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Neuropsychiatr Dis Treat. 2014 Dec 22;11:33-40. doi: 10.2147/NDT.S73906. eCollection 2015.

Defensive function of persecutory delusion and discrepancy between explicit and implicit self-esteem in schizophrenia: study using the Brief Implicit Association Test.

Author information

1
Department of Psychiatry, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
2
Gojouyama Hospital, Nara, Japan.
3
Yashio Hospital, Saitama, Japan.
4
Department of Psychiatry, Kyoto Second Red Cross Hospital, Kyoto, Japan.

Abstract

BACKGROUND:

If delusions serve as a defense mechanism in schizophrenia patients with paranoia, then they should show normal or high explicit self-esteem and low implicit self-esteem. However, the results of previous studies are inconsistent. One possible explanation for this inconsistency is that there are two types of paranoia, "bad me" (self-blaming) paranoia and "poor me" (non-self-blaming) paranoia. We thus examined implicit and explicit self-esteem and self-blaming tendency in patients with schizophrenia and schizoaffective disorder. We hypothesized that patients with paranoia would show lower implicit self-esteem and only those with non-self-blaming paranoia would experience a discrepancy between explicit and implicit self-esteem.

METHODS:

Participants consisted of patients with schizophrenia and schizoaffective disorder recruited from a day hospital (N=71). Participants were assessed for psychotic symptoms, using the Brief Psychiatric Rating Scale (BPRS), and self-blaming tendency, using the brief COPE. We also assessed explicit self-esteem, using the Rosenberg Self-Esteem Scale (RSES), implicit self-esteem, using Brief Implicit Association Test (BIAT), and discrepancy between explicit and implicit self-esteem.

RESULTS:

Contrary to our hypothesis, implicit self-esteem in paranoia and nonparanoia showed no statistical difference. As expected, only patients with non-self-blaming paranoia experienced a discrepancy between explicit and implicit self-esteem; other groups showed no such discrepancy.

CONCLUSION:

These results suggest that persecutory delusion plays a defensive role in non-self-blaming paranoia.

KEYWORDS:

coping style; external attribution; poor me paranoia; remitted paranoid delusion

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