The distinction of a delusion

[Decepticon]

I am preparing for an exam, and have a question about delusions. The way I have understood it, delusion is a term for a belief that shows that the patient has a distorted view of reality.

My psych-book defines delusions as beliefs that are fixed (not changing over time, regardless of what arguments you present the person with), false and idiosyncratic.

My question is how accurate the definition of delusion is, if meant to be reflective of a destorted reality-sense.

By making a distinction between individuals that have a belief that is peculiar to them, and those having a belief with common features seen in a larger population, can you actually be sure that you aren't excluding people having a common biologic trait? Can you prove it?

Say I had a firm belief that the temperature outside would drop everytime I watched a TV talk show, you could prove me wrong by showing how the temperature didn't actually drop by turning on the TV. If I kept on believing it, you would know that there was something distorted about my reality perceptions.

Say I believe that an outer force from another galaxy has the possibility to rid me of of a disease I have, and that I was able to communicate through prayer with this galaxy force on a daily basis. My belief would not change over time, you could not change my conviction with arguments, and you could not have me admit there is a chance that I could be wrong. There is a huge discrepancy between scientific data supporting my belief, and the firmness of my belief. However, you couldn't, epistemologically, prove me wrong. Would you be able to say that my sense of reality was distorted?

Say I believe in the Christian God, and that the Lord has the ability to heal my disease, and that I was able to communicate with the Lord through prayer (not actually hearing his voice from outside of my head) on a daily basis. My belief would not change over time, you could not change my conviction with arguments, and you could not have me admit there is a chance that I could be wrong. There is a huge discrepancy between scientific data supporting my belief, and the firmness of my belief. However, you couldn't, epistemologically, prove me wrong. Would you be able to say that my sense of reality was distorted?

I do believe that the psychological basis behind religion is different than the idiosyncratic delusions. But how can you know for sure. (And then you have all the people with idiosyncratic religious beliefs, blurring the transition on one criteria)

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[nsx]

Christianity is not peculiar.

You could argue that Newton was delusional in his day despite "scientific evidence."

I believe in God and enjoy arguing this point Also another reason why psychiatry

I am preparing for an exam, and have a question about delusions. The way I have understood it, delusion is a term for a belief that shows that the patient has a distorted view of reality.

My psych-book defines delusions as beliefs that are fixed (not changing over time, regardless of what arguments you present the person with), false and idiosyncratic.

My question is how accurate the definition of delusion is, if meant to be reflective of a destorted reality-sense.

By making a distinction between individuals that have a belief that is peculiar to them, and those having a belief with common features seen in a larger population, can you actually be sure that you aren't excluding people having a common biologic trait? Can you prove it?

Say I had a firm belief that the temperature outside would drop everytime I watched a TV talk show, you could prove me wrong by showing how the temperature didn't actually drop by turning on the TV. If I kept on believing it, you would know that there was something distorted about my reality perceptions.

Say I believe that an outer force from another galaxy has the possibility to rid me of of a disease I have, and that I was able to communicate through prayer with this galaxy force on a daily basis. My belief would not change over time, you could not change my conviction with arguments, and you could not have me admit there is a chance that I could be wrong. There is a huge discrepancy between scientific data supporting my belief, and the firmness of my belief. However, you couldn't, epistemologically, prove me wrong. Would you be able to say that my sense of reality was distorted?

Say I believe in the Christian God, and that the Lord has the ability to heal my disease, and that I was able to communicate with the Lord through prayer (not actually hearing his voice from outside of my head) on a daily basis. My belief would not change over time, you could not change my conviction with arguments, and you could not have me admit there is a chance that I could be wrong. There is a huge discrepancy between scientific data supporting my belief, and the firmness of my belief. However, you couldn't, epistemologically, prove me wrong. Would you be able to say that my sense of reality was distorted?

I do believe that the psychological basis behind religion is different than the idiosyncratic delusions. But how can you know for sure. (And then you have all the people with idiosyncratic religious beliefs, blurring the transition on one criteria)

 

[Decepticon]

Christianity is not peculiar.

You could argue that Newton was delusional in his day despite "scientific evidence."

I believe in God and enjoy arguing this point Also another reason why psychiatry

Lots of brilliant people believe in God. Lots of brilliant authors etc. have been bipolar, etc. Epistemologically, I have to admit you can't disprove a being of some sort.

I wasn't really intending to be trolling Christians here, perhaps I should have been more clear on that. I am learning psych, and I need some help to understand the concept of delusion. Is the definition solely dependent upon the patient?

If I have a kidney disease, my kidneys don't work no matter what you think of them, no matter how many other patients also share the same kidney disease. It is still a disease. If my brain gives me a distorted sense of reality, the definition of that reality distortion should be given by what is wrong with me, and not dependent upon how many others share the same perceptions. Prevalence of a thought cannot be taken as a proof there ain't nothing wrong with my reality sense, that is what seems to bug me.

Is there any other descriptive way of explaining delusions, or explaining why idiosyncraticity is part of defining a delusion?

Or is a delusion ultimately simply defined as, whatever the psychiatrist views as a belief that has to be a result of something irrational or logic-defying?

Like you said, many scientists would fit the delusion criteria I listed- namely all those proposing theories that were later proved to be false, and who couldn't be swayed to believe anything else than their peculiar theory. I suppose their brains aren't really the same as the brain of a someone experiencing other classic delusions, but from the definition, you can't really distinguish, can you?

So I am looking for some input, or some more precise definition here, what is actually diagnosed when you say "delusion"

 

[Decepticon]

I guess what I am trying to say is: from a pure descriptive behavioral perspective, it seems impossible to clearly demarcate what is a delusion. You have to throw in some of your own speculation, based on your own understanding of what seems plausible or not.

If I believe that green martians will descend from the sky and zap me in the bum, if I were to watch porn on my computer, you would categorize med as delusional.

If I believe that the Lord will punish me for watching porn on my computer, you would not categorize me as delusional.

What if I believed the Lord would make me fail the next USMLE step for watching porn on my computer? Would that make me delusional? Or if I believed the Lord looked like a man, would that make med delusional?

Can you tell, without introducing speculation on what causes people to have certain beliefs?

 

[peppy]

I am a student too, so I will defer to any of the docs who want to weigh in, but I believe the definition in the DSM-IV makes the distinction that a delusion is "not accepted by other members of the person's culture or subculture".
A lot of cultural beliefs are clearly untrue or bizarre if you really examine them (not just religious ones), so I would see the distinction as being that believing in something because you've been taught by others in your society to believe in such things is not evidence of a pathological brain process the way that coming up with an irrational belief out of whole cloth on your own is.
There's also the issue of whether the belief causes problems with functioning in society. A lot of people in the general public have traits or tendencies that are similar to those seen in the personality disorders, but just not to the degree that it interferes with that person's functioning in life and society. Having an unconventional/bizarre belief is not going to get you admitted to the psychiatric floor unless it is getting in the way of functioning or posing some sort of danger.

 

[Decepticon]

A lot of cultural beliefs are clearly untrue or bizarre if you really examine them (not just religious ones), so I would see the distinction as being that believing in something because you've been taught by others in your society to believe in such things is not evidence of a pathological brain process the way that coming up with an irrational belief out of whole cloth on your own is.

Well, that is what I personally believe , and it certainly looks like upbringing is part of what faith/beliefs you develop. But that is what I was aiming at, that is not descriptive distinction, you make the distinction between delusion and normal faith based on assumed origin. I am not saying that is w.r.o.n.g.

There's also the issue of whether the belief causes problems with functioning in society. A lot of people in the general public have traits or tendencies that are similar to those seen in the personality disorders, but just not to the degree that it interferes with that person's functioning in life and society.

Mmm... that is kind of a slippery slope, because how is "functioning in society" defined categorically? Do I have a disease if I don't like watching NFL? My social functioning will clearly be impaired in some circles if I don't like football, beer or whatever, right? And even being Christian can cause social impairment in some circles in Europe, so by that definition, you could certainly fit big religions into it as well.

Having an unconventional/bizarre belief is not going to get you admitted to the psychiatric floor unless it is getting in the way of functioning or posing some sort of danger.

Well, I hope not. Scientists and innovators need to have unconventional sides to come up with new stuff. It could get pretty crammed on the psych ward.

 

[nsx]

it seems impossible to clearly demarcate what is a delusion.

We can agree on this.
No offense at your post By presenting two different sides of the same argument, I was trying to demonstrate that the criteria for a delusion appears to be simply anything that differs from majority belief.

as n==>1, delusion==> true

Kind of like Wikipedia's requirement that information only be "verifiable."

It's hard to put stock in loaded statements like "delusional", when so much of the dsm-IV is open to interpretation.

 

[DrIng]

One of the aspects of a delusions that you are missing is that it has to be out of keeping with a persons culture- for example i had a patient who has a priest who believed in particular regligious manifestations, with his consent we talked with other members of his religious order and found out that his beliefs were out of keeping with theirs (I'm keeping this vague to preserve confidentiality), if the other priests had definitely said that yes little red dots are the manifestions of Mary then it wouldn't have been considered a delusion.