Cognitive factors maintaining persecutory delusions in psychosis: The contribution of depression.
Abstract
Depression is common in people with schizophrenia, but how it might directly contribute to the persistence of psychotic symptoms has rarely been tested. The key aim of the present study was to test whether depression and associated cognitive processes predict the maintenance of persecutory delusions. Three groups of participants were tested at baseline: 60 patients with persecutory delusions in the context of a schizophrenia spectrum diagnosis, 30 patients with depression, and 30 nonclinical controls. They completed interviewer and self-report assessments of depression and paranoia, and measures of six cognitive factors (schematic beliefs, experiential avoidance, autobiographical memory, problem solving, rumination, worry style). The patients with persecutory delusions were then assessed again, six months later. It was found that 50% of the patients with persecutory delusions met diagnostic criteria for major depression. Cognitive processes found to be associated with depression across the groups were negative schematic beliefs about the self, experiential avoidance and rumination, but not autobiographical memory or problem solving. The severity of initial depression in patients with persecutory delusions predicted the persistence of paranoia over six months. A number of cognitive factors also predicted the persistence of persecutory delusions, including negative schematic beliefs about the self, worry, and problem-solving difficulties. In conclusion, depression is common in patients with current persecutory delusions, and it shows similar cognitive features to major depressive disorder. The results of this study indicate that depression and related processes may contribute to the maintenance of paranoia. Trials are warranted of depression-related therapeutic techniques for people with persecutory delusions.
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Several studies have supported the correlation and predictive relationship between rumination and depressive symptoms, anxiety, positive symptoms and negative symptoms.
“Several studies have supported the correlation and predictive relationship between rumination and depressive symptoms,12,13 anxiety,13 positive symptoms13–16 and negative symptoms.17”
From Dispositional Mindfulness and Psychotic Symptoms in Schizophrenia Spectrum Disorders: The Mediating Roles of Rumination and Negative Emotion (2022) · cites this paper as [16]
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- Authors
- Vorontsova, N., Garety, P., & Freeman, D.
- Affiliations
- King's College London (GB)
- University of Oxford (GB)
- Venue
- Journal of Abnormal Psychology
- Published
- 2013-11
- Volume
- 122
- Issue
- 4
- Pages
- 1121-1131
- ISSN
- 0021-843X (ISSN-L)
- 1939-1846
- OpenAlex
- W2022646248
- Cited by
- 107
- References
- 83
- Citations by year
- 2026: 2 · 2025: 7 · 2024: 5 · 2023: 3 · 2022: 9 · 2021: 6 · 2020: 11 · 2019: 10 · 2018: 13 · 2017: 14 · 2016: 9 · 2015: 10 · 2014: 8
- FWCI
- 6.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Abnormal Psychology (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- UPT. Syiah Kuala University Library (Syiah Kuala University) (submittedVersion)
- Funders
- Department of Health
- South London and Maudsley National Health Service Foundation Trust and the Institute of Psychiatry, King’s College London
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- persecutory delusions, paranoia, depression, schizophrenia spectrum, experiential avoidance, rumination, worry, problem solving, autobiographical memory, cognitive processes
- MeSH terms
- Adult, Analysis of Variance, Cognition, Delusions, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychotic Disorders, Surveys and Questionnaires, Risk Factors, Schizophrenia, Paranoid, Schizophrenic Psychology, Case-Control Studies
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