TY - JOUR
T1 - Delusions beyond beliefs
T2 - a critical overview of diagnostic, aetiological, and therapeutic schizophrenia research from a clinical-phenomenological perspective
AU - Feyaerts, Jasper
AU - Henriksen, Mads G
AU - Vanheule, Stijn
AU - Myin-Germeys, Inez
AU - Sass, Louis A
N1 - Copyright © 2021 Elsevier Ltd. All rights reserved.
PY - 2021/3
Y1 - 2021/3
N2 - Delusions are commonly conceived as false beliefs that are held with certainty and which cannot be corrected. This conception of delusion has been influential throughout the history of psychiatry and continues to inform how delusions are approached in clinical practice and in contemporary schizophrenia research. It is reflected in the full psychosis continuum model, guides psychological and neurocognitive accounts of the formation and maintenance of delusions, and it substantially determines how delusions are approached in cognitive-behavioural treatment. In this Review, we draw on a clinical-phenomenological framework to offer an alternative account of delusion that incorporates the experiential dimension of delusion, emphasising how specific alterations to self-consciousness and reality experience underlie delusions that are considered characteristic of schizophrenia. Against that backdrop, we critically reconsider the current research areas, highlighting empirical and conceptual issues in contemporary delusion research, which appear to largely derive from an insufficient consideration of the experiential dimension of delusions. Finally, we suggest how the alternative phenomenological approach towards delusion could offer new ways to advance current research and clinical practice.
AB - Delusions are commonly conceived as false beliefs that are held with certainty and which cannot be corrected. This conception of delusion has been influential throughout the history of psychiatry and continues to inform how delusions are approached in clinical practice and in contemporary schizophrenia research. It is reflected in the full psychosis continuum model, guides psychological and neurocognitive accounts of the formation and maintenance of delusions, and it substantially determines how delusions are approached in cognitive-behavioural treatment. In this Review, we draw on a clinical-phenomenological framework to offer an alternative account of delusion that incorporates the experiential dimension of delusion, emphasising how specific alterations to self-consciousness and reality experience underlie delusions that are considered characteristic of schizophrenia. Against that backdrop, we critically reconsider the current research areas, highlighting empirical and conceptual issues in contemporary delusion research, which appear to largely derive from an insufficient consideration of the experiential dimension of delusions. Finally, we suggest how the alternative phenomenological approach towards delusion could offer new ways to advance current research and clinical practice.
KW - Antipsychotic Agents/therapeutic use
KW - Cognitive Behavioral Therapy
KW - Delusions/diagnosis
KW - Humans
KW - Psychiatry/trends
KW - Schizophrenia/therapy
KW - Schizophrenic Psychology
UR - http://www.scopus.com/inward/record.url?scp=85100660503&partnerID=8YFLogxK
U2 - 10.1016/S2215-0366(20)30460-0
DO - 10.1016/S2215-0366(20)30460-0
M3 - Review
C2 - 33485408
SN - 2215-0366
VL - 8
SP - 237
EP - 249
JO - The Lancet. Psychiatry
JF - The Lancet. Psychiatry
IS - 3
ER -