“Ego-Dystonic” Delusions as a Predictor of Dangerous Behavior

Abstract

This paper aims to report a possible warning sign for dangerous behavior in delusional psychotic patients. We demonstrate an association between aggressive or auto-aggressive ideation and "ego-dystonic" grandiose delusions, where the patient believes to possess unique qualities but finds them unbearable. The study is based on the sample of seven interviews with five psychotic in-patients at the Kfar Shaul Mental Health Center, Jerusalem, Israel. All patients experienced an acute psychotic episode, and committed acts of aggression or suicidality. The research method is narrative analysis of semi-structured interviews. Patients report ideas of grandiose self-identification with deities, Biblical figures or celebrities, yet report their reluctance to be in these high positions due to feelings of unworthiness, withdrawal, and social isolation. Resulting frustration arguably leads to aggressive and suicidal ideation or actions. Contrary to the established view, grandiose delusions are not free of association with (auto-)aggression. The patient's ego-dystonic attitude towards his/her delusional identity may serve as the warning sign for dangerous behavior and, as such, should be searched for and recognized by the mental health professionals.

Changes of intuition in paranoid personality disorder

“…The severity of paranoid delusions seems to correlate with the intensity of affectivity, such as fear and aggressive moods, which may potentially lead to violent behavior [e.g. ( 16 , 17 )]. Albeit coming with an increased risk for violence, especially in comorbidity with other disorders (such as antisocial personality disorder), this must not necessarily be the case in PPD.…”

The Default Space Theory of Consciousness: Phenomenological Support from Personal Observations and Clinical Deficits

“…This may result in beliefs that an infinite external space exists within themselves; therefore they believe they have an omnipotent power over the external world. These sufferers of grandiosity may feel that God or deities are within themselves, or that they are such beings [70]. However, they may not be able to deny their visceral, human nature, awakening them to thoughts that they cannot live up to such grandiose delusions.…”

“…However, they may not be able to deny their visceral, human nature, awakening them to thoughts that they cannot live up to such grandiose delusions. Reports of low self-esteem, aggressive behavior, or even suicide resulting from these delusions are not uncommon [70].…”