied by psychiatric diagnoses, these detailed documentaries revealed particular social (e.g., lack of positive role models, bullying), environmental (e.g., poverty, homelessness), and historical (e.g., child abuse, failure in school) factors that might have brought about the individual's personal problems. Seeing people in the actual places where they live and hearing about their struggles first-hand can evoke sympathy and empathy in viewers, potentially freeing them from the technical abstractions and pathological attributions inherent in psychiatric diagnoses.

Methamphetamine (METH) is a powerful central nervous system stimulant which elevates mood, alertness, energy levels and concentration in the short-term. However, chronic use and/or at higher doses METH use often results in psychosis, depression, delusions and violent behavior. METH was formerly used to treat conditions such as obesity and attention deficit hyperactivity disorder, but now is primarily used recreationally. Its addictive nature has led to METH abuse becoming a global problem. At a cellular level, METH exerts a myriad of effects on the central and peripheral nervous systems, immune system and the gastrointestinal system. Here we present how these effects might be linked and their potential contribution to the pathogenesis of neuropsychiatric disorders. In the long term, this pathway could be targeted therapeutically to protect people from the ill effects of METH use. This model of METH use may also provide insight into how gut, nervous and immune systems might break down in other conditions that may also benefit from therapeutic intervention.

Background Atypical antipsychotics may be beneficial in treating the core psychopathology of anorexia nervosa (AN). Methods An 8 week open-label study of quetiapine was conducted in eight severely ill DSM-IVAN patients consecutively admitted to a specialist eating disorders unit. Participants were assessed by EDE-12, MADRS, YBOCS, SAPS-delusions and CDR neuropsychological battery at baseline, 4 weeks and 8 weeks, and by weekly body mass index (BMI), CGI and extrapyramidal scores. Quetiapine doses ranged from 50 mg to 800 mg per day, according to efficacy and tolerability. Results Seven participants completed 4 weeks and five participants completed 8 weeks. All participants had clinically significant levels of specific eating disorders psychopathology, and mild to moderately severe depressive symptomatology. Apart from initial mild sedation, no subjects experienced any significant adverse events. Over 4 weeks there was no significant difference in BMI, but a significant difference in the EDE-12 restraint score. There were significant differences on BMI and EDE-12 restraint subscale scores over 8 weeks.

The main goal of this dissertation is to show the results of Michael Persingers research on the mystic states of consciousness from the third person perspective. In this paper also my own studies based on TMS rule will be shown. The research did in the 1973 by Andrew Greeley et al. clearly show that a 87 million (37%) people who live in the US had at least one experience of sensed presence. How-ever there was many studies on the mystic states of consciousness, many of them was rather phenomenological analysis than a science. This study shows that third person approach to the mystic has real explanatory power.
The second goal of this dissertation is to show the importance of the third person approach in the philosophical disciplines connected to anthropology. Using the third person methods in the research on traditional subjects is not the depreciation of these subjects. Just in opposite – using the scientific methods in the right way, we can save the traditional subjects from the devaluation.

Delusions are explanations of anomalous experiences. A theory of delusion requires an explanation of both the anomalous experience and the apparently irrational explanation generated by the delusional subject. Hence, we require a model of rational belief formation against which the belief formation of delusional subjects can be evaluated. Method. I first describe such a model, distinguishing procedural from pragmatic rationality. Procedural rationality is the use of rules or procedures, deductive or inductive, that produce an inferentially coherent set of propositions. Pragmatic rationality is the use of procedural rationality in context. I then apply the distinction to the explanation of the Capgras and the Cotard delusions. I then argue that delusions are failures of pragmatic rationality. I examine the nature of these failures employing the distinction between performance and competence familiar from Chomskian linguistics. Results. This approach to the irrationality of delusions reconciles accounts in which the explanation of the anomalous experience exhausts the explanation of delusion, accounts that appeal to further deficits within the reasoning processes of delusional subjects, and accounts that argue that delusions are not beliefs at all. (Respectively, one-stage, two-stage, and expressive accounts.) Conclusion. In paradigm cases that concern cognitive neuropsychiatry the irrationality of delusional subjects should be thought of as a performance deficit in pragmatic rationality.

Objective: Body dysmorphic disorder (BDD) is characterized by severe dissatisfaction with one ' s appearance. The aim of this study was to examine belief characteristics in BDD, particularly delusional beliefs and their relationship to other cognitive styles. Methods: Fourteen DSM-IV BDD patients and 14 matched control participants completed questionnaires that measured delusions, creative experiences, self-esteem, self-ambivalence, depression and anxiety symptoms. Results: BDD patients endorsed three times as many delusional beliefs as controls, but the number of delusional ideas in the BDD sample was on a continuum and did not divide patients into two discrete groups. Additionally, the BDD group had higher fantasy proneness, lower self-esteem, higher self-ambivalence and higher depression and anxiety. Conclusions: The data support the conceptualization of BDD as a single disorder with varying degrees of delusional thinking and suggests that BDD should not be dichotomized according to the presence or absence of delusional thinking, as is currently the case in the DSM-IV.

Background Ketamine has previously been shown to induce delusion-like or referential beliefs, both acutely in healthy volunteers and naturalistically among nonintoxicated users of the drug. Delusions are theoretically underpinned by increased superstitious conditioning or the erroneous reinforcement of random events. Materials and methods Using a novel and objectively measured superstitious conditioning task, experiment 1 assessed healthy volunteers before and during placebo (n= 16), low-dose (n=15), and high-dose ketamine (n=16) under randomized and double-blind conditions. Experiment 2 used the same task to compare ketamine users (n=18), polydrug controls (n=19), and nondrug-using controls (n=17). Results In experiment 1, ketamine produced dose-dependent psychotomimetic effects but did not cause changes in superstitious conditioning. Experiment 2 found increased levels of superstitious conditioning among ketamine users compared to polydrug and nondrug-using controls, respectively, as evidenced by both objective task responses and subjective beliefs following the task.

This paper defines concepts of culture, ethnicity, and paranoia. It then explores the relationship between culture and ethnicity and the development of paranoia both in mental health settings and in the wider world. The importance of cultural awareness training while dealing with an ethnic population in any multicultural setting is emphasized. When exploring paranoia, proper exploration of its genesis is essential to distinguish between pathological and nonpathological paranoia.

Гуманитарные дисциплины, чьим традиционным предметом изучения был и остается текст, все чаще прибегают к рассмотрению психофизиологической реальности, обуславливающей и регулирующей текстопорождение. По всей видимости, целый ряд вопросов, центральных для лингвистики, философии языка, нарратологии, фольклористики и литературоведения, не может обоснованно обсуждаться без обращения к когнитивным и ментальным характеристикам говорящего. Таковы, например, общие проблемы языковой коммуникации: соотношение языка и идиолекта; возникновение и бытование дискурсов и речевых жанров; соотношение канона и импровизации при восприятии, передаче и воспроизведении текста, -список тем практически не ограничен. Примечательной при этом кажется современная тенденция гуманитарных дисциплин привлекать нетиповые текстуальные материалы, маргинальные по условиям порождения и/или функционирования. Достаточно упомянуть о повышенном интересе последних десятилетий к лингвистике измененных состояний сознания, к вербальной продукции билингвов или душевнобольных в противовес языковой норме, к наивной литературе в противовес художественной, к словотворчеству экзотических социальных или географических популяций в противовес мажоритарным. Очевидно, вследствие относительной прозрачности языка как семиотического медиума (приведшей, в частности, к известному игнорированию значимости языка в психиатрической практике), связи между порождаемыми текстами и порождающим сознанием тем заметнее, чем дальше эти тексты отстоят от стандартного, принятого речевого узуса.

Pour citer cet article : Graux J, et al. Les cénesthopathies : un trouble des émotions d'arrière plan. Regards croisés des sciences cognitives et de la phénoménologie. Encephale (2010), Résumé Les notions de cénesthésie et cénesthopathie ont eu une influence considérable sur la psychiatrie du xix e et du début du xx e siècle. La cénesthésie caractérise une forme de perception globale, implicite et affective du corps. Les cénesthopathies sont une entité clinique résultant d'une forme d'altération de la cénesthésie, qui se caractérise par des sensations corporelles anormales ou étranges. Dans cette revue de la littérature, nous reprenons l'histoire et l'évolution de ces deux concepts, pour évaluer leur influence contemporaine dans la clinique, la nosographie, la phénoménologie et les neurosciences cognitives. Aujourd'hui, si les notions de cénesthésie et cénesthopathie ont en grande partie perdu leur usage en psychiatrie, il en demeure cependant des traces dans notre clinique et nos nosographies contemporaines parfois sous le nom de nouveaux concepts. Plus encore, ces concepts sont actuellement redécouverts au profit des recherches entreprises dans le champ des neurosciences, notamment à travers les modèles de la neuropsychiatrie cognitive des délires.