Psychosis and Delusional States and Their Relationship with Normal Anomalous Experience - Essay Example

Psychosis and Delusional s and Their Relationship with Normal Anomalous Experience Affiliation with more information about affiliation, research grants, conflict of interest and how to contact Psychosis and Delusional States and Their Relationship with Normal Anomalous Experience Introduction: Psychosis and delusional states are mental problems that have caused great concern for the human race and the psychological fraternity has been researching for years to answer various questions relating to the causative factors, diagnosis as well as treatment. Patients with these problems have to endure a great deal of “disturbing experiences” and usually the diagnosis and treatment focuses on the mind and behaviour levels (Kapur, 2003, p.13). Most common reason attributed to the development of psychosis is abnormality in the transmission of dopamine, which is a “mediator of motivational salience” (p.13). Evidence, on the other hand, suggests that “50% or more of cases” of the “psychiatric complications of dementing disorders” are characterised by delusions of fluctuating levels (Hassett, 2002, p.81). Thus, it becomes evident that both psychosis and delusional states are conditions that can seriously hamper the mental health and well being of individuals. Definition of Psychosis Including Behavioural/Emotional/Cognitive Characteristics: Psychosis can be broadly defined as a serious mental health condition that entails a “high risk of chronicity and social disability” that can impair the social functions as well as the social relations of the affected individuals (Caton, Samet & Hasin, p.257). Studies find that “15% - 20% of nonaffective” and “25% - 33% of affective” psychoses usually will remit within six months while the rest of the cases can develop chronic conditions requiring further treatment (p.257). In a recent study, Adams et al (2013) identify the inability to draw correct inferences about the world, arising from “an imbalance” in the convictions about beliefs, as the major symptom of psychosis (p.3). The authors further illustrate the criteria for the diagnosis of psychosis as under: i) Delusions and hallucinations ii) Thought disorder and catatonia iii) Abnormalities of perceptual organisation Thus, it transpires that psychosis is characterised by symptoms such as delusions as well as disorders in the thought processes besides the abnormalities in the perception of the affected people. Similarly, previous studies also find that symptoms of psychosis develops in individuals through “two proximal routes” such as changes occurring in the cognitive as well as affective systems, and the disturbance in the affective systems that the individuals endure (Garety et al, 2001, p.189). The authors further identify the former as a more common form, where any event that triggers a problem may disrupt the “cognitive process” in the vulnerable individuals (p.189). Thus, the cognitive process becomes biased due to which they may begin “jumping to conclusions” without applying reason (p.191). Similarly, people affected by the problem of psychosis tend to lose their “self-concept and self-esteem” and develop delusions or hallucinations with negative connotations (p.191). In addition, affected persons also will have “emotional distress” with anxiety that triggers delusions or hallucinations and they will be unable to distinguish between illusion and reality (p.192). Definition of Delusional States Including Behavioural/Emotional/Cognitive Characteristics: Delusions can be broadly be defined as “Fixed, false beliefs” that normally do not fall within the cultural norms or environment of affected individuals and are “often idiosyncratic” but significant for them while difficult for others to understand (The Early Diagnosis and Management of Psychosis, 2002, p.8). Delusions can be categorised into six types including, persecutory, religious, grandiose, somatic, passivity delusions and “delusions of reference” (p.8). The DSM-IV-TR of the American Psychiatric Association considers delusion as “false belief” on the basis of wrong inferences about an “external reality” and affected individuals firmly hold to a notion, disregarding any evidence existing to the contrary (Mohr et al, 2010, p.158). However, for diagnosis psychologists distinguish between the other beliefs and delusions and where judgement of values is involved in the false belief, it can be regarded as delusion only when the judgement becomes extreme to such an extent as to “defy credibility” (p.158). However, the authors point to the fact that the conventions about delusion have often been challenged and, therefore, they consider delusions as “multi-dimensional phenomena” instead of referring to them as “discrete discontinuous entities” (p.159). Thus, they contend that in order to determine the presence of the problem, a “list of dimensions” has to be taken into account rather than a sole criterion (p.159). Thus, modern research suggests that delusion may include even those in which truth and falsity cannot be determined such as religious delusions, and also those in which the context of the delusion may in fact be true, such as the “delusions of jealousy” (Ile et al, 2011, p.9). Definition of Normal Anomalous Experience: Anomalous experience can be defined as certain kinds of “strange experiences” that defies understanding or explanation on the basic of scientific or logical reasoning and these experiences “deviate” from the usual experiences that humans have and are often considered as “bizarre” (Dein, 2012, p.61-62). These experiences can occur as voices, vision or “thought processes” and, apparently, there can be overlapping among them (p.62). These also include paranormal experiences or beliefs, which can occur due to any “childhood trauma” that can produce lasting psychological repercussions (p.66). In this context it becomes relevant that such childhood traumatic experiences as well as anomalous experience can contribute to the development of delusions, which may trigger psychosis. However, for the purpose of this study, religious beliefs and voice hearing etc will be considered as the platform for discussion of the relationship between normal anomalous experience and psychosis and delusion. Analysis of the Relationship between Psychosis, Delusions and Anomalous Experience: Psychosis is a mental condition characterised by delusions or hallucinations and the evidence emerging from research suggests that certain individuals, when confronted with any negative emotional event or anomalous experience, such as hearing a delusional voice, may immediately jump to a perception of some “external threat” and manifest paranoia (Read et al, 2005, p.342). Similarly, in the study by Morrison, Frame and Larkin (2003), the authors find that delusional beliefs such as voice hearing or any unreasonable, perceived supernatural experience can be perceived as an attempt to “search for meaning,” which is triggered by anomalous experiences associated with psychosis (p.340). Similarly, the study by Brugger and Mohr (2008) suggests that the individuals with psychosis, who have delusions, attribute meaning to “temporal coincidences” due to their desire to understand the meaning of events such as voice hearing or “spatial configurations” (p.1292). On the other hand, referring to hypothetical studies of Maher (1974, 1988 and 1992), Davis and Egan (2013) contend that delusions occur in affected individuals as a “normal response” to the anomalous experience sustained by them and it triggers in them hallucinations such as voice hearing (p.2). Similarly, researchers like Prasko et al (2010) contend that beliefs about voice hearing and the “voices’ power” can be understood as a semi-rational response to anomalous experience in the affected persons (p.136). They further find that the cognitive problems entail anomalous conscience experiences that make them perceive thoughts as voice and when the affected individual feels they are “externally caused and personally significant” these anomalous experiences develop into psychosis (p.137). Studies further show that some of the affected persons manifest negative symptoms such as disengagement from activities as a “response to positive symptoms” such as delusional experiences, threat perception, hearing voices etc (Sivec & Montesano, 2012, p.261). On the other hand, some studies vouch for the fact that a psychotic disorder can entail conditions of Monosymptomatic Hypchondriachal Psychosis (MHP), or “somatic delusional disorder,” which is characterised by sleep-related problems as a response to normal anomalous experience (Ajiboye & Yusuf, 2013, p.89). On the other hand, Oluwole, Dada and Obadeju (2013) illustrate a case where a psychotic patient has resorted to removing his testes as an anomalous response to a misconception that ejaculation “weakened his supernatural power” (p.89). Earlier studies by Freeman et al (2002) demonstrate that individuals who are affected by psychosis tend to remain confused, which creates anomalous experiences such as hearing voices, deliberate actions perceived as unintentional etc and these symptoms “drive a search for meaning” (p.334). The authors further go on to contend that strong evidence exists to substantiate the fact that schizophrenics manifest “subtle anomalous perceptual experiences” (p.334). Evidence further suggests that in hypnagogic state, which is a condition parallel to psychosis, affected individuals have anomalous experiences like hearing a “voice distinctly” and “authoritatively” (McCreery, 2008, p.17). Similarly, many studies identify religion as a motif, which is “central to delusion” and argue that when culture, which is an integral part of religion, undergoes a drastic change the resultant stress will produce anomalous experiences in individuals afflicted with psychosis (Gold & Gold, 2012, p.10). Studies find that psychotic disorders such as schizophrenia are characterised by an “alteration in the sense of self” that results from a “primary insufficiency” due to anomalous experience (Sass et al, 2013, p.430). Thus, patients who are depersonalised due to psychosis affliction often claim that they hear an “unpleasant voice” shouting at them (p.434). These evidences do clearly substantiate the inference of the relationship between psychosis, delusions and anomalous experiences. The study by Corlett et al (2009) finds that perception aberration and illusions found in psychotic patients can be attributed to anomalous experience and “magical thinking” (p.1). However, a study by Bell, Halligan and Ellis (2008) challenges Maher’s theory and argues that there are at least “some” cases of delusions in which “gross perceptual distortions” are absent (p.11). While this contention points to the fact that anomalous experiences may not be present in certain instances of psychosis and delusions, it does not rule out existence of the relationship among psychosis, delusions and anomalous experiences. Conclusion: From the evidence gleaned from a wide variety of literature reviewed during this study, it transpires that anomalous experience such as voice hearing and hallucinations based on religious beliefs are present in patients suffering from both psychosis and delusions. It has also become apparent that any anomalous experience that a person undergoes as a child due as a defence mechanism to traumas or childhood hood abuse can also have an impact on the delusions or psychotic problems he or she may experience as an adult. Only a few studies have suggested that the presence of anomalous experience is not a prerequisite for psychosis or delusions of all types, which does not seem to be a sufficient reasoning to challenge or refute the validity of the notion that anomalous experience is one characteristic found in most of the cases of psychosis and delusions. Thus, various studies analysed during the course of this research establishes a positive relationship between anomalous experiences and delusions as well as psychosis. References Adams, R. A. et al. (2013). The Computational Anatomy of Psychosis. Frontiers in Psychiatry, 4 (47): 1-26 Ajiboye, P. O. & Yusuf, A. D. (2013). Monosymptomatic Hypochondriacal Psychosis (somatic delusional disorder): A Report of Two Cases. African Journal of Psychiatry, 16: 87-89 Bell, V., Halligan, P. W. & Ellis, H. D. (2008). Are Anomalous Perceptual Experiences Necessary for Delusions? Journal of Nervous and Mental Disease, 196 (1): 3-8 Brugger, P. & Mohr, C. (2008). The Paranormal Mind: How the Study of Anomalous Experiences and Beliefs may Inform Cognitive Neuroscience. Cortex: The Journal Devoted to the Study of the Nervous System and Behaviour, 44 (10): 1291-1298 Caton, C. L. M., Samet, S. & Hasin, D. S. (2000). When Acute State Psychosis and Substance Use Co-Occur: Differentiating Substance-Induced and Primary Psychotic Disorders. Journal of Psychiatric Practice, September 2000: 256-266 Corlett, P. R. et al. (2009). Illusions and Delusions: Relating Experimentally Induced False Memories to Anomalous Experiences and Ideas. Frontiers in Behavioural Neuroscience, 3: 1-9 Davies, M. & Egan, A. (2013). Delusion: Cognitive Approaches Bayesian Inference and Compartmentalisation. The Oxford Handbook of Philosophy and Psychiatry. Oxford: Oxford University Press. Dein, S. (2012). Mental Health and the Paranormal. International Journal of Transpersonal Studies, 31 (1): 61-74 The Early Diagnosis and Management of Psychosis: A Booklet for General Practitioners. (2002). ORYGEN Youth Health. Retrieved from Freeman, D. et al. (2002). A Cognitive Model of Persecutory Delusions. British Journal of Clinical Psychology, 41: 331-347 Garety, P. A. et al. (2001). A Cognitive Model of the Positive Symptoms of Psychosis. Psychological Medicine, 31: 189-195 Gold, J. & Gold, I. (2012). The “Truman Show” Delusion: Psychosis in the Global Village. Cognitive Neuropsychiatry, 1-18. Hassett, A. (2002). Schizophrenia and Delusional Disorders with Onset in Later Life. Revista Brasileria de Psiquiatria (Journal of the Brazilian Psychiatric Association), 1: 81-86 Ile, L. et al. (2011). Delusions and Beliefs – An Endless Debate. Romanian Journal of Psychiatry, XIII (1): 7-12 Kapur, S. (2003). Psychosis as a State of Aberrant Salience: A Framework Linking Biology, Phenomenology, and Pharmacology in Schizophrenia. American Journal of Psychiatry, 169: 13-23 McCreery, C. (2008). Dreams and Psychosis: A New Look at an Old Hypothesis. Oxford Forum. Mohr, S. et al. (2010). Delusions with Religious Content in Patients with Psychosis: How They Interact with Spiritual Coping. Psychiatry, 73 (2): 158-172 Morrison, A. P., Frame, L. & Larkin, W. (2003). Relationships between Trauma and Psychosis: A Review and Integration. British Journal of Clinical Psychology, 42: 331-353 Oluwole, L. O., Dada, M. U. & Obadeji, A. (2013). Self-inflicted Bilateral Orchidectomy Precipitated by Erotic Bizarre Delusions: A Case Report. African Journal of Psychiatry, 16: 87-89 Prasko, J. (2010). Narrative Cognitive Behaviour Therapy for Psychosis. Activitas Nervosa Superior Rediviva, 52 (2): 135-146 Read, J., Os, J. V., Morrison, O. P. & Ross, C. A. (2005). Childhood Trauma, Psychosis and Schizophrenia: A Literature Review with Theoretical and Clinical Implications. Acta Psychiatrica Scandinavica, 112: 330-350 Sass, L., Pienkos, E., Nelson, B. & Medford, N. (2013). Anomalous Self-experience in Depersonalisation and Schizophrenia: A Comparative Investigation. Consciousness and Cognition, 22: 430-441 Sivec, H. J. & Montesano, V. L. (2012). Practice Review: Cognitive Behavioural Therapy for Psychosis in Clinical Practice. Psychotherapy, 49 (2): 258-270 Read More