Nakamura Mitsuo, Hayakawa Tomomi, Okamura Aiko, Kohigashi Mutsumi, Fukui Kenji, Narumoto Jin
Department of Psychiatry, Graduate School of Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Gojouyama Hospital, Nara, Japan.
Neuropsychiatr Dis Treat. 2014 Dec 22;11:33-40. doi: 10.2147/NDT.S73906. eCollection 2015.
If delusions serve as a defense mechanism in schizophrenia patients with paranoia, then they should show normal or high explicit self-esteem and low implicit self-esteem. However, the results of previous studies are inconsistent. One possible explanation for this inconsistency is that there are two types of paranoia, "bad me" (self-blaming) paranoia and "poor me" (non-self-blaming) paranoia. We thus examined implicit and explicit self-esteem and self-blaming tendency in patients with schizophrenia and schizoaffective disorder. We hypothesized that patients with paranoia would show lower implicit self-esteem and only those with non-self-blaming paranoia would experience a discrepancy between explicit and implicit self-esteem.
Participants consisted of patients with schizophrenia and schizoaffective disorder recruited from a day hospital (N=71). Participants were assessed for psychotic symptoms, using the Brief Psychiatric Rating Scale (BPRS), and self-blaming tendency, using the brief COPE. We also assessed explicit self-esteem, using the Rosenberg Self-Esteem Scale (RSES), implicit self-esteem, using Brief Implicit Association Test (BIAT), and discrepancy between explicit and implicit self-esteem.
Contrary to our hypothesis, implicit self-esteem in paranoia and nonparanoia showed no statistical difference. As expected, only patients with non-self-blaming paranoia experienced a discrepancy between explicit and implicit self-esteem; other groups showed no such discrepancy.
These results suggest that persecutory delusion plays a defensive role in non-self-blaming paranoia.
如果妄想在患有偏执狂的精神分裂症患者中作为一种防御机制，那么他们应该表现出正常或较高的外显自尊以及较低的内隐自尊。然而，先前研究的结果并不一致。对于这种不一致的一种可能解释是，存在两种类型的偏执狂，即“糟糕的我”（自我责备型）偏执狂和“可怜的我”（非自我责备型）偏执狂。因此，我们研究了精神分裂症和分裂情感性障碍患者的内隐和外显自尊以及自我责备倾向。我们假设患有偏执狂的患者内隐自尊较低，并且只有那些非自我责备型偏执狂患者会在外显和内隐自尊之间存在差异。
参与者包括从日间医院招募的精神分裂症和分裂情感性障碍患者（N = 71）。使用简明精神病评定量表（BPRS）评估参与者的精神病症状，使用简易应对方式问卷评估自我责备倾向。我们还使用罗森伯格自尊量表（RSES）评估外显自尊，使用简版内隐联想测验（BIAT）评估内隐自尊，以及评估外显和内隐自尊之间的差异。
与我们假设相反，偏执狂和非偏执狂患者的内隐自尊没有统计学差异。正如预期的那样，只有非自我责备型偏执狂患者在外显和内隐自尊之间存在差异；其他组没有这种差异。
这些结果表明，被害妄想在非自我责备型偏执狂中起防御作用。
