Attribution Therapy for Paranoid Delusions: A Case Study

Abstract

Paranoid delusions are associated with an abnormal attributional style that serves the function of preventing the activation of latent discrepancies between self-perceptions and self-ideals at the expense of contributing to the paranoid patient's negative perceptions of the intentions of others. In this case study we describe a therapeutic strategy designed to allow a patient suffering from persecutory delusions to re-attribute negative life experiences to situational causes rather than to a conspiracy directed towards himself. It was hypothesized that no resistance was encountered from the patiet because no attempt was made to re-attribute negative events to internal causes. A reduction in paranoid ideation, which was maintained at follow-up, was accompanied by changes on formal measures of attributions. The implications of these findings for cognitive models of paranoid ideation, and for the development of interventions for deluded patients are discussed.