As it is written, For thy sake we are killed all the day long; we are accounted as sheep for the slaughter. Nay, in all these things we are more than conquerors through him that loved us. Despite repeated persecutions that Paul suffered from his opponents during his time, he was determined to remain an active Christian. Paul traveled beyond the border of his country and visited various remote countries to proclaim the gospel of Jesus Christ. Perhaps the greatest achievement of Apostle Paul is that he wrote many inspiring letters to early Christian churches that were sparsely located around the globe.
Those letters of Paul eventually became part of the manuscripts that were canonized into the bible. Today, Christians throughout the world continue to find motivation and inspiration from the letters that Paul wrote to early Christian churches! Please subdue the power of my enemies, and let your Holy Spirit energize me to remain faithful to you, so that I can reign with you in heaven. Learn more at www. You must be logged in to post a comment. Information provided on this website is tailored to fit your spiritual growth and personal development. It does not represent any legal advice.
Read More. Toggle navigation. Early believers survived their trial moments; they also had effective evangelism. A young lawyer called Saul spearheaded the persecution of early Christians. He was obsessed of his Judaism religion and persecuted Christianity. He persecuted Christians from door to door, and from town to town. Eventually, Saul met with the Lord and became saved. Saul converted to Christianity and changed his name to Paul. Jesus Christ saved Paul and turned him to his fisherman — an evangelist! Acts 9. They attempted to kill Paul, however God protected him.
Persecution of saints is inevitable People who have professed their faith in Jesus Christ will suffer persecution in this world, but Jesus will help us prevail. The persecution of saints would come in different forms, and make believers experience pain. However, believers ought to maintain focus and serve God effectively. Christians must be courageous to find motivation in our persecutions. As we endure in faith, we must allow the Holy Spirit of God to rule us. It is usually a strange, uncanny mood in which the environment appears to be changed in a threatening way but the significance of the change cannot be understood by the patient who is tense, anxious and bewildered.
Finally, a delusion may crystallize out of this mood and with its appearance there is often a sense of relief. In this an abnormal significance, usually in the sense of self-reference, despite the absence of any emotional or logical reason, is attributed to normal perception. Jaspers delineated the concept of delusional percept; and Gruhle used this description to cover almost all delusions.
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Schneider considered the essence of delusional perception to be the abnormal significance attached to a real percept without any cause that is understandable in rational or emotional terms; it is self-referent, momentous, urgent, of overwhelming personal significance and of course false.
This is the symptom when the patient recalls as remembered an event or idea that is clearly delusional in nature, that is, delusion is retrojected in time. These are sometimes called retrospective delusions. Delusional awareness is an experience which is not sensory in nature, in which ideas or events take on an extreme vividness as if they had additional reality. Delusional significance is the second stage of the occurrence of delusional perception. Objects and persons are perceived normally, but take on a special significance which cannot be rationally explained by the patient.
Delusions are infinitely variable in their content but certain general characteristics commonly occur. It is determined by the emotional, social and cultural background of the patient. Common general themes include persecution, jealousy, love, grandiose, religious, nihilistic, hypochondriacal and several others. It is the most frequent content of delusion. It was distinguished from other types of delusion and other forms of melancholia by Lasegue The interfering agent may be animate or inanimate, other people or machines; may be system, organizations or institutions rather than individuals.
Sometimes the patient experiences persecution as a vague influence without knowing who is responsible. May occur in conditions like: Schizophrenia, Affective psychosis: Manic, Depressive type, and Organic states: Acute, chronic. Persecutory overvalued ideas are a prominent facet of the litiginous type of paranoid personality disorder. Described by Ey may be manifested as delusion, overvalued idea, depressive affect or anxiety state. Various terms have been used to describe abnormal, morbid or malignant jealousy.
Enoch and Trethowan have considered the demonstration of delusion of infidelity in distinguishing psychotic from other types. Mullen has classified morbid jealousy with disorders of passion in which there is an overwhelming sense of entitlement and a conviction that others are abrogating their rights. The other two are the querulant who are indignant at infringements of rights and the erotomanic who are driven to assert their rights of love.
Delusion of infidelity may occur without other psychotic symptoms. Such delusions are resistant to treatment and do not change with time. Delusions of jealousy are common with alcohol abuse, they may also occur in some organic states, and are often associated with impotence, e.
Husbands or wives may show sexual jealousy, as may sexual cohabitees and homosexual pairs. Morbid jealousy makes a major contribution to the frequency of wife battering and is one of the commonest motivations for homicide. The respect the fixed and permanent delusions attending erotomania sometimes prompt those laboring under it to destroy themselves or others, for though in general tranquil and peaceful, the patient sometimes becomes irritable, passionate and jealous.
These have sometimes been classified as paranoia, rather than paranoid schizophrenia; these delusional symptoms sometimes occur in the context of manic-depressive psychosis. A variation of erotomania was described by and retains the name of de Clerambault Typically, a woman believes a man, who is older and of higher social status than she, is in love with her. In this the patient may believe himself to be a famous celebrity or to have supernatural powers.
Expansive or grandiose delusional beliefs may extend to objects, so leading to delusion of invention. Grandiose and expansive delusions may also be part of fantastic hallucinosis, in which all forms of hallucinations occur. The form of the delusion is dictated by the nature of the illness. So religious delusions are not caused by excessive religious belief, nor by the wrongdoing which the patient attributes as cause, but they simply accentuate that when a person becomes mentally ill his delusions reflect, in their content, his predominant interests and concerns.
Although common, they formed a higher proportion in the nineteenth century than in the twentieth century and are still prevalent in developing countries. Initially the patient may be self-reproachful and self-critical which may ultimately lead to delusions of guilt and unworthiness, when the patients believe that they are bad or evil persons and have ruined their family.
They may claim to have committed an unpardonable sin and insist that they will rot in hell for this. These are common in depressive illness, and may lead to suicide or homicide. These are the reverse of grandiose delusions where oneself, objects or situations are expansive and enriched; there is also a perverse grandiosity about the nihilistic delusions themselves. Feelings of guilt and hypochondriacal ideas are developed to their most extreme, depressive form in nihilistic delusions.
Delusions impair respect for and competence of the sufferer and promote compensatory delusional interpretation. None of these factors are absolute but any or all may act synergistically to initiate and maintain delusion. Conrad proposed five stages of which are involved in the formation of delusions:. Freud proposed that delusion formation involving denial, contradiction and projection of repressed homosexual impulses that break out from unconscious.
Later in de Clerambault, put forth the view that chronic delusions resulted from abnormal neurological events infections, intoxications, lesions. Maher offered a cognitive account of delusions which emphasized disturbances of perception. He proposed that a delusional individual suffers from primary perceptual abnormalities, seeks an explanation which is then developed through normal cognitive mechanism, the explanation i.
Also, delusion is maintained in the same way as any other strong belief. These are further reinforced by anxiety reduction due to developing explanation for disturbing or puzzling experiences. He postulated that delusions in schizophrenia arise from faulty logical reasoning. The defect apparently consists of the assumption of the identity of two subjects on the ground of identical predicates e. Learning theorists have tried to explain delusions in terms of avoidance response, arising specially from fear of interpersonal encounter.
Luhmann defines that information, message and understanding connects the social systems with the psychic ones. If the psychic system fails to recognize the message of information correctly or is unable to negotiate between understanding and misunderstanding message, it detaches itself from the social system to which it is normally closely connected. This detachment releases the possibility of unhindered autistic fulfillment of desires and uncontrolled fear may appear as delusions.
Acute delusions are the result of an increased activity of the euromodulators dopamine and norepinephrine. This not only leads to a state of anxiety, increased arousal and suspicion, but also to an increased signal to noise ratio in the activation of neural networks involved in higher order cognitive functions, leading to formation of acute delusions.
Alteration in the neuromodulatory state not only causes the occurrence of unusual experiences but also modify neruroplasicity which influences the mechanism of long term changes. So chronic delusions may be maintained by a permanently increased neuromodulatory state, or by an extremely decreased noradrenergic neuromodulatory state Black wood et al. It refers to the capacity of attributing mental states such as intentions, knowledge, beliefs, thinking and willing to oneself as well as to others.
Amongst other things this capacity allows us to predict the behavior of others. Frith postulated that paranoid syndromes exhibit a specific ToM deficit, e. Since deluded patients in symptomatic remission performed as well as normal controls at ToM tasks, ToM deficits seem to be a state rather than a trait variable. Delusions driven by underlying affect mood congruent may differ neurocognitively from those which have no such connection mood incongruent.
Thus, specific delusion-related autobiographical memory contents may be resistant to normal forgetting processes, and so can escalate into continuous biased recall of mood congruent memories and beliefs. Regarding threat and aversive response, identification of emotionally weighted stimuli relevant to delusions of persecution has been seen. It assumes that the probability-based decision-making process in delusional individuals requires less information than that of healthy individuals, causing them to jump to conclusions, which is neither a function of impulsive decision-making nor a consequence of memory deficit.
Kemp et al. The findings in reasoning abilities in delusional patients are only subtle and one might question the strength of their causality in delusional thinking. Bentall and others proposed that negative events that could potentially threaten the self-esteem are attributed to others externalized causal attribution so as to avoid a discrepancy between the ideal self and the self that is as it is experienced. An extreme form of a self-serving attributional style should explain the formation of delusional beliefs, at least in cases where the delusional network is based on ideas of persecution, without any co-occurring perceptual or experiential anomaly.
During the course of illness, the preferential encoding and recall of delusion-sensitive material can be assumed to continually reinforce and propagate the delusional belief. The emergence of symptoms assumed to depend upon an interaction between vulnerability and stress. Therefore the formation of delusion begins with a precipitator such as life event, stressful situations, drug use leading to arousal and sleep disturbance. This often occurs against the backdrop of long-term anxiety and depression.
The arousal will initiate inner outer confusion causing anomalous experiences as voices, actions as unintended or perceptual anomalies which will turn on a drive for a search for meaning, leading to selection of explanation in the form of delusional belief [ Figure 1 ]. Roberts G. The earlier works like Hartley suggested that vibration caused by brain lesion may match with vibrations associated with real perception.
Ey believed delusion to be a sign of cerebral dysfunctions and Morselli listed the metabolic states for delusional pathogenesis. Jackson suggested pathogenesis of delusions due to combination of loss of functions of damaged part of brain. Cummings found that a wide variety of conditions can induce psychosis, particularly those that affect the limbic system, temporal lobe, caudate nucleus. He also noted that dopaminergic excess or reduced cholinergic activity also predispose to psychosis. He suggested that the common locus is limbic dysfunctions leading to inappropriate perception and paranoid delusion formation.
Septo-hippocampal dysfunction model: The dysfunction leads to erroneous identification of neutral stimuli as important and judge expected as actual. Storage of erroneous information leads to delusion formation. Semantic memory dysfunction model: Delusions form due to inappropriate lying down of semantic memory and their recollections.
The study indicated that severity of delusions was associated with hypometabolism in additional prefrontal and anterior cingulate regions. Delusion of alien control has been linked with hyperactivation of the right inferior parietal lobule and cingulate gyrus, brain region important for visuospatial functions.
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Organic delusional disorders are more likely to be noted in extrapyramidal disorders involving the basal ganglia and thalamus and in limbic system disease. Alexander et al. Any lesions, dysfunctions or derangements that affect any part of this loop can be expected to alter beliefs and emotional behavior [ Figure 2 ].
Prediction error theories of delusion formation suggest that under the influence of inappropriate prediction error signal, possibly as a consequence of dopamine dysregulation, events that are insignificant and merely coincident seem to demand attention, feel important and relate to each other in meaningful ways. Delusions ultimately arise as a means of explaining these odd experiences Kapur, ; Maher, The insight relief gained by arriving at an explanatory scheme leads to strong consolidation of the scheme in memory. In support of this view, aberrant prediction error signals during learning in patients with first-episode psychosis have been confirmed experimentally.
Furthermore, the magnitude of aberrant prediction error signal correlated with delusion severity across a group of patients with first-episode psychosis. However, there are important characteristics of delusions that still demand explanation: Notably their persistence. Normal associations can extinguish if they prove erroneous, normal beliefs can be challenged and modified. But delusions are noteworthy for the fact that they remain even in the absence of support and in the face of strong contradictory evidence. We believe that this striking clinical phenomenon can be explained within the same framework by considering key findings from the animal learning literature, a literature that has been formerly invoked to explain chronic relapse to drug abuse; extinction and reconsolidation.
If delusion formation may be explained in terms of associative learning then perhaps extinction may represent the process through which delusions are resolved. Extinction involves a decline in responding to a stimulus that has previously been a consistent predictor of a salient outcome. Prediction error is also central to extinction. It has been suggested that negative prediction error a reduction in baseline firing rate of prediction error coding neurons leads the organism to categorize the extinction situation as different from the original, reinforced, situation and it now learns not to expect the salient event in that situation.
This learning focuses on contextual cues, allowing the animal to distinguish the newly non-reinforced context from the old, reinforced one. Extinction does not involve unlearning of the original association, but rather the formation of a new association between the absence of reinforcement and the extinction situation. Extinction experiences the absence of expected reinforcement invoke an inhibitory learning process which eventually overrides the original cue response in midbrain dopamine neurons.
Individuals with psychosis do not learn well from these absent but expected events, nor do they consolidate the learning that does occur. But there is more to delusion maintenance than persistence in the absence of supportive evidence: delusions persist even when there is evidence that directly contradicts them.
When confronted with counterfactual evidence, deluded individuals do not simply disregard the information. Rather, they may make further erroneous extrapolations and even incorporate the contradictory information into their belief.
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So, while delusions are fixed, they are also elastic and may incorporate new information without shifting their fundamental perspective. Once a simple delusional belief is adopted with conviction, the subsequent course is very variable. Some patients have fleeting or brief delusional states, spontaneously remitting and returning to normal.
Others elaborate and develop their belief into a comprehensive system which may remain unaltered even with regular medication. The multidimensionality of delusional experience also has implications for the conceptualization of the temporal course of psychotic decompensation and resolution. Individual dimensions of delusional experience often change independently of one another during the course of a psychotic episode, so that recovery can be determined by changes in one of the several dimensions Garety and Freeman, Encapsulation: Patients vary very much in the degree to which they can maintain their original personality and adapt to a normal life.
It is frequently seen in residual states. In some cases one sees a longitudinal splitting as it were in the current of life, both the reality adapted and the delusional life go on alongside each other. On certain occasions e. Meeting certain people, return to familiar locations, meeting the doctor who had treated the patient the delusional complex comes to the surface and florid symptoms reappear.
Jorgensen found three types of recovery, one with full and the other two with partial recovery of delusional beliefs. In patients with partial recovery, decrease in pressure precede, decrease in other dimensions. For two-thirds there was no change in the degree or insight during recovery.
Delusions are a key clinical manifestation of psychosis and have particular significance for the diagnosis of schizophrenia. Although common in several psychiatric conditions, they also occur in a diverse range of other disorders including brain injury, intoxication and somatic illness.
Delusions are significant precisely because they make sense for the believer and are held to be evidentially true, often making them resistant to change. Although an important element of psychiatric diagnosis, delusions have yet to be adequately defined. The last decade has witnessed a particular intensification of research on delusions, with cognitive neuroscience-based approaches providing increasingly useful and testable frameworks from which to construct a better understanding of how cognitive and neural systems are involved.
There is now considerable evidence for reasoning, attention, metacognition and attribution biases in delusional patients. Recently, these findings have been incorporated into a number of cognitive models that aim to explain delusion formation, maintenance and content. Although delusions are commonly conceptualized as beliefs, not all models make reference to models of normal belief formation. It has been argued that aberrant prediction error signals may be important not only for delusion formation but also for delusion maintenance since they drive the retrieval and reconsolidation-based strengthening of delusional beliefs, even in situations when extinction learning ought to dominate.
Given the proposed function of reconsolidation, in driving automaticity of behavior it is argued that in an aberrant prediction error system, delusional beliefs rapidly become inflexible habits. Taking this translational approach will enhance our understanding of psychotic symptoms and may move us closer to the consilience between the biology and phenomenology of delusions.
Source of Support: Nil. Conflict of Interest: None declared. National Center for Biotechnology Information , U. Journal List Ind Psychiatry J v. Ind Psychiatry J. Chandra Kiran and Suprakash Chaudhury. Author information Copyright and License information Disclaimer. Address for correspondence: Dr. E-mail: moc.
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Abstract Delusion has always been a central topic for psychiatric research with regard to etiology, pathogenesis, diagnosis, treatment, and forensic relevance. Keywords: Delusions, Etiology, Psychopathology, Phenomenology. Open in a separate window. Jaspers regarded a delusion as a perverted view of reality, incorrigibly held, having three components: They are held with unusual conviction They are not amenable to logic The absurdity or erroneousness of their content is manifest to other people.
Table 3 Phenomenological classification of delusions. Table 4 Classification of delusions according to cause Cutting Primary and secondary delusions The term primary implies that delusion is not occurring in response to another psychopathological form such as mood disorder. Delusional mood It is usually a strange, uncanny mood in which the environment appears to be changed in a threatening way but the significance of the change cannot be understood by the patient who is tense, anxious and bewildered.
Delusional perception In this an abnormal significance, usually in the sense of self-reference, despite the absence of any emotional or logical reason, is attributed to normal perception. Delusional memory This is the symptom when the patient recalls as remembered an event or idea that is clearly delusional in nature, that is, delusion is retrojected in time. Delusional awareness Delusional awareness is an experience which is not sensory in nature, in which ideas or events take on an extreme vividness as if they had additional reality. Delusion of persecution It is the most frequent content of delusion.
Delusion of infidelity Described by Ey may be manifested as delusion, overvalued idea, depressive affect or anxiety state. Grandiose delusions In this the patient may believe himself to be a famous celebrity or to have supernatural powers. Delusions of guilt and unworthiness Initially the patient may be self-reproachful and self-critical which may ultimately lead to delusions of guilt and unworthiness, when the patients believe that they are bad or evil persons and have ruined their family.
Factors concerned in the germination of delusions: Disorder of brain functioning Background influences of temperament and personality Maintenance of self-esteem The role of affect As a response to perceptual disturbance As a response to depersonalization Associated with cognitive overload. Factors concerned in the maintenance of delusions: The inertia of changing ideas and the need for consistency Poverty of interpersonal communication Aggressive behavior resulting from persecutory delusions provokes hostility Delusions impair respect for and competence of the sufferer and promote compensatory delusional interpretation.
Learning theory Learning theorists have tried to explain delusions in terms of avoidance response, arising specially from fear of interpersonal encounter. The role of emotions Delusions driven by underlying affect mood congruent may differ neurocognitively from those which have no such connection mood incongruent. Probabilistic reasoning bias It assumes that the probability-based decision-making process in delusional individuals requires less information than that of healthy individuals, causing them to jump to conclusions, which is neither a function of impulsive decision-making nor a consequence of memory deficit.
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Theory of attributional bias Bentall and others proposed that negative events that could potentially threaten the self-esteem are attributed to others externalized causal attribution so as to avoid a discrepancy between the ideal self and the self that is as it is experienced. Multifactorial model The emergence of symptoms assumed to depend upon an interaction between vulnerability and stress. Figure 1. Neurobiological theories The earlier works like Hartley suggested that vibration caused by brain lesion may match with vibrations associated with real perception.
Figure 2. Others respond well to standard treatment. Adler A. In: Witte K. H, editor. Kommentierte textkritische Ausgabe. Goettingen: Vandenhoeck and Ruprecht; Blackwood N. J, Howard R. J, Bentall R. P, Murray R. Cognitive neuropsychiatric models of persecutory delusions.
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Estes W. Processes of memory loss, recovery, and distortion. Psychol Rev.
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Frith C. D, Frith U. Interacting minds-a biological basis. Delusions and correlating rCBF findings. Neurology Psychiatry Brain Research. Garety P. A, Freeman D. Cognitive approaches to delusions: A critical review of theories and evidence. British Journal of Clinical Psychology. Hoff P. Behav Sci Law. Effectiveness of cognitive therapy for delusion in routine clinical practice. British Journal of Psychiatry. Janzarik W. Strukturdynamische Grundlagen der Psychiatrie.
Stuttgart: Enke; Kapur S. Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. Am J Psychiatry. Maher B. Delusional thinking and perceptual disorder. Journal of Individual Psychology. Moorhead S, Turkington D. The CBT of delusional disorder: The relationship between schema vulnerability and psychotic content.
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