The Effects of Paranoid and or Persecutory Delusions on Feelings of Social Inclusion and Exclusion

Background: Current psychological theories of persecutory delusions appear limited in being able to explain their interpersonal nature. Unanswered questions include why the content of delusions mostly involves persecution by other people. Research into rejection including rejection sensitivity may provide a rational for delusion personalisation and also may indicate how rejection may be implicated in the maintenance of delusions. The aim of this study was to investigate responses to rejection for individuals with a psychosis that includes persecutory delusions compared with controls. Methodology: Participants (22 with psychosis with persecutory delusions, 18 with an anxiety disorder and 19 healthy individuals) played a computerised game of catch (Cyberball). Half of each group was either included or excluded, inducing a mood change in those rejected. Questionnaires were completed to measure mood change, indicating rejection sensitivity. A second task was completed enabling participants to react either antisocially or neutrally towards the game characters. Measures of psychological and demographic variables were also collected. Results: There was a large effect between the excluded and included participants. There was a null finding for the hypothesis that the psychotic group would have higher levels of rejection sensitivity than the anxious and healthy groups. There was also a null finding for the hypothesis that the psychosis group will be more likely to respond antisocially after rejection and make more negative attributions about the game character’s personalities. However, there was a trend for a the psychotic group to be more antisocial after inclusion. Conclusions: The results obtained in the study were contrary to those expected. Rejection appears to be a similarly negative experience for all participants, but differences may be observed behavioural responses with those with psychosis appearing ambivalent to inclusion or exclusion.