Tuesday, September 09, 2008

MENTAL HEALTH - Persecutory Delusions


Persecutory Delusions



What Are Persecutory Delusions?

     Persecutory Delusions, sometimes called Querulant delusions, are when a person believes (wrongly) that they are being picked on, or threatened by someone/something else.

     This can be someone familiar to them (e.g. a family member, friend, group), someone in the media (e.g. a film star), an organisation (e.g. the CIA), or even aliens.

It is classed under a group of Disorders known as the Delusional (Paranoid) Disorders.

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Paranoia/Definition
     Paranoia is an unfounded or exaggerated distrust of others, sometimes reaching delusional proportions. Paranoid individuals constantly suspect the motives of those around them, and believe that certain individuals, or people in general, are "out to get them."

What is Paranoia?
     Paranoia involves feelings of persecution and an exaggerated sense of self-importance. Paranoia occurs in many mental disorders and is rare as an isolated mental illness. Since the delusions involve only one area, a person with paranoia can usually work and function in everyday life, however, their lives may be limited and isolated. There are different types of paranoia including conjugal paranoia, erotomania, hypochondriacal paranoia, and different types of paranoid disorders such as paranoid personality and paranoid schizophrenia.

Description
     Paranoid perceptions and behavior may appear as features of a number of mental illnesses, including depression and dementia, but are most prominent in three types of psychological disorders: paranoid schizophrenia, delusional disorder (persecutory type), and paranoid personality disorder (PPD).

     Individuals with paranoid schizophrenia and persecutory delusional disorder experience what is known as persecutory delusions: an irrational, yet unshakable, belief that someone is plotting against them.

     Persecutory delusions in paranoid schizophrenia are bizarre, sometimes grandiose, and often accompanied by auditory hallucinations. Delusions experienced by individuals with delusional disorder are more plausible than those experienced by paranoid schizophrenics; not bizarre, though still unjustified. Individuals with delusional disorder may seem offbeat or quirky rather than mentally ill, and, as such, may never seek treatment.

     Persons with paranoid personality disorder tend to be self-centered, self-important, defensive, and emotionally distant. Their paranoia manifests itself in constant suspicions rather than full-blown delusions.

     The disorder often impedes social and personal relationships and career advancement. Some individuals with PPD are described as "litigious," as they are constantly initiating frivolous law suits. PPD is more common in men than in women, and typically begins in early adulthood.

Causes and symptoms
     The exact cause of paranoia is unknown. Potential causal factors may be genetics, neurological abnormalities, changes in brain chemistry, (tumors- lesions etc) and stress. Acute, or short term, paranoia may occur in some individuals overwhelmed by stress.

     The Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), the diagnostic standard for mental health professionals in the United States, lists the following symptoms for paranoid personality disorder:

suspicious; unfounded suspicions; believes others are plotting against him/her

preoccupied with unsupported doubts about friends or associates

reluctant to confide in others due to a fear that information may be used against him/her

reads negative meanings into innocuous remarks bears grudges

perceives attacks on his/her reputation that are not clear to others, and is quick to counterattack - or quick to spread her 'beliefs' of such (mental) occurances - taking the delusional aspect and manifesting it into "real life".


maintains unfounded suspicions regarding the fidelity of a spouse or significant other - family , friends, collegues
(etc).


Key Terms

Persecutory delusion:
     A fixed, false, and inflexible belief that others are engaging in a plot or plan to harm an individual.


For Your Information


Resources/Organizations

     American Psychiatric Association. 1400 K Street NW, Washington, DC 20005. (888) 357-7924.

     American Psychological Association (APA). 750 First St. NE, Washington, DC 20002-4242. (202) 336-5700. ttp://www.apa.org.

     National Alliance for the Mentally Ill (NAMI). Colonial Place Three, 2107 Wilson Blvd., Ste. 300, Arlington, VA 22201-3042. (800) 950-6264.

     National Institute of Mental Health. Mental Health Public Inquiries, 5600 Fishers Lane, Room 15C-05, Rockville, MD 20857. (888) 826-9438

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PARANOID PERSONALITY DISORDER



Suspicious
     An unmistakable sign of paranoia is continual mistrust. People with paranoid personality disorder are constantly on their guard because they see the world as a threatening place. They tend to confirm their expectations by latching on to any speck of evidence that supports their suspicions and ignore or misinterpret any evidence to the contrary.

     They are ever watchful and may look around for signs of a threat. Anyone in a new situation--beginning a job or starting a relationship, for example--is cautious and somewhat guarded until he or she learns that the fears are groundless.
     People suffering from paranoia cannot abandon their fears. They continue to expect trickery and to doubt the loyalty of others. In a personal relationship or marriage, this suspiciousness may take the form of pathological, unrealistic jealousy.


Hypersensitive
     Because persons with paranoid personality disorder are hyperalert, they notice any slight and may take offense where none is intended. As a result, they tend to be defensive and antagonistic.

     When they are at fault, they cannot accept blame, not even mild criticism. Yet they are highly critical of others.

Other people may say that these individuals make "mountains out of molehills."


Cold and Aloof
     In addition to being argumentative and uncompromising, the people with paranoid personality disorder are often emotionally cut off from other people. They appear cold and, in fact, often avoid becoming intimate with others. They pride themselves on their rationality and objectivity.

     People with a paranoid outlook on life rarely come to the attention of clinicians--it is not in their nature to seek help. Many presumably function competently in society. They may seek out social niches in which a moralistic and punitive style is acceptable, or at least tolerated to a certain degree.


DELUSIONAL (PARANOID) DISORDER
     Psychiatrists make a distinction between the milder paranoid personality disorder described above and the more debilitating delusional (paranoid) disorder. The hallmark of this disorder is the presence of a persistent, nonbizarre delusion without symptoms of any other mental disorder.

     Delusions are firmly held beliefs that are untrue, not shared by others in the culture, and not easily modifiable. Five delusional themes are frequently seen in delusional disorder. In some individuals, more than one of them is present.

     -- Ruth is a clerk typist who is efficient and helpful. Her employers and co-workers value her contribution to the office. But Ruth spends her evenings writing letters to State and Federal officials. She feels that God has opened her mind and given her the cure for cancer. She wants some leading treatment center to use her cure on all its patients so that the world can see she is right. Many of her letters go unanswered, or she receives noncommittal replies that only make her feel that no one understands that she can save all cancer patients if only given the chance. When one of her letters is answered by an employee of the official to whom she wrote, she is sure that the official is being deliberately kept unaware of her knowledge and power. Sometimes she despairs that the world will ever know how wonderful she is, but she doesn't give up. She just keeps writing. Ruth suffers from one of the delusional disorders, grandiose delusion.

     The most common delusion in delusional disorder is that of persecution. While persons with paranoid personality might suspect their colleagues of joking at their expense, persons with delusional disorder may suspect others of participating in elaborate master plots to persecute them.

     They believe that they are being poisoned, drugged, spied upon, or are the targets of conspiracies to ruin their reputations or even to kill them.

     They sometimes engage in litigation in an attempt to redress imagined injustices. Another theme seen frequently is that of delusional jealousy. Any sign--even a meaningless spot on clothing, or a short delay in arriving home--is summoned up as evidence that a spouse is being unfaithful.

     Erotic delusions are based on the belief that one is romantically loved by another, usually someone of higher status or a well-known public figure. Individuals with erotic delusions often harass famous persons through numerous letters, telephone calls, visits, and stealthy surveillance.

     * Persons with grandiose delusions often feel that they have been endowed with special powers and that, if allowed to exercise these powers, they could cure diseases, banish poverty, ensure world peace,or perform other extraordinary feats.

     Individuals with somatic delusions are convinced that there is something very wrong with their bodies--that they emit foul odors, have bugs crawling in or on their bodies, or are misshapen and ugly. Because of these delusions, they tend to avoid the society of other people, share no photos, memories (etc, and spend much time consulting "others" for their imagined condition. (be it MD - Counselor- Religious Pratictioner - Confidant... etc..)

     Whether or not persons with delusional disorder are dangerous to others has not been systematically investigated, but clinical experience suggests that such persons are rarely homicidal.

     Delusional patients are commonly angry people, and thus they are perceived as threatening.

In the rare instances when individuals with delusional disorder become:violent, verbally abusive, revengeful, instigators, plotting...

Their victims are usually people who unwittingly fit into their delusional scheme. (conviniently)

     The person in most danger from an individual with delusional disorder is a spouse/lover, family, or friend.