Psychological processes underlying delusional thinking in late-onset psychosis: a preliminary investigation

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Abstract

Background and aims

It has been suggested that delusions may serve as a defence against negative self-representations. The present study investigated general psychological well-being and evidence for defensive emotional processes among people with late-onset psychosis.

Method

The performance and responses of older people with late-onset psychosis (n = 13), older people with depression (n = 15), and age-matched healthy controls (n = 15) were compared in a cross-sectional design. Participants rated their own levels of depression and self-esteem, and completed an emotional Stroop task to establish whether there was evidence of implicit depression in the absence of explicit acknowledgement. Participants rated themselves on a number of personal attributes in relation to two life stages to generate discrepancies in ‘actual’, ‘ideal’ and ‘other’ self-concepts, and completed measures of their perceptions of current and past psychological well-being.

Results

People with late-onset psychosis showed no evidence of overt depression or low-self esteem. All three groups showed an attentional bias to depression-related and age-related words, although response times overall were faster for controls. The psychosis group showed no discrepancies between either their past or their current ‘actual’ and ‘other’ selfconcepts, suggesting that they do not have more negative views about how others see them.

Conclusions

Evidence from this study does not support the application of the ‘delusion-as-defence’ model to late-onset psychosis, but methodological constraints must be borne in mind when interpreting the findings.

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