Cognitive Factors Involved in Persecutory Delusions

Delirium isn't necessarily a symptom of persecutory delusions. However, this condition does feed on certain cognitive biases the intervention must focus on. Today's article will discuss them, along with the variables that feed it.

Persecutory delusions, be it in the context of schizophrenia, another delusional disorder, or a brief psychotic one, have different categories: delusions of guilt, grandeur, of control, and of persecution, among many others.

Although they’re associated with insanity and it’s believed that delusions can’t be explained, this isn’t entirely true. Some cognitive factors are known to be involved in an individual developing and maintaining the type of delusions of persecution.

A delusion is part of the broad spectrum of symptoms that may be present in schizophrenia or a brief psychotic disorder. It’s the main symptom of persecutory delusions.

Delusions don’t imply that a person is insane: it isn’t a mechanism foreign to mentally healthy people. In fact, it adds a hopeful idea: as researchers understand it, delirium could disappear by modifying some cognitive schemes. Today’s article will present and explain those cognitive factors involved in persecutory beliefs.

What exactly are persecutory delusions?

A delusion is a set of erroneous beliefs or misinterpretations of perceptions or experiences. These ideas are still there regardless of the extensive evidence to the contrary and don’t manifest in the majority. This complicates intervention in disorders such as schizophrenia when associated with delusions.

Some individuals believe that events, details, or phrases are personal to them in every way and have a special significance — delusion of reference. Others think their body is sick and changing or that their face is becoming square or their leg is growing — delirium of somatic type. Then there are those who think someone is out to get them: persecutory delusion.

The latter, the subject of this article, refers to a strong belief that there’s a conspiracy against the person experiencing the delusion. They feel someone is after them and even searching their belongings and tapping their phone. In addition, they can easily suspect many people, even close associates, of being a part of this conspiracy.

For example, a person begins to have this kind of delusion and thinks their people are conspiring against them and intend to kill them to keep their house. They tell people close to them and even give them evidence. Then, the family member may try to convince them otherwise and even show them evidence. However, this only strengthens their belief and now they’re convinced that this person is also a part of the conspiracy. Thus, it promotes social isolation and leads to the deterioration of family relationships.

In fact, this can also happen to the therapist when they’re undergoing psychological treatment. The therapists are now also part of the conspiracy because they insist the concerns are mere delusions. As you can imagine, the treatment of persecutory delusions is quite challenging.

Cognitive factors common to persecutory delusions

Researchers determined that people with persecutory delusions have several common cognitive factors through various studies. These enhance the delusion and explain, to some extent, why delusional people continue to find evidence to support their idea that someone is out to get them.

Attentional and memory biases

There are many attentional biases. In fact, those events that confirm the person’s delusion are particularly significant for them. This also happens to people with social phobias.

For example, they tend to avoid looking at eyes and mouths (since these are the features that most identify facial expressions) in order to avoid feeling threatened. In addition, they tend, as a result of this bias, to remember more threatening information much more vividly — angry faces rather than happy ones.

All this ultimately translates into the fact that they’re highly sensitive to social punishment. In fact, they see others as a threat. Also, in their day-to-day lives, they detect a greater number of angry friends or peers.

In addition to the attentional bias, this also happens because they can interpret any message that reaches them in this regard. In other words, thinking the other is angry when this isn’t the case.

Information elaboration processes

There are also processes of hypothesis generation that are different from those of the general population in people with persecutory delusion. Observable biases help collect information that’s different from the rest, reaffirming the basic idea that someone is after them. Some of these cognitive factors are:

• Probabilistic reasoning. These individuals quickly jump to conclusions. They do so without thinking, availing themselves of “likelihood”. This means they need less information than average to make a decision. This is because they’re confident they’re right. The problem comes when this probabilistic reasoning is also used with emotional material.
• Covariation biases. Similarly, these individuals make quick associations between events. Hence, they make erroneous associations between situations or events that have nothing to do with each other.
• Self-referential biases. These individuals see themselves as the main characters of a movie or drama. Everything is about them (the attitudes of their peers, comments, conversations…). In addition, the defensive or aggressive attitude of the person experiencing delirium means they’re often not treated well. Of course, such treatment is only more proof that everyone’s against them.

Causal attributions: what’s my fault and what’s yours?

There’s also another bias within the cognitive factors: the self-serving and externalizing one. From it, a person elaborates causal attributions of events and all negative ones are everyone else’s fault. This happens because others are threatening. Thus, they’re responsible for everything bad that comes their way.

This achieves two things. It feeds the delusion because it confirms they’re bad people and do bad things. Also, the avoidance of the person’s guilt with persecutory delusions. This bias is adaptive and reduces the discomfort created by the delusion itself.

In addition, these people tend to give extraordinary explanations for everything that happens to them, both physical and emotional. They attribute their own difficulties in everyday life to implausible causes and think things like “I’m being watched. The government is sending me electromagnetic waves and these give me a headache.”

Finally, they often present somatic sensations, such as anxiety, headaches, or itching, which they often interpret as indicators that others are doing them wrong.

Persecutory delusions – ideas of justice and goodness as part of the problem

Finally, there are certain ideas about the world that are rather particular within the cognitive factors of persecutory delusions. Is the world fair? Subjects with depression tend to think the world is equally fair. The general population tends to think it’s a little fairer to themselves. However, it’s the opposite in the case of people with persecutory delusions. This is because they think the world is much more unfair to them.

The deeper beliefs of people with delusions about justice, goodness, and the value of humanity are different. The idea that others are treated better not only erodes self-esteem, it’s also what determines and filters all other thoughts and cognitive processes.

Every emotion, thought, and action is tainted by the idea that the world is unfair and that no one can be trusted. This can feed an individual with feelings of inferiority, obviously damaging their self-esteem, which can lead them to try to feel better through adaptive mechanisms: the persecutory belief, where nothing that happens is their fault.

The conclusion to draw here is that, many times, people focus on the content of the delusion rather than on the cognitive factors that have led to it when it comes to delusional disorders. Many simply think these people are “crazy” when the development of a persecutory delusion actually makes perfect sense. One can explain it and, therefore, treat it.

Focusing less on falsifying the delusional patient’s story and more on working with biases and dysfunctional cognitive schemas can improve their situation without running the risk of the therapist becoming part of the delusion.