Differences in Cognitive and Emotional Processes Between Persecutory and Grandiose Delusions

Background: Cognitive models propose that cognitive and emotional processes, in the context of anomalies of expe-rience, lead to and maintain delusions. No large-scale stud-ies have investigated whether persecutory and grandiose delusions reflect differing contributions of reasoning and affective processes. This is complicated by their frequent cooccurrence in schizophrenia. We hypothesized that persecutory and grandiose subtypes would differ signifi-cantly in their associations with psychological processes. Methods: Participants were the 301 patients from the Psychological Prevention of Relapse in Psychosis Trial (ISRCTN83557988). Persecutory delusions were present in 192 participants, and grandiose delusions were present in 97, while 58 were rated as having delusions both of persecution and grandiosity. Measures of emotional an