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“Ego-Dystonic” Delusions as a Predictor of Dangerous Behavior

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Abstract

This paper aims to report a possible warning sign for dangerous behavior in delusional psychotic patients. We demonstrate an association between aggressive or auto-aggressive ideation and “ego-dystonic” grandiose delusions, where the patient believes to possess unique qualities but finds them unbearable. The study is based on the sample of seven interviews with five psychotic in-patients at the Kfar Shaul Mental Health Center, Jerusalem, Israel. All patients experienced an acute psychotic episode, and committed acts of aggression or suicidality. The research method is narrative analysis of semi-structured interviews. Patients report ideas of grandiose self-identification with deities, Biblical figures or celebrities, yet report their reluctance to be in these high positions due to feelings of unworthiness, withdrawal, and social isolation. Resulting frustration arguably leads to aggressive and suicidal ideation or actions. Contrary to the established view, grandiose delusions are not free of association with (auto-)aggression. The patient’s ego-dystonic attitude towards his/her delusional identity may serve as the warning sign for dangerous behavior and, as such, should be searched for and recognized by the mental health professionals.

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Authors and Affiliations

  1. Kfar Shaul Mental Health Center, The Hadassah Medical School, The Hebrew University of Jerusalem, Givat Shaul B, Jerusalem, 91060, Israel

    Zislin Joseph & Durst Rimona

  2. Department of Linguistic and Languages, McMaster University, Hamilton, ON, Canada

    Kuperman Victor

Authors
  1. Zislin Joseph
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  2. Kuperman Victor
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  3. Durst Rimona
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Correspondence to Zislin Joseph.

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Joseph, Z., Victor, K. & Rimona, D. “Ego-Dystonic” Delusions as a Predictor of Dangerous Behavior. Psychiatr Q 82, 113–120 (2011). https://doi.org/10.1007/s11126-010-9150-2

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  • DOI: https://doi.org/10.1007/s11126-010-9150-2

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