Case studies

Two cases will be presented, one for each type o f paranoia (based upon content o f delusions).

Case 1 - a man with ‘poor me’ paranoia

This person, who shall be called John (not his real name), is participant number 15 listed in table 1. He had been on the run from someone whom he thought was trying to kill him for many years. This had taken him all over the country, and he had supported him self during this time by finding work, which he was well able to do, having been trained in a manual profession. He avoided particular places where he thought associates and friends o f his persecutor might spot him. He had no other psychotic symptoms other than this very strong belief that someone was trying to kill him.

When the researcher met him, he had recently been started on atypical anti-

psychotics which had enabled him to remain as an inpatient before being transferred to a supported hostel. Previous attempts to hospitalise him had resulted in him absconding out o f a strong fear that he may have been found by his persecutor.

Based on the content o f his delusions, he was classified as having a ‘poor m e’ type o f paranoia, however, his scores for ‘poor m e’ and ‘bad m e’ attributions on the PSQ came below the median level for the entire sample. As has been discussed earlier,

range o f those expected from non-delusional people, as no normative data was available for the PSQ.

Parenting

John scored 33 out o f a possible total o f 36 for levels o f maternal care, and 26 out o f 36 for paternal care. He scored 0 for maternal overprotection and 6 for paternal overprotection. On his grid (see fig 5.) he construed his father and m other very positively, giving mean scores o f 11.4 and 11.3 for each construct respectively. The highest possible mean score being 13.

A cluster analysis using the Webgrid III Focus Clustering function, was carried out. Percentage agreement between construal o f elements was calculated using this function.

Percentage agreement for construal of: self and ideal self 81.0% self and social self 87.0% self and someone disliked 48.8%

In addition to the small difference between the way in which the self and ideal self were construed, John also construed him self positively in absolute terms, not giving him self any negative ratings on any o f the constructs, however on the constructs insecure, ill, sad and disorganized, he had rated him self as zero, which strictly speaking means that he was saying that that construct does not apply to him, or perhaps that it did but he found him self unable to give him self a negative rating on any o f these.

Repertory g rid

Fig 3 Repertory grid for participant 15

5 1 3 7 1 0 1 3 1 0 7 7 1 1 1 3 1 1 3 1 3 1 3 kjrid r o ^ocxi 6 1 3 9 1 0 1 3 1 3 1 3 8 1 3 1 3 1 7 7 1 3 y <fcod 1 0 1 0 1 0 7 7 1 3 9 1 1 7 9 7 7 7 1 3 3 9 7 9 1 3 9 5 7 1 1 1 3 1 1 1 1 3 1 3 dishor/^si 7 1 3 2 1 3 1 3 7 7 7 7 1 3 7 1 3 1 3 1 3 m 1 1 1 1 7 8 1 O 1 2 9 1 3 1 1 9 7 7 7 7 we ) ? 1 1 3 7 1 0 1 1 1 3 1 3 1 1 3 1 3 7 1 1 1 1 1 3 friend}^ 1 1 1 9 1 3 1 1 9 1 3 1 1 1 1 1 3 1 1 1 1 1 1 3 cairv><7 4 1 0 4 1 3 1 3 1 3 1 3 6 9 9 1 1 3 1 3 1 1 1 3 9 7 7 9 7 1 1 7 1 1 7 7 7 1 1 1 0 1 0 8 1 3 1 3 7 1 1 3 1 O 1 3 7 1 3 1 3 1 3 h^rd 1 2 1 3 8 1 1 3 1 3 1 1 1 3 1 3 7 1 3 7 7 1 3 1 7 5 1 3 1 O 1 3 7 7 1 3 9 1 1 1 1 1 1 1 2 1 2 9 1 3 1 1 1 1 1 3 1 1 1 3 1 3 7 1 1 1 3 1 3 cac-.v>57 par h a p p y p f a t h e r s e l f f o r o t h e r s s a d p e r s o n e m p l o y e r e a s y e m p l o y e r d i f f i c u l t i d e a l s e l f s e l f in 1 y e a r s e l f s o m e o n e I d i s l i k e m o t h e r s o m e o n e I l i k e f r i e n d t n e r e r s o n

Constructs are situated down the sides o f the grid and elements are situated at the bottom.

Grid scores were converted to positive numbers for the purpose o f the analysis, therefore, a rating o f 7 is equivalent to a rating o f zero (or not applicable to that element), and a rating below 7 is equivalent to a negatively rating on that for that element on a particular construct.

Fig 3.1 Map of principal components with elements (red text) and constructs (blue text) for person with poor me’ paranoia

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Fig 4.1 Map of principal components with elements (red text) and constructs (blue text) for person with bad me’ paranoia

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