Cognitive therapy of delusional beliefs

Alford, Brad A.; Beck, Aaron T.

doi:10.1016/0005-7967(94)90134-1

Cited by 79 publications

(37 citation statements)

References 28 publications

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“…41 One therapeutic strategy springing from this point is the normalization of beliefs. Both Alford and Beck 42 and Kingdon and Turkington 43 point out that there is much subcultural hostility and criticism to psychotic content and so they suggest normalizing delusional beliefs by relating them to more culturally acceptable belief, to destigmatize the delusions and also show the link between delusional preoccupation and current stress. These authors report symptom improvement as a consequence of normalization.…”

Section: Normalizing Fixed Beliefsmentioning

confidence: 99%

Cognitive and Meta-cognitive Dimensions of Psychoses

O’Connor

2009

Can J Psychiatry

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T he cognitive approach distinguishes between the normality of psychotic experiences and the later appraisal and (sub)cultural context making sense of the experience and emotional reaction to the thoughts. A key claim here is that the symptoms of a psychotic experience, for example, voice hearing, delusions, persecutory ideas, and dissociations, are all phenomena that have been experienced at one time by most people without psychosis. What makes the symptoms more persistent in the case of psychosis is a peculiar combination of emotional stress, feelings of vulnerability, threat appraisals, cognitive styles, and cultural and personal beliefs that together create distress and dysfunction about anomalous experiences.Thus cognitive models represent a sharp shift away from a medical model focusing on symptoms toward viewing the psychotic experiences as a product of an interaction of several psychological process dimensions. Further, most of these process dimensions, which include external attribution, threat appraisal, resistance to thoughts coupled with low self-esteem, and fluctuations in affective state, if taken separately, constitute also processes present in different degrees in nonclinical populations. This paper outlines cognitive approaches to understanding and treating positive psychotic symptoms, such as hallucinations, delusions, and dissociations. Recent cognitive accounts of psychosis are reviewed along with the claim that it is not the symptoms themselves but cognitive and meta-cognitive appraisals (attributions and beliefs) about the significance of the symptoms that cause distress and dysfunction. Psychotic symptoms do lie on a continuum with normal experience. Cognitive appraisal dimensions may interact with reasoning styles such as inferential confusion, cognitive slippage, fantasy proneness, and perceptual immersion (styles also normally distributed in the population) and together persuade the person with psychosis to live in fictional narratives as if they were real. Recent clinical studies suggest that addressing beliefs about symptoms modifying inferential styles and normalizing experiences may help symptom management.Can J Psychiatry. 2009;54(3):152-159. Highlights· Psychoeducation techniques normalizing anomalous experiences in psychosis could help relieve symptom distress. · Cognitive therapy may usefully target beliefs and meta-worries in response to anomalous experiences rather than the experiences themselves. · Hallucinations and delusions may not result from perceptual distortion but rather from cognitive styles, which encourage cognitive, affective, and sensory immersion in fictional narratives.that the thought has been injected into them by an evildoer, instead of treating the sensation as a maturational event.Someone who understands that stress narrows attention may well let go that they forgot an important errand when stressed. For someone who does not or cannot accept such forgetfulness, even under stress, some other unusual cause must be sought and the memory lapse means they are m...

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Section: Normalizing Fixed Beliefsmentioning

confidence: 99%

Cognitive and Meta-cognitive Dimensions of Psychoses

O’Connor

2009

Can J Psychiatry

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“…20 It seems crucial to initially adopt an accommodating and nonconfrontational approach. Alford and Beck 21 suggest that, in allowing the patient free rein to talk, the therapist can gradually make the link between external stressors, emotion, and beliefs, leading to a joint exploration of alternative explanations for certain beliefs. A study by Chadwick and Lowe, 10 preparatory interviews lasting from 6 to 12 sessions were spent with each individual before the delusions were challenged.…”

Section: Discussionmentioning

confidence: 99%

Treating Delusional Disorder: A Comparison of Cognitive-Behavioural Therapy and Attention Placebo Control

O’Connor¹,

Stip²,

Pélissier³

et al. 2007

Can J Psychiatry

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Cognitive-behavioural therapy (CBT) has proved effective in treating delusions, both in schizophrenia and delusional disorder (DD). Clinical trials of DD have mostly compared CBT with either treatment as usual, no treatment, or a wait-list control. This current study aimed to assess patients with DD who received CBT, compared with an attention placebo control (APC) group. Method: Twenty-four individuals with DD were randomly allocated into either CBT or APC groups for a 24-week treatment period. Patients were diagnosed on the basis of structured clinical interviews for mental disorders and the Maudsley Assessment of Delusion Schedule (MADS). Results: Completers in both groups (n = 11 for CBT; n = 6 for APC) showed clinical improvement on the MADS dimensions of Strength of Conviction, Insight, Preoccupation, Systematization, Affect Relating to Belief, Belief Maintenance Factors, and Idiosyncrasy of Belief. Conclusion: When compared with APC, CBT produced more impact on the MADS dimensions for Affect Relating to Belief, Strength of Conviction, and Positive Actions on Beliefs.

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“…Take the case of Cognitive Behavioural Therapy (CBT), perhaps the most popular ap roach to the treatment of delusions. This ap roach is premised in the idea that delusions are a type of belief (Alford and Beck, 1994). One of the main technics of CBT consists in questioning the patient's delusional belief in light of counterevidence (Dickerson, 2000).…”

Section: The Argument About Responsivenessmentioning

confidence: 99%

The typology problem and the doxastic approach to delusions

López-Silva

2016

Filosofia Unisinos

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This paper explores one of the most fundamental philosophical worries underlying the occurrence of delusions, namely, the problem about the specific type of mental state that grounds a delusional report or, as I shall call it, 'the typology problem'. The analysis is developed as follows: (i) After formulating and circumscribing the target problem, (ii) I explore the main tenets and advantages of the doxastic view of delusions, perhaps, the strongest candidate currently available within the typology debate. (iii) After, I clarify and evaluate four of the main counter-arguments against the doxastic view offering a number of counter replies to these attacks. (iv) Finally, I conclude that the anti-doxastic argumentation offers no good reasons to abandon the doxastic model and that this model does not need to appeal to external resources to reply to such counter-arguments. At the same time, I finalize with some of the challenges that remain open within the doxastic view.Keywords: psychosis, delusions, doxastic view of delusions, typology problem. RESUMOEsse artigo explora uma das preocupações filosóficas mais fundamentais que subjazem à manifestação de delírios, a saber, o problema do tipo específico de estado mental que fundamenta um relato de delírio -o que chamarei de 'problema tipológico'. A análise empreendida é desenvolvida do seguinte modo: (i) Após formular e circunscrever o problema-alvo, (ii) exploro os principais comprometimentos e vantagens da explicação doxástica dos delírios, que é talvez a mais forte dentre as soluções propostas dentro do debate tipológico. (iii) A seguir, esclareço e avalio quatro dos principais argumentos contra a explicação doxástica, oferecendo réplicas a esses ataques. (iv) Finalmente, concluo que a argumentação anti-doxástica não oferece boas razões para abandonarmos o modelo doxástico e argumento que esse modelo não precisa apelar a recursos externos para responder aos argumentos anti-doxásticos. Termino o artigo expondo alguns desafios ao modelo doxásti-co que permanecem em aberto.Palavras-chave: psicose, delírios, visão doxástica de delírios, problema tipológico.

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Cognitive therapy of delusional beliefs

Cited by 79 publications

References 28 publications

Cognitive and Meta-cognitive Dimensions of Psychoses

Cognitive and Meta-cognitive Dimensions of Psychoses

Treating Delusional Disorder: A Comparison of Cognitive-Behavioural Therapy and Attention Placebo Control

The typology problem and the doxastic approach to delusions

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