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Cited by 48Schizophrenia research and treatmentMental Health and PsychiatryClinical Reasoning and Diagnostic Skills

The use of intuitive and analytic reasoning styles by patients with persecutory delusions

Freeman, Daniel, Lister, Rachel, Evans, Nicole·2014·Journal of Behavior Therapy and Experimental Psychiatry
DOI 10.1016/j.jbtep.2014.06.005
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Abstract

Background and objectives A previous study has shown an association of paranoid thinking with a reliance on rapid intuitive ('experiential') reasoning and less use of slower effortful analytic ('rational') reasoning. The objectives of the new study were to replicate the test of paranoia and reasoning styles in a large general population sample and to assess the use of these reasoning styles in patients with persecutory delusions.Method 30 Patients with persecutory delusions in the context of a non-affective psychotic disorder and 1000 non-clinical individuals completed self-report assessments of paranoia and reasoning styles.Results The patients with delusions reported lower levels of both experiential and analytic reasoning than the non-clinical individuals (effect sizes small to moderate). Both self-rated ability and engagement with the reasoning styles were lower in the clinical group. Within the non-clinical group, greater levels of paranoia were associated with lower levels of analytic reasoning, but there was no association with experiential reasoning.Limitations The study is cross-sectional and cannot determine whether the reasoning styles contribute to the occurrence of paranoia. It also cannot be determined whether the patient group's lower reasoning scores are specifically associated with the delusions.Conclusions Clinical paranoia is associated with less reported use of analytic and experiential reasoning. This may reflect patients with current delusions being unconfident in their reasoning abilities or less aware of decision-making processes and hence less able to re-evaluate fearful cognitions. The dual process theory of reasoning may provide a helpful framework in which to discuss with patients decision-making styles.

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  • The sample size was calculated to provide 90% power to detect a small effect size in paranoia (standardised mean difference 0.15) with 2614 participants, accounting for 40% attrition.

    “Based on the SDs observed from a previous study29 for the GPTS (SD 10·4), a total sample size of 2614 participants (ie, 1307 per group) would provide 90% power to detect a small effect size in paranoia, with a standardised mean difference of 0·15, while accounting for a high amount of expected attrition (40%).”

    From The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis (2017) · cites this paper as [29]

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Authors
Freeman, D., Lister, R., & Evans, N.
Affiliations
University of Oxford (GB)
Corresponding author
Freeman, Daniel
ORCID
Freeman, Daniel
Venue
Journal of Behavior Therapy and Experimental Psychiatry
Publisher
Elsevier BV
Published
2014-12
Volume
45
Issue
4
Pages
454-458
ISSN
0005-7916 (ISSN-L)
DOI
10.1016/j.jbtep.2014.06.005
OpenAlex
W2078309210
Cited by
48
References
27
Citations by year
2026: 13 · 2023: 3 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 5 · 2018: 6 · 2017: 4 · 2016: 6 · 2015: 3 · 2014: 1
FWCI
3.56
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
Medical Research Council (MRC) (G0902308)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
  • Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords
persecutory delusions, paranoia, intuitive thinking, analytical thinking, dual-process theory, reasoning styles, non-affective psychosis, decision-making
MeSH terms
Adult, Consciousness, Delusions, Female, Humans, Male, Middle Aged, Paranoid Disorders, Psychiatric Status Rating Scales, Thinking, Intuition, Young Adult, Self Report

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