Persecutory delusions: A review and theoretical integration

Persecutoty (paranoid) delusions are a frequently observed clinical phenome non. In. recent years, an increasing volume of research has attempted to ex plain these types of beliefs in terms of psychological mechanisms. Theories have emphasized early experience, perceptual abnormalities, motivational f actors, and information-processing deficits. In this article we review rele vant findings, including our own studies of the role of causal attributions and theory of mind deficits. We propose a new integrative model that build s on this work. The core of the model is an account Of the way that causal attributions influence self-representations, which in turn influence future attributions: the attribution-self-representation cycle. We argue that bia ses in this cycle cause negative events lobe attributed to external agents and hence con tribute to the building of a paranoid world view. These abnor malities are amenable to investigation by functional neuroimaging, and rece nt studies have implicated specific areas of neuroactivation. However, thes e findings do not necessarily suggest that paranoid delusions are entirely biological in origin, and there is evidence that adverse early experience m ay play a role in determining the development of a cognitive vulnerability to paranoid thinking. (C) 2001 Elsevier Science Ltd. All rights reserved.