The DOI matches its Crossref record; 157 of the 157 references it cites were found in a registry or an index.
Advances in understanding and treating persecutory delusions: a review
Open accessAbstract
PURPOSE: Persecutory delusions are a central psychotic experience, at the severe end of a paranoia spectrum in the general population. The aim of the review is to provide an introduction to the understanding of persecutory delusions, highlight key putative causal factors that have the potential to be translated into efficacious treatment, and indicate future research directions. METHODS: A narrative literature review was undertaken to highlight the main recent areas of empirical study concerning non-clinical and clinical paranoia. RESULTS: Six main proximal causal factors are identified: a worry thinking style, negative beliefs about the self, interpersonal sensitivity, sleep disturbance, anomalous internal experience, and reasoning biases. Each has plausible mechanistic links to the occurrence of paranoia. These causal factors may be influenced by a number of social circumstances, including adverse events, illicit drug use, and urban environments. CONCLUSIONS: There have been numerous replicated empirical findings leading to a significant advance in the understanding of persecutory delusions, now beginning to be translated into cognitive treatments. The first trials specifically focussed on patients who have persecutory delusions in the context of psychotic diagnoses are occurring. Initial evidence of efficacy is very promising.
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![Fig. 1 The distribution of total paranoia scores in the general population [15]](/paper-figures/87ad0b497ded46b4bfb6778576ff43c1/advances-in-understanding-and-treating-persecutory-delusions-a-review-figure-1.jpg)
![Fig. 2 The paranoia hierarchy [14]](/paper-figures/c80ae724d67c458d97361c81d531b206/advances-in-understanding-and-treating-persecutory-delusions-a-review-figure-2.jpg)
![Fig. 3 Outline of factors involved in delusion formation [31]](/paper-figures/4f71774d34e849a7ac745e505fdbf7d4/advances-in-understanding-and-treating-persecutory-delusions-a-review-figure-3.jpg)
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“Likewise, cognitive models of psychosis [23] emphasise the role of emotional processes, particularly anxiety, in the onset and maintenance cycle of psychotic symptoms [5, 24].”
From A brief CBT intervention for depersonalisation/derealisation in psychosis: Study protocol for a feasibility randomised controlled trial (2016) · cites this paper as [5]
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Cites
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Sprong, M., Schothorst, P., Vos, E., Hox, J., & Van Engeland, H. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.107.035899 · Cited by 832
Suspicious minds: The psychology of persecutory delusions
Freeman, D. (2007) · Clinical Psychology Review · doi:10.1016/j.cpr.2006.10.004 · Cited by 814
Self-citationCognitive approaches to delusions: a critical review of theories and evidence.
Garety, P. A., & Freeman, D. (1999) · British Journal of Clinical Psychology · doi:10.1348/014466599162700 · Cited by 794 · cited 1×
“ised from an updated search continuing on from our three earlier systematic literature reviews of delusions [24–26].”
BackgroundSelf-citationPsychological investigation of the structure of paranoia in a non-clinical population
Freeman, D., Garety, P. A., Bebbington, P. E., Smith, B., Rollinson, R., Fowler, D., Kuipers, E., Ray, K., & Dunn, G. (2005) · British Journal of Psychiatry · doi:10.1192/bjp.186.5.427 · Cited by 786
Self-citation
Research works printed but not linked: 2
- Tiernan B, Tracey R, Shannon C (2014) Paranoia and self-concepts in psychosis. Psychiatry Res 30:202–313
- Freeman D, Freeman J (2012) You can be happy: the scientifically proven way to change how you feel. Prentice Hall Life, Harlow
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Sorted by citations
Dudley, R., Taylor, P., Wickham, S., & Hutton, P. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv150 · Cited by 353
Reininghaus, U., Kempton, M. J., Valmaggia, L., Craig, T. K. J., Garety, P., Onyejiaka, A., Gayer-Anderson, C., So, S. H., Hubbard, K., Beards, S., et al. (2016) · Schizophrenia Bulletin · doi:10.1093/schbul/sbv190 · Cited by 304
Self-citationFreeman, D., Dunn, G., Startup, H., Pugh, K., Cordwell, J., Mander, H., Černis, E., Wingham, G., Shirvell, K., & Kingdon, D. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00039-5 · Cited by 295
Self-citationThe role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review
Reeve, S., Sheaves, B., & Freeman, D. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.09.001 · Cited by 273
“A focus on individual psychotic experiences has allowed development of detailed theoretical models, for example for paranoia (Freeman, Garety, Kuipers, Fowler, & Bebbington, 2002) accompanied by corresponding innovations in treatment (Freeman & Garety, 2014).”
BackgroundSelf-citationChildhood adversities and psychosis: evidence, challenges, implications
Morgan, C., & Gayer-Anderson, C. E. (2016) · World Psychiatry · doi:10.1002/wps.20330 · Cited by 278
Metadata
- Authors
- Freeman, D., & Garety, P.
- Affiliations
- Warneford Hospital (GB)
- King's College London (GB)
- Corresponding author
- Freeman, Daniel
- Venue
- Social Psychiatry and Psychiatric Epidemiology
- Published
- 2014-07-09
- Volume
- 49
- Issue
- 8
- Pages
- 1179-1189
- ISSN
- 0933-7954 (ISSN-L)
- 1433-9285
- PMC
- PMC4108844
- OpenAlex
- W2013939918
- Cited by
- 348
- References
- 157
- Citations by year
- 2026: 14 · 2025: 23 · 2024: 24 · 2023: 22 · 2022: 18 · 2021: 22 · 2020: 36 · 2019: 41 · 2018: 37 · 2017: 43 · 2016: 35 · 2015: 29 · 2014: 4
- FWCI
- 5.09
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Social Psychiatry and Psychiatric Epidemiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- South London and Maudsley NHS Foundation Trust
- National Institute for Health and Care Research (NF-SI-0510-10121)
- King's College London
- Medical Research Council (G0902308)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hallucinations in medical conditions
- Keywords
- persecutory delusions, paranoia, negative self-beliefs, interpersonal sensitivity, sleep disorders, reasoning biases, cognitive intervention, psychosis, illicit drug use, urban environment, life events
- MeSH terms
- Adult, Aged, Anxiety, Culture, Delusions, Female, Humans, Internal-External Control, Male, Middle Aged, Paranoid Disorders, Psychotic Disorders, Risk Factors, Schizophrenia, Paranoid, Severity of Illness Index, Thinking, Cognitive Behavioral Therapy
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