Attention, Theory of Mind, and Causal Attributions in People with Persecutory Delusions: A Preliminary Investigation

Introduction: Abnormal attributions and deficits in theory of mind (ToM) skills have been implicated in paranoid delusions. Bentall and Kinderman (1998) have proposed that ToM deficits tend to prevent individuals from making situational attributions and therefore increase the probability of external-personal attributions, which in turn lead to paranoid beliefs. They further suggested that more fundamental information-processing deficits, by affecting theory of mind skills, increase the probability of paranoid attributions.

Methods: Relationships between attention, ToM and attributions were assessed in acute and remitted paranoid patients and normal controls. Participants performed the digit span with distraction task, false belief and deception tasks, and a measure of attributional style.

Results: Compared to the controls, acute patients were distractible, performed poorly on ToM, and made more attributions that were judged external-personal by independent raters (but not as judged by self-ratings). ToM scores predicted the number of external-personal attributions as expected, but the effect of distraction on ToM was equivocal.

Conclusions: Preliminary support was found for the hypotheses, but further studies are required using a range of executive, attentional, ToM, and attribution measures.