Skip to main content

Optimism in Schizophrenia

In this post, Catherine BortolonAssistant Professor of Clinical Psychology at University Grenoble Alpes, France, and Stéphane Raffard, Professor of Clinical Psychology at University Paul Valéry, Montpellier, France, discuss their paper “The contribution of optimism and hallucinations to grandiose delusions in individuals with schizophrenia” recently published in Schizophrenia Research.



We are interested in the psychological mechanisms that might contribute to psychotic experiences (e.g., delusional ideas) in individuals with and without a mental disorder.

Recently, we become more interested in grandiose ideas (or delusions), which are defined as false beliefs about inflated worth, power, knowledge, identity, and which are firmly held despite evidence of the contrary (APA, 2013). It might include the belief of having a special power such as mind reading, a special identity such as being a king or related to Kurt Cobain, and in terms of knowledge, it can include being a prominent researcher who made significant contributions to the scientific domain.

Grandiose delusions are found in around half of the individuals with a diagnosis of schizophrenia and despite being associated with poor clinical outcome and refusal of medication (Bowers, 2010; Thara & Eaton, 1996); they have received little attention from researchers.

In our paper, my colleagues and I explored the association between grandiose delusions and future expectations in individuals who have received a diagnosis of schizophrenia. We were in particularly interested in positive future expectations also called optimism.

Optimism tends to reflect the extent to which people hold favorable expectancies for their future (Carver and Scheier, 2014). Humans expect positive events in the future even when there is no evidence to support such expectations (Sharot et al., 2011). Although this optimism bias is traditionally considered as adaptive, aberrant optimistic bias has been suggested to contribute to mania symptoms in bipolar disorders, which very often also includes grandiose delusions (Schönfelder and al., 2017).

In the context of this study, we found that optimism regarding the future, together with the experience of hearing voices or seeing things (hallucinations), was associated with grandiose delusions in a sample of 115 participants with a diagnosis of schizophrenia. We postulated that a repetitive style of thinking about future positive expectations in the context of grandiose delusions may help individuals to create an idealized representation of one’s future potential in the face of stress and adversity caused by the disease and previous trauma (Knowless, et al., 2011; Raffard, et al., 2016; Grbic, 2013; Renny, 2016).

In fact, in schizophrenia disorder, hope and the belief that positive events will occur is reduced (partially) due to the stigma associated with schizophrenia (Lysaker et al., 2005; Thornicroft et al., 2009). An abnormal optimism regarding one’s future in individuals with a diagnosis of schizophrenia holding grandiose delusions might represent an initial attempt to cope with stressful situations and maintain a favorable view of oneself, which may later become a rigid belief when other cognitive biases are present (Garety et al., 2012).

That is, we suggest that optimism in the context of grandiose ideas that conflict with reality may participate in the maintenance of these beliefs, and consequently tamper psychological adjustment when individuals are confronted with difficult situations (Carver & Scheier, 2002).

These results are, however, preliminary. We need more information on whether individuals with a diagnosis of schizophrenia holding grandiose delusions indeed present an aberrant optimistic bias (when compared to healthy individuals) and how they use available information (desirable and undesirable) to update their positive future expectations (Kuzmanovic & Rigoux, 2016).

Popular posts from this blog

Delusions in the DSM 5

This post is by Lisa Bortolotti. How has the definition of delusions changed in the DSM 5? Here are some first impressions. In the DSM-IV (Glossary) delusions were defined as follows: Delusion. A false belief based on incorrect inference about external reality that is firmly sustained despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other members of the person's culture or subculture (e.g., it is not an article of religious faith). When a false belief involves a value judgment, it is regarded as a delusion only when the judgment is so extreme as to defy credibility.

Rationalization: Why your intelligence, vigilance and expertise probably don't protect you

Today's post is by Jonathan Ellis , Associate Professor of Philosophy and Director of the Center for Public Philosophy at the University of California, Santa Cruz, and Eric Schwitzgebel , Professor of Philosophy at the University of California, Riverside. This is the first in a two-part contribution on their paper "Rationalization in Moral and Philosophical thought" in Moral Inferences , eds. J. F. Bonnefon and B. Trémolière (Psychology Press, 2017). We’ve all been there. You’re arguing with someone – about politics, or a policy at work, or about whose turn it is to do the dishes – and they keep finding all kinds of self-serving justifications for their view. When one of their arguments is defeated, rather than rethinking their position they just leap to another argument, then maybe another. They’re rationalizing –coming up with convenient defenses for what they want to believe, rather than responding even-handedly to the points you're making. Yo...

Models of Madness

In today's post John Read  (in the picture above) presents the recent book he co-authored with Jacqui Dillon , titled Models of Madness: Psychological, Social and Biological Approaches to Psychosis. My name is John Read. After 20 years working as a Clinical Psychologist and manager of mental health services in the UK and the USA, mostly with people experiencing psychosis, I joined the University of Auckland, New Zealand, in 1994. There I published over 100 papers in research journals, primarily on the relationship between adverse life events (e.g., child abuse/neglect, poverty etc.) and psychosis. I also research the negative effects of bio-genetic causal explanations on prejudice, and the role of the pharmaceutical industry in mental health. In February I moved to Melbourne and I now work at Swinburne University of Technology.  I am on the on the Executive Committee of the International Society for Psychological and Social Approaches to Psychosis and am the Editor...