Understanding, treating, and renaming grandiose delusions: A qualitative study
Louise Isham1,2, Laura Griffith3, Anne-Marie Boylan4
1Oxford Cognitive Approaches to Psychosis (O-CAP), Department of Psychiatry, University of Oxford, UK.
Psychology and Psychotherapy
|December 1, 2019
Summary
Grandiose delusions cause significant harm across multiple life domains. Patients find these beliefs meaningful, and psychological interventions targeting maintenance factors like belief meaning and anomalous experiences may help.
Area of Science:
- Psychiatry
- Psychology
Background:
- Grandiose delusions are under-researched psychotic experiences.
- Understanding patient experiences is crucial for effective treatment.
Purpose of the Study:
- To explore the harmful consequences of grandiose delusions from the patient perspective.
- To identify psychological mechanisms maintaining these delusions.
- To understand patient-desired support from clinical services.
Main Methods:
- Qualitative interview design.
- Thematic analysis and grounded theory.
- 15 patients with past or present grandiose delusions were interviewed.
Main Results:
- Patients reported physical, sexual, social, occupational, and emotional harms.
- Grandiose beliefs were highly meaningful, providing purpose, belonging, or self-identity.
- Maintenance factors included belief meaning, anomalous experiences, mania, fantasy, reasoning biases, and immersive behaviors.
Conclusions:
- Grandiose delusions are psychologically rich experiences with potential targets for psychological intervention.
- The term 'grandiose delusion' may be imprecise; 'delusions of exceptionality' is proposed as an alternative.
- Patients are receptive to psychological therapies for these experiences.
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