Humour and grandiosity : a systematic review of humour experiences in psychosis and an empirical preliminary investigation of 'theory of mind' and 'attributional style' in adults with grandiose delusions

This thesis first reviews the literature on humour experiences in adults experiencing psychosis. An empirical study was next conducted to test the application of socio-cognitive models of paranoid delusions to grandiose delusions. A systematic search of the literature was conducted on electronic academic databases between 1980 and 2012. Seventeen studies that have utilised humorous tasks within explorations of either the comprehension and/or the appreciation of humorous stimuli were found. The literature suggests difficulties comprehending humour are clear in individuals with experiences of psychosis, and that this difficulty is augmented when there is a need to infer the mental states of others to understand jokes or humorous scenarios. However, the findings with respect to appreciation are less clear. Here the evidence points to the role of co-morbid mood symptoms such as depression and mania in the attenuation of humour appreciation. In the empirical study, a cross-sectional design was employed to compare the performance of individuals with grandiose delusions to a depressed control group on measures of Theory of Mind (ToM) and attributional style. Participants experiencing grandiose delusions performed significantly worse on both ToM tasks and produced significantly fewer references to mental states in a dialogue task. Following a symptom-based approach, the presence of a grandiose delusion was significantly associated with poorer ToM on the joke appreciation and stories task. Participants with a grandiose delusion appear to have a ToM impairment independently of the severity of a comorbid persecutory delusion. Implications for clinical practice are also noted.EThOS - Electronic Theses Online ServiceGBUnited Kingdo