Guilt Delusion: What It Is, Characteristics, Causes And Treatment
The delusion of guilt shows the characteristics of other delusions, but presenting as its central theme the unrealistic belief that we are to blame for a negative event.
This type of delirium is normally linked to depression, but the treatment used will depend on the main condition causing this problem.
In this article you will learn better what is meant by delirium and specifically by delusion of guilt.what are its main symptoms, the causes that generate it and how to treat it.
Delusions are considered a psychological alteration associated with mental disorders that affect the content of thought; are defined as false judgments that are maintained by the subject with full conviction even when evidence and experiences incompatible with that idea are presented. In this way, it is a symptom typical of psychotic pathology, although it can occur in patients with other disorders other than those typically psychotic: for example, in bipolar disorder, depressive disorders, delirium or dementia.
They are immodest and incorrigible beliefs, that is, they remain stable over time. They show themselves with great conviction and intensity: the subject is fully convinced that they reflect reality and there is nothing that can change your mind; His thinking is not supported by his culture, and his environment does not have this same belief.
In the same way, the delusional idea generates great concern in the subject; Much, if not all, of your day revolves around this belief. On some occasions, especially in patients with schizophrenia, the delusional idea is implausible, which means that it does not make sense and cannot occur in reality; For example, he may believe that he has lost his internal organs and that he is empty inside.
Normally delusions are personal in nature, and given the patient’s full belief in these ideas, He does nothing to avoid them nor fights for them to disappear..
Delusions are a psychotic symptom; By themselves they do not cause a disorder; it is necessary to meet other criteria such as the presence of other symptoms or a minimum duration of the condition.
On the other hand, It is important to differentiate it from the other characteristic psychotic symptom: hallucinations. These are considered an alteration of perception, and the five senses are affected, that is, the subject can see, hear, smell, feel touch or taste a stimulus that does not really exist.
Now that we know what a delusional idea is and what its main characteristics are, we will focus on the delusion of guilt.
What is delusion of guilt?
In the delirium of guilt we observe a full conviction of the idea that one is guilty of something and that one’s current negative state is one’s fault. This type of delusion is mainly shown in subjects with major depressive disorder, who, apart from having symptoms typical of the depressive state, also present psychotic symptoms, in this case a delusional idea.
It will be important that we ensure that the idea of guilt is presented intensely, persistently and with high conviction; These characteristics must be shown to be able to differentiate from simple guilt for an event that has occurred and about which we believe we could have done more.
Main symptoms
The symptoms presented by patients with this type of delirium are those of delusional ideas but focused on the issue of being guilty and responsible for an event. The subject may have hallucinations linked to delirium, that is, they are consistent with its theme; But normally in subjects with depression and delusions of guilt, other psychotic symptoms are not usually observed. The mood is consistent with delirium, for this reason it is common for it to appear in depressed individuals.
Also we observed anosognosia, a term that means that the patient is not aware of having any pathology, he perceives it as something real. The affectation that the individual shows will depend on what other symptoms he or she has; For example, schizophrenia disorder presents greater alteration than delusional disorder. However, in the delusion of guilt, a special impact on the psychosocial sphere is not perceived.
Less affected cases imply that only the environment linked to the topic of the delusional idea will be affected., the patient being able to continue functional in other contexts. Likewise, if there is no intervention, delirium tends to become chronic, becoming increasingly integrated into the subject’s life. Despite treating it, the subject remains more vulnerable to developing it again when faced with a stimulus that triggers it.
Causes
There are different causes that can lead to the appearance of a delusion of guilt; As happens in most disorders, Some of these triggers are due to biological or genetic factors, such as a viral infection or neurodevelopmental problems.and another part is influenced by environmental, learned causes, such as the upbringing environment or the family.
It is believed that the factors linked to the appearance of delusional ideas are the following: brain dysfunctions, the personality type (depending on personality, there is a greater predisposition to present a delusion and it also influences its theme), the maintenance of self-esteem (this factor usually occurs in delusions that refer to oneself), and affect (the delusion of guilt is shown mainly in depression; therefore, affect will have a great influence in this case).
Other factors related to the appearance of delusions are unusual experiences (in the face of experiences that the subject has and cannot explain, it is believed that the tendency to use delusional ideas to make sense of them may arise) cognitive overload (such as excessive activation) or hypervigilance (is linked to a change in brain function that could lead to the formation of delusions).
In addition, Interpersonal variables influence the manifestation of delusional ideas (a deficit in social skills is observed that would lead to difficulties in social interactions), social isolation (as a consequence the subject would not have social validation of their beliefs), and situational variables (such as sensory isolation or lack of stimulation) .
The inertia to maintain belief is observed in all subjects, not only in those who have developed a pathology; If the idea is accepted by the patient and believed to be true, it will be difficult for him to abandon or change it. Another relevant phenomenon is the self-fulfilling prophecy: the delusional idea influences and affects behavior, causing the environment to end up acting confirming the delusion.
Attribution biases are also important.: As strange perceptions or experiences continue to occur, they verify the delirium.
Treatment
When we begin the treatment of delirium, it will be necessary to assess what the patient’s main condition is, that is, it is observed whether, apart from delirium, there is a mental disorder, such as the aforementioned depressive disorder. If so, psychotherapy professionals focus on intervening in the primary problem using the treatment techniques specific to that pathology.
However, To reduce delusions, the treatments that have been proposed are very similar to those used with schizophrenia.. When we confront the delusional idea, it is important to do it progressively to gain the patient’s trust. In most cases, the subject does not attend therapy voluntarily but is referred by a doctor or by family recommendation.
The use of psychotropic drugs is also useful, especially when the patient is agitated or altered, in the acute phase. Psychological intervention, as we have said, is similar to that used for the treatment of schizophrenia, with cognitive-behavioral therapy being the most used to deal with delusions.
One of the most proven interventions is the cognitive therapy of Chadwick, Birchwood and Trower based on cognitive restructuring.. The two main techniques are verbal challenge, which presents the ultimate intention to challenge the delusional beliefs, and reality testing, which is based on empirical verification of the delusional belief.
