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Cogn Neuropsychiatry. 2006 Jul;11(4):402-15.

The inferiority complex in paranoia readdressed: a study with the Implicit Association Test.

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Universitätklinikum Hamburg-Eppendorf, Hamburg, Germany.



It has been theorised that patients with persecutory delusions display a lack of covert self-esteem (formerly termed the 'inferiority complex'), while at the same time displaying normal or even heightened levels of explicit self-esteem. However, the empirical basis for this assumption is inconsistent.


In view of apparent shortcomings of prior studies to assess implicit self-esteem, the Implicit Association Test was utilised to readdress this theory. The Rosenberg scale served as an index of overt self-esteem. A total of 23 schizophrenic patients, 13 of whom showed current symptoms of persecutory delusions, participated in the study; 41 healthy and 14 depressed participants served as controls.


Schizophrenic patients showed decreased levels of both implicit and explicit self-esteem relative to healthy controls. In line with recent studies, patients with current ideas of persecutory delusions displayed greater explicit self-esteem than nonparanoid patients.


The present study lends partial support for the notion that persecutory delusions serve as a defence against low implicit self-esteem, although the explicit self-esteem of these patients is still lower than in normal participants. Apart from abnormalities of attributional style, which have been assumed to convert low into high self-esteem, the assumption that a 'feeling of personal significance' heightens self-esteem in paranoid schizophrenia deserves further consideration.

[Indexed for MEDLINE]

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