Persecutory delusions and the determination of self-relevance: an fMRI investigation

Psychol Med. 2004 May;34(4):591-6. doi: 10.1017/S0033291703008997.

Abstract

Background: People with persecutory delusions regard ambiguous data in the social domain as self-relevant and selectively attend to threatening information. This study aimed to characterize these social cognitive biases in functional neuroanatomical terms.

Method: Eight schizophrenic patients with active persecutory delusions and eight matched normal controls underwent functional magnetic resonance imaging while determining the self-relevance of ambiguous self-relevant or unambiguous other-relevant neutral and threatening statements.

Results: In determining self-relevance, the deluded subjects showed a marked absence of rostral-ventral anterior cingulate activation together with increased posterior cingulate gyrus activation in comparison to the normal subjects. The influence of threat on self-relevance determination did not yield statistically significant differences between deluded and normal subjects.

Conclusions: Abnormalities of cingulate gyrus activation while determining self-relevance suggest impaired self-reflection in the persecutory deluded state. This may contribute to persecutory belief formation and maintenance.

MeSH terms

  • Adult
  • Brain / physiology*
  • Brain Mapping*
  • Delusions / diagnosis*
  • Delusions / physiopathology
  • Gyrus Cinguli / physiology*
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Paranoid Disorders / diagnosis*
  • Paranoid Disorders / physiopathology
  • Self Psychology*