Current theories in psychology now suggest that behaviours that were primarily associated with psychotic disorders, such as delusional experiences, can be observed in the healthy general population (van Os, Linscott, Myin-Germeys, Delespaul and Krabbendam, 2009). Delusions, a common symptom of schizophrenia, have been associated with a tendency to jump to conclusions. In simpler terms, it has been discussed that those that experience delusions will reach final decisions earlier than controls upon the basis of little evidence (Huq, Garety and Hemsley, 1988). The aim of the research was to investigate the factors that may moderate this susceptibility to jump to conclusions amongst the sub-clinical range of delusional thinking amongst the distinct construct measures of the Peters et al. Delusions Inventory (PDI: Peters, Day and Garety, 1996). Numerous studies were conducted to investigate: intelligence, probability calculation ability, experimental task design and task delivery upon the emergence of the jump to conclusions bias (Chapters II-VI). Moderator analyses identified that task design and task delivery were strong predictors of the quantity of information requested prior to finalising a decision; with restricted data gathering occurring with the use of face-to-face abstract tasks (Chapter III and VI B). When tasks included neutral and emotionally-unstimulating material, a data gathering bias was either not observed (Chapter II) or data gathering was enhanced amongst those with high belief conviction. Perceived life stress, perceived task stress and specific reasoning styles were investigated in an attempt to explain the situation-specific differences (Chapters VII and VIII). It was concluded in the General Discussion that delusional thinking appears to be associated with hasty decision making, under specific situational circumstances and can differ between the distinct constructs of the PDI measure (Peters et al. 1996). Sub-clinical delusional ideation is an overall summation of belief distress, preoccupation and conviction. The current research argues that the three psychological dimensions of delusional belief can influence decision making uniquely; specifically in relation to the emergence of a data gathering bias.

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In its many manifestations, psychosis leads to a number of clinical and philosophical debates. Despite their practical and conceptual importance, a number of these debates remain unresolved. Appealing to the connection between phenomenological descriptions, empirical evidence, and philosophical analysis, this dissertation is devoted to the careful examination of five of the main debates surrounding the occurrence of delusions of thought insertion, one of the most complex and severe symptoms of psychotic disorders. Roughly speaking, patients suffering from thought insertion report that external agents of different nature have placed certain thoughts into the patients' minds. The introduction to this compilation clarifies the main distinctions underlying the general discussions about delusions and the specific debates surrounding thought insertion. The introduction is followed by a collection of five papers. The first paper tries to explain the way in which subjects self-attribute their own conscious thoughts in terms of agency. The second paper, assuming that delusions are a type of belief, engages with the discussion about the role that experiential abnormalities have in the process of formation of the delusional belief of thought insertion. The third paper examines the role that affective impairments might have in the process of production of thought insertion, an issue that is often overlooked by current dominant approaches to thought insertion. Taken altogether, the first three papers of this collection offer a novel understanding of the aetiology and architecture of thought insertion. The fourth paper examines a much larger discussion that overlaps with the debate about the subjective features of thought insertion. It is argued that cases of thought insertion - in conjunction with other psychotic phenomena - undermine the current self-presenting theory of consciousness, a theory meant to explain the most fundamental subjective character of conscious experiences. Finally, the fifth paper of the compilation engages with a more general discussion about the nature and role that delusions might play in a subject's life. It is argued against the dominant view that there are good reasons to characterize a certain type of monothematic delusions (including some cases of thought insertion) as biologically adaptive.

Purpose: A systematic review and meta-analysis tested the 'paranoia as a defence' model's original prediction that those experiencing persecutory delusions would take excessive credit for positive events as part of an attributional style that protects them from low self-esteem. The empirical project explored forensic mental health nurses' experiences of a Cognitive Analytic Therapy (CAT) training programme with an emphasis on complex case conceptualisation and implications for clinical practice. Methods: In relation to the systematic review and meta-analysis, those experiencing persecutory delusions were compared to those with non-paranoid psychosis, depression, and healthy controls, in terms of the magnitude of internalising attributional bias (IAB) for positive events. Correlation analysis also examined the association between magnitude of IAB and paranoia severity. In the empirical study, 10 forensic mental health nurses took part in semi-structured interviews to qualitatively explore their experiences and applications of CAT training. Results: Consistent with the model, an internalising attributional bias was present for those experiencing paranoid delusions when compared to individuals with depression. Contrary to the model, there were no differences between the other control groups and there was no significant correlation between IAB and paranoia severity. Internal attributions for positive events appear to be associated with depression, rather than paranoia. Analysis of the empirical data provided a rich account of nurses' experiences of the CAT training and how this helped them to conceptualise complex patients and promoted more positive ways of working. Conclusions: The findings from the systematic review and meta-analysis do not support the original model, but are consistent with the modified 'paranoia as a defence' model of persecutory delusions. Other cognitive models also help explain paranoia suggesting that refining the existing models further could be useful. The empirical findings suggest that CAT could be a valuable model of psychologically informed practice for nurses working in a forensic setting. Specifically, training appeared to help nurses develop a better understanding of their patients, greater self-reflection skills, and improved clinical care approaches.

Religious beliefs and practices are an important source of symptom relief for individuals with schizophrenia; however, it can also be a debilitating source of symptom exacerbation. This quantitative study examined the cognitions and religious life orientations of Christian individuals both with and without a diagnosis of schizophrenia, as measured by the Rust Inventory of Schizotypal Cognitions (RISC) and the Religious Life Inventory (RLI) to examine a baseline for healthy religious cognitions. The aberrant-salience and attribution theories were used to explore the relationship between psychotic stimuli and religious attributions. One hundred and thirty Christian individuals from an outpatient mental health facility, both with and without a diagnosis of schizophrenia completed the RISC and the RLI. A t-test showed that individuals with schizophrenia scored higher on average on the schizotypal cognitions continuum than individuals without a diagnosis. The results of an ANOVA indicated that individuals with a Quest religious life orientation rendered higher scores on the schizotypal cognitions scale. This research study showed that higher levels of schizotypal cognitions were associated with low religiosity. Overall, individuals with schizophrenia showed no difference in religiosity compared to individuals without schizophrenia. This study addressed the stigma of religious practice among individuals with schizophrenia. Results of this study have positive social implications for individuals with schizophrenia and their practitioners/clergy who incorporate religion as a coping method for symptom relief.

The focus of this thesis is to investigate the use of art therapy in the treatment of an individual diagnosed with schizophrenia. In this qualitative narrative single case study, eleven art therapy sessions are described using non-directive spontaneous art making with a 37-year-old man residing in a psychosocial rehabilitation program. The research study describes this client�s delusional world, and explores the struggle of making sense of his traumatic experiences in early childhood. The themes that emerge in this exploratory study are many and grief and bereavement are the focus as the client uncovers the connections between the past and the present. The process of the art therapy sessions and the progression in the imagery from chaos to serenity is described as the client moves from darkness into light, and as we witness his exploration of space in the images of the whirlwind that reappear throughout the sessions.

The following study is an examination of the deluded heroine in the novel between 1740 and 1820. Through close readings of fiction by Samuel Richardson, Charlotte Lennox, Frances Burney, Charlotte Smith, Ann Radcliffe and Jane Austen, and discussion of relevant works by other authors of the period, the reasons for the prevalence of this figure are considered. The thesis proposes that this choice of protagonist enabled the exploration of a number of the issues that most concerned contemporary novelists. Principal amongst these was the question of identification between reader and literary protagonist. Throughout this period authors engaged in attempts to develop and control the audience's response. The desired end was the "improvement" of readers by the experience of the situations, mistakes and trials of the text's central characters. Increasingly though, the unpredictable and fluctuating nature of the readers' reactions was recognised. The result was a conflict between "text as instruction", the moral education that authors professed to offer, and "text as fiction", the attractions of story, adventure and imagination which were ostensibly valued only as they brought readers to works intended to improve them. The connection of the latter to romance was a further source of tension. The establishment of the novel as a model for life was premised on claims to probability, but aspects of the texts remained which worked against mimetic representation. These oppositions explain the contemporary popularity of the quixotic narrative, since the quixote both enacted the "madness" of excessive imaginative involvement with literature and could also be shown learning to make a "correct" choice of genre for reading. The strategies that can be observed within the quixote novel have a wider application when they are considered alongside the patterns of imitation, influence and parody which characterise the fiction of the period. In order to examine these features, the thesis includes an analysis of two important literary dialogues: those between Richardson and Lennox, and between Radcliffe and Austen. My focus on the heroine acknowledges the significance of gender in the period's fiction. Created by both female and male authors, such figures could be either exemplary models or quixotic warnings. They nevertheless share an experience of delusion followed by enlightenment constructed in order to benefit the "reading Misses" following their adventures. Unlike much recent criticism, however, my concern is more with the author as creative artist, text as literary process and reader as imaginative participant, than with historical or sociological contexts.

The focus of this thesis is to investigate the use of art therapy in the treatment of an individual diagnosed with schizophrenia. In this qualitative narrative single case study, eleven art therapy sessions are described using non-directive spontaneous art making with a 37-year-old man residing in a psychosocial rehabilitation program. The research study describes this client�s delusional world, and explores the struggle of making sense of his traumatic experiences in early childhood. The themes that emerge in this exploratory study are many and grief and bereavement are the focus as the client uncovers the connections between the past and the present. The process of the art therapy sessions and the progression in the imagery from chaos to serenity is described as the client moves from darkness into light, and as we witness his exploration of space in the images of the whirlwind that reappear throughout the sessions.

Six neuropsychological topics illustrating altered perceptions and illusory beliefs are explored with particular emphasis on the neurobiological underpinnings of such phenomena. The first five topics are phantom limb, out-of-body experiences including depersonalization and near-death experiences, delusions with an emphasis on the effects of psychedelic drugs, autonomic reflex actions including respiration and heartbeat, and virtual reality. The last topic focuses on three disorders impairing perception and cognition, namely, Anton-Babinski, Charles Bonnet, and Diogenes Syndromes. Many of the related neurobiological mechanisms reflect disturbances of both lower-level and multisensory processing along with specific cortical impairments such as at the temporoparietal junction. The latter has been linked, for example, to out-of-body experiences. Similarly, aberrant neural learning and signaling such as that based on synaptic receptor disturbances show how the interplay between lower-level brain activity and that in the prefrontal cortex contributes to delusions. Specific hypotheses set forth to explain these alterations in perception and cognition are reviewed, such as a remapping theory which depicts cortical reorganization in response to synaptic changes mediated by receptors. The effects of these perceptual/cognitive distortions on experiential pleasure/pain and on adaptability are also explored.

M.A. / Once upon a time in a kingdom that existed along the outskirts of our land, there lived some people who were not too popular in our kingdom because they did not cleave to the way of our world. So, these people were locked away, and sentenced to spend time in our dungeons until they were ready to accept the way the kingdom was run. Delusional Dave believed that he was to marry the princess, even though she was only 11 years old. He was of a lowly nature, not even comparing to the standards of a page in the —courts. It was not acceptable that he should even imagine being with a princess maiden, let alone a princess. Sweet Sandy would rant about ideas that were ahead of the times. She believed that she could run the world through programs in her head, she adhered to the concept of infinity, with millions of people working for her. How could such a lowly subject of the kingdom imagine to have such self imposed importance among so many? Rancid Robby was not an agreeable character in the kingdom, because he admonished others through his belief that they were doubles, impostors to do him harm. He believed that the impostors who paraded as the 'doctors' and 'healers' of the kingdom had planted in his head a microchip so small, whereby damage to his brain would occur daily. These three subjects of the kingdom could be heard screaming, ranting and raving into the small hours of the night. Their cries would fall on deaf ears, as the superiority who ran the kingdom and operated the working of the dungeons, would not listen to the cries of madness, would not hear what the people were trying so desperately to say, and could not find it in their hearts to bring relief and comfort to those with the desperate cries. Oh, not to slander the good of the people, the 'decision-makers', who were in charge of deciding the fate of the madmen. They wanted so badly to help, but all they knew was the 'truth' that ran the soul of the kingdom. That truth being the directive of 'conform to the ways of the world or die in the dungeons'. If only Delusional Dave, Sweet Sandy and Rancid Robby were to conform and be like the others in the kingdom, then they would survive. Alas, this was not to be.... This story does not have a happy ending, as these poor subjects of the kingdom were soon lost in the abyss of the one and only reality that the kingdom was prepared to see and hear. That of normality...