ABSTRACT
This chapter outlines recent theoretical and empirical developments in the understanding of causal attributions in paranoia and persecutory delusions, and illustrates novel clinical approaches to therapeutic intervention targeted at changing causal attribution within a course of treatment using cognitive behavioural therapy. The attributional model of paranoia proposes that people with paranoid delusions show an attentional bias towards material that is both threat-related and related to negative self-representations. Kinderman and Bentall reported a single case study of cognitive behavioural therapy directed at modifying maladaptive attributions driving persecutory delusions. Mr Rattigan was a 28-year-old white single male. He was admitted to an acute psychiatric ward under Section 3 of the 1983 Mental Health Act following an assessment by his GP and an approved social worker. The Auditory Hallucinations Rating Scale (AHRS) and Delusions Rating Scale (DRS), now known as the Psychotic Symptom Rating Scale were used to assess the severity of a number of dimensions for each scale.
