INTRODUCTION: Bentall and colleagues (Bentall & Kaney, 1996; Kinderman & Bentall, 1996, 1997) claim that persecutory delusions are constructed defensively, for the maintenance of self-esteem. A central prediction of their model is that such delusions will be associated with discrepancies between overt and covert self-esteem. METHODS: The present study employed a new methodology that has been widely used in investigations of implicit attitudes, the Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998), to assess covert self-esteem and to test the above prediction. Overt self-esteem was assessed using the Rosenberg Self-Esteem Scale and an adjective self-relevance ratings measure. These measures were administered to 10 patients with acute persecutory delusions, 10 patients with remitted persecutory delusions, and 19 healthy control participants. RESULTS: Patients with persecutory delusions were found to have lower covert self-esteem (as assessed using the IAT) than healthy controls and patients with remitted persecutory delusions. On two measures of overt self-esteem, however, the persecutory deluded group did not differ significantly from the other groups once the effects of comorbid depression had been taken into account. CONCLUSIONS: These results are thus consistent with a model of persecutory delusions as serving the defensive function of maintaining self-esteem.
INTRODUCTION: Bentall and colleagues (Bentall & Kaney, 1996; Kinderman & Bentall, 1996, 1997) claim that persecutory delusions are constructed defensively, for the maintenance of self-esteem. A central prediction of their model is that such delusions will be associated with discrepancies between overt and covert self-esteem. METHODS: The present study employed a new methodology that has been widely used in investigations of implicit attitudes, the Implicit Association Test (IAT; Greenwald, McGhee, & Schwartz, 1998), to assess covert self-esteem and to test the above prediction. Overt self-esteem was assessed using the Rosenberg Self-Esteem Scale and an adjective self-relevance ratings measure. These measures were administered to 10 patients with acute persecutory delusions, 10 patients with remitted persecutory delusions, and 19 healthy control participants. RESULTS:Patients with persecutory delusions were found to have lower covert self-esteem (as assessed using the IAT) than healthy controls and patients with remitted persecutory delusions. On two measures of overt self-esteem, however, the persecutory deluded group did not differ significantly from the other groups once the effects of comorbid depression had been taken into account. CONCLUSIONS: These results are thus consistent with a model of persecutory delusions as serving the defensive function of maintaining self-esteem.