The efficacy of CBT for psychosis will be enhanced by a greater
understanding of the mechanisms underlying symptoms. Therefore, an
investigation is reported that examined a role for a neglected factor,
anxiety, in the maintenance of delusional beliefs. It was hypothesized that
processes responsible for chronic worry, as detailed by Wells’ (1994a)
meta-cognitive model, contribute to delusional distress. Questionnaire
measures of anxiety, chronic worry and of meta-worry and related processes
were administered to individuals with persecutory delusions (N=15)
and individuals with generalized anxiety disorder (GAD)
(N=14). Evidence was found for the presence of dysfunctional
meta-cognitive processes in the clinically anxious group, which adds to
the growing support for the model of GAD. Moreover, it was found that many
of the individuals with persecutory delusions had high levels of general
worry, and the factors implicated in the meta-cognitive model of anxiety
were also present in this group. The results indicated that delusional
distress is not simply related to content but is associated with whether
the individual experiences meta-worry concerning the control of
delusion-relevant worries, that is, whether he or she worries about not
being able to control thoughts about the belief. This is the first
theoretical development of the important dimension of delusional distress.