There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalised (characterised by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes In study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n=27) and a healthy control group (n=47) were compared on self-structure indices. In study 2 (n = 27), the clinical group also completed the card sort task before and after randomisation to either a 12-week mindfulness-based psychological therapy or treatment as usual control.Self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects and had more compartmentalised self-structures compared with controls. There were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalisation and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.
- compartmentalisation; self-structure; self-concept; persecutory delusions; schizophrenia