The DOI matches its Crossref record; 87 of the 87 references it cites were found in a registry or an index.
Persecutory delusions: a cognitive perspective on understanding and treatment.
Open accessAbstract
A spectrum of severity of paranoia (unfounded thoughts that others are deliberately intending to cause harm) exists within the general population. This is unsurprising: deciding whether to trust or mistrust is a vital aspect of human cognition, but accurate judgment of others' intentions is challenging. The severest form of paranoia is persecutory delusions, when the ideas are held with strong conviction. This paper presents a distillation of a cognitive approach that is being translated into treatment for this major psychiatric problem. Persecutory delusions are viewed as threat beliefs, developed in the context of genetic and environmental risk, and maintained by several psychological processes including excessive worry, low self-confidence, intolerance of anxious affect and other internal anomalous experiences, reasoning biases, and the use of safety-seeking strategies. The clinical implication is that safety has to be relearned, by entering feared situations after reduction of the influence of the maintenance factors. An exciting area of development will be a clinical intervention science of how best to enhance learning of safety to counteract paranoia.
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“Psychological processes linked with this problem are cognitive fusion with internal experiences and maladaptive coping strategies such as experiential avoidance, thought suppression and worry (66, 98–100).”
From Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach (2023) · cites this paper as [66]
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“Paranoia is what results when that decision-making skews excessively to the negative so that judgments are inaccurate (Freeman, 2016).”
From A counterweight model for understanding and treating persecutory delusions. (2025) · cites this paper as Freeman, 2016
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Cites
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Psychological investigation of the structure of paranoia in a non-clinical population
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Cited by
Sorted by citations
Freeman, D. H., Bradley, J., Antley, A., Bourke, E., DeWeever, N., Evans, N., Černis, E., Sheaves, B., Waite, F., Dunn, G., et al. (2016) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.115.176438 · Cited by 243
The concomitants of conspiracy concerns
Freeman, D., & Bentall, R. (2017) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-017-1354-4 · Cited by 166
Bloomfield, M., Chang, T., Woodl, M. J., Lyons, L. M., Cheng, Z. H., Bauer‐Staeb, C., Hobbs, C., Bracke, S., Kennerley, H., Isham, L., et al. (2021) · World Psychiatry · doi:10.1002/wps.20841 · Cited by 161
Treatable clinical intervention targets for patients with schizophrenia
Freeman, D., Taylor, K. M., Molodynski, A., & Waite, F. (2019) · Schizophrenia Research · doi:10.1016/j.schres.2019.07.016 · Cited by 125
Self-citationReeve, S., Emsley, R., Sheaves, B., & Freeman, D. (2017) · Schizophrenia Bulletin · doi:10.1093/schbul/sbx103 · Cited by 131
Metadata
- Authors
- Freeman, D.
- Affiliations
- Warneford Hospital (GB)
- Corresponding author
- Freeman, Daniel
- ORCID
- Freeman, Daniel
- Venue
- The Lancet Psychiatry
- Publisher
- Elsevier BV
- Published
- 2016-07
- Volume
- 3
- Issue
- 7
- Pages
- 685-692
- ISSN
- 2215-0366 (ISSN-L)
- OpenAlex
- W2460693432
- Cited by
- 356
- References
- 87
- Citations by year
- 2026: 52 · 2025: 44 · 2024: 39 · 2023: 48 · 2022: 37 · 2021: 25 · 2020: 25 · 2019: 36 · 2018: 28 · 2017: 16 · 2016: 6
- FWCI
- 4.09
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Lancet Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute for Health and Care Research (RP-2014-05-003)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- persecutory delusions, paranoia, threat beliefs, cognitive approach, delusion maintenance, reasoning biases, excessive worry, low self-confidence, safety learning
- MeSH terms
- Cognition, Delusions, Humans, Randomized Controlled Trials as Topic
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