Udachina Alisa, Varese Filippo, Oorschot Margreet, Myin-Germeys Inez, Bentall Richard P
Clinical Psychology Unit, Department of Psychology, The University of Sheffield, Sheffield, UK.
J Nerv Ment Dis. 2012 Sep;200(9):777-83. doi: 10.1097/NMD.0b013e318266ba57.
The dynamics of self-esteem and paranoia were examined in 41 patients with past or current paranoia and 23 controls using questionnaires and the Experience Sampling Method (a structured diary technique). For some analyses, patients were further divided into three groups: a) individuals who believed that persecution is underserved ("poor me"; PM), b) individuals who believed that persecution is justified ("bad me"; BM), and c) remitted patients. The results revealed that PM and especially BM patients had highly unstable psychological profiles. Beliefs about deservedness of persecution fluctuated over 6 days. BM beliefs were associated with low self-esteem and depression. Measured concurrently, paranoia predicted lower self-esteem in the BM patients. Prospectively, paranoia predicted lower subsequent self-esteem in BM patients but higher subsequent self-esteem in PM patients. Our results suggest that paranoia can serve a defensive function in some circumstances. The reasons for inconsistencies in self-esteem research in relation to paranoia are discussed.
采用问卷调查和经验取样法（一种结构化日记技术），对41名曾患或现患妄想症的患者以及23名对照者的自尊和妄想动态变化进行了研究。在一些分析中，患者被进一步分为三组：a）认为迫害是不公正的个体（“可怜的我”；PM），b）认为迫害是合理的个体（“坏的我”；BM），以及c）康复患者。结果显示，PM组尤其是BM组患者的心理状况极不稳定。关于迫害合理性的信念在6天内波动。BM信念与低自尊和抑郁相关。同时测量发现，妄想症预示着BM组患者的自尊较低。前瞻性研究表明，妄想症预示着BM组患者随后的自尊较低，但PM组患者随后的自尊较高。我们的结果表明，在某些情况下，妄想症可能起到防御作用。文中讨论了与妄想症相关的自尊研究中存在不一致的原因。
