A cognitive investigation of schizophrenic delusions.

Delusions have traditionally been regarded as unmodifiable false beliefs. Both Freud (1911) and Jaspers (1968) argue that there is a unidirectional relationship between a delusional belief and consensually validatable realtiy: the delusion structures reality in accordance with the delusion's demand. In contrast, we postulate that there is a bidirectional interaction between the delusion and external events. We believe that external events might modify the rigid belief when there is a dramatic incongruity between specific beliefs and selected events. The following investigation was motivated by a desire to understand more clearly how some overtly delusional patients come to lose their delusions during the course of treatment for schizophrenia. Do delusions simply melt away under the influence of major tranquilizers, or does the delusional patient play some active part in assessing the validity of this belief?