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How Do People with Persecutory Delusions Evaluate Threat in a Controlled Social Environment? A Qualitative Study Using Virtual Reality

Published online by Cambridge University Press:  08 October 2013

Miriam Fornells-Ambrojo ,
Daniel Freeman ,
Mel Slater ,
David Swapp ,
Angus Antley  and
Chris Barker
Miriam Fornells-Ambrojo*
Affiliation:
University College London, UK
Daniel Freeman
Affiliation:
University of Oxford, UK
Mel Slater
Affiliation:
ICREA- University of Barcelona, Spain, and University College London, UK
David Swapp
Affiliation:
University College London, UK
Angus Antley
Affiliation:
University College London, UK
Chris Barker
Affiliation:
University College London, UK
*
Reprint requests to Miriam Fornells-Ambrojo, Research Department of Clinical, Educational and Health Psychology, University College London, 1–19 Torrington Place, London WC1E 7HB, UK. E-mail: miriam.fornells-ambrojo@ucl.ac.uk
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Abstract

Background: Environmental factors have been associated with psychosis but there is little qualitative research looking at how the ongoing interaction between individual and environment maintains psychotic symptoms. Aims: The current study investigates how people with persecutory delusions interpret events in a virtual neutral social environment using qualitative methodology. Method: 20 participants with persecutory delusions and 20 controls entered a virtual underground train containing neutral characters. Under these circumstances, people with persecutory delusions reported similar levels of paranoia as non-clinical participants. The transcripts of a post-virtual reality interview of the first 10 participants in each group were analysed. Results: Thematic analyses of interviews focusing on the decision making process associated with attributing intentions of computer-generated characters revealed 11 themes grouped in 3 main categories (evidence in favour of paranoid appraisals, evidence against paranoid appraisals, other behaviour). Conclusions: People with current persecutory delusions are able to use a range of similar strategies to healthy volunteers when making judgements about potential threat in a neutral environment that does not elicit anxiety, but they are less likely than controls to engage in active hypothesis-testing and instead favour experiencing “affect” as evidence of persecutory intention.

Keywords

Paranoiapersecutory delusionssafety behaviourscognitive behaviour therapy for psychosisvirtual reality
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 1 , January 2015 , pp. 89 - 107
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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