There is evidence that Asperger syndrome is associated with delusional beliefs. Cognitive theories of delusions in psychosis literature propose a central role for impaired theory of mind ability in the development of delusions. The present study investigates the phenomenology of delusional ideation in Asperger syndrome. Fortysix individuals with Asperger syndrome participated and were found to have relatively high levels of delusional ideation, primarily grandiose or persecutory. Factors associated with delusional belief were anxiety, social anxiety and self-consciousness, but not theory of mind ability or autobiographical memory. The findings indicate that delusional belief is a prominent feature in Asperger syndrome, but do not support a mentalization based account. A preliminary cognitive model of delusions in Asperger syndrome is proposed and the theoretical and clinical implications of the findings are discussed.
AMERICAN PSYCHIATRIC ASSOCIATION (1987) Diagnostic and Statistical Manual of Mental Disorders, 3rd edn rev. (DSM-III-R). Washington, DC: APA .
2.
BECK, A. T. (1976) Cognitive Therapy and the Emotional Disorders. New York: International Universities Press .
3.
BENTALL, R. P. & KANEY, S. (1989) ‘Content-Specific Information Processing and Persecutory Delusions: An Investigation Using the Emotional Stroop Test’ , British Journal of Medical Psychology62 (4): 355–364 .
4.
BLACKSHAW, A. J. , KINDERMAN, P. , HARE, D. J. & HATTON, C. (2001) ‘Theory of Mind, Causal Attribution and Paranoia in Asperger Syndrome’ , Autism5 (2): 147–163 .
5.
BURGESS, P. W. & SHALLICE, T. (1997) The Hayling and Brixton Tests. UK: Thames Valley Test Company Limited .
6.
CHADWICK, P. , BIRCHWOOD, M. & TROWER, P. (1998) Cognitive Therapy for Delusions, Voices and Paranoia. Chichester: Wiley .
7.
CLARKE, D. J. , LITTLEJOHNS, C. S. , CORBETT, J. A. & JOSEPH, S. (1989) ‘Pervasive Developmental Disorders and Psychoses in Adult Life’ , British Journal of Psychiatry155: 692–699 .
8.
CLARKE, D. , BAXTER, M. , PERRY, D. & PRASHER, V. (1999) ‘The Diagnosis of Affective and Psychotic Disorders in Adults with Autism: Seven Case Reports’ , Autism3 (2): 149–164 .
9.
CORCORAN, R. (2000) ‘Theory of Mind in Other Clinical Conditions: Is a Selective “Theory of Mind” Deficit Exclusive to Autism?’, in S. BARON-COHEN , H. TAGER-FLUSBERG & D. J. COHEN (eds) Understanding Other Minds: Perspectives from Developmental Cognitive Neuroscience, 2nd edn.Oxford: Oxford University Press .
10.
CORCORAN, R. (2001) ‘Theory of Mind and Schizophrenia’, in P. W. CORRIGAN & D. L. PENN (eds) Social Cognition and Schizophrenia. Washington, DC: American Psychological Association .
11.
CORCORAN, R. , MERCER, G. & FRITH, C. D. (1995) ‘Schizophrenia, Symptomatology and Social Inference: Investigating Theory of Mind in People with Schizophrenia’ , Schizophrenia Research17 (1): 5–13 .
12.
CRAIG, J. S. , HATTON, C. , CRAIG, F. B. & BENTALL, R. P. (2004) ‘Persecutory Beliefs, Attributions and Theory of Mind: Comparison of Patients with Paranoid Delusions, Asperger's Syndrome and Normal Controls’ , Schizophrenia Research69 (1): 29–33 .
13.
DARR, G. C. & WORDEN, F. G. (1951) ‘Case Report Twenty Eight Years after an Infantile Autistic Disorder’ , American Journal of Orthopsychiatry21: 559–569 .
14.
FEAR, C. , SHARP, H. & HEALY, D. (1996) ‘Cognitive Processes in Delusional Disorders’ , British Journal of Psychiatry168 (1): 1–8 .
15.
FENIGSTEIN, A. & VANABLE, P. A. (1992) ‘Paranoia and Self-Consciousness’ , Journal of Personality and Social Psychology62 (1): 129–138 .
16.
FENIGSTEIN, A. , SCHEIER, M. F. & BUSS, A. H. (1975) ‘Public and Private Self-Consciousness: Assessment and Theory’ , Journal of Clinical and Consulting Psychology43 (4): 522–527 .
17.
FLETCHER, P. C. , HAPP…, F. , FRITH, U. , BAKER, S. C. , DOLAN, R. J. , FRACKOWIAK, R. S. J. & FRITH, C. D. (1995) ‘Other Minds in the Brain: A Functional Imaging Study of “Theory of Mind” in Story Comprehension’ , Cognition57 (2): 109–128 .
18.
FREEMAN, D. , GARETY, P. A. & PHILLIPS, M. L. (2000) ‘The Examination of Hypervigilance for External Threat in Individuals with Generalized Anxiety Disorder and Individuals with Persecutory Delusions Using Visual Scan Paths’ , Quarterly Journal of Experimental Psychology: Human Experimental Psychology53A: 549–567 .
19.
FRITH, C. D. (1979) ‘Consciousness, Information Processing and Schizophrenia’ , British Journal of Psychiatry168: 61–67 .
20.
FRITH, C. D. & CORCORAN, R. (1996) ‘Exploring “Theory of Mind” in People with Schizophrenia’ , Psychological Medicine26 (3): 521–530 .
21.
GARETY, P. A. & FREEMAN, D. (1999) ‘Cognitive Approaches to Delusions: A Critical Review of Theories and Evidence’ , British Journal of Clinical Psychology38 (2): 113–154 .
22.
GHAZUIDDIN, M. , WEIDNER-MIKHAIL, E. & GHAZIUDDIN, N. (1998) ‘Comorbidity of Asperger Syndrome: A Preliminary Report’ , Journal of Intellectual Disability Research42 (4): 279–283 .
23.
HADDOCK, G. & TARRIER, N. (1998) ‘Cognitive Behaviour Therapy for Psychotic Symptoms in Schizophrenia’, in N. TARRIER , A. WELLS & G. HADDOCK (eds) Treating Complex Cases: The Cognitive Behavioural Approach. Chichester: Wiley .
24.
HAPP…, F. (1994) ‘An Advanced Test of Theory of Mind: Understanding of Story Characters’ Thoughts and Feelings by Able Autistic, Mentally Handicapped and Normal Children and Adults’ , Journal of Autism and Developmental Disorders24 (2): 129–154 .
25.
HARE, D. J. (1997) ‘The Use of Cognitive Behavioural Therapy with People with Asperger Syndrome’ , Autism1 (2): 215–225 .
26.
HARE, D. J. (2004) ‘Developing Cognitive Behavioural Work with People with ASD’ , Good Autism Practice5 (1): 18–22 .
27.
HARE, D. J. & PAINE, C. (1997) ‘Developing Cognitive Behavioural Treatments for People with Asperger's Syndrome’, Clinical Psychology ForumDecember 1997: 5–8.
28.
HARE, D. J. , JONES, J. P. R. & PAINE, C. (1999) ‘Approaching Reality: The Use of Personal Construct Assessment in Working with People with Asperger Syndrome’ , Autism3 (2): 165–176 .
29.
HOWELL, D. C. (1992) Statistical Methods for Psychology, 3rd edn.California: Duxbury .
30.
HOWLIN, P. (2004) Autism and Asperger Syndrome: Preparing for Adulthood(2nd edition). London: Routledge .
31.
KANEY, S. , BOWEN-JONES, K. & BENTALL, R. P. (1999) ‘Persecutory Delusions and Autobiographical Memory’ , British Journal of Clinical Psychology38 (1): 97–102 .
32.
KOPELMAN, M. D. , WILSON, B. A. & BADDELEY, A. D. (1989) ‘The Autobiographical Memory Interview: A New Assessment of Autobiographical and Personal Semantic Memory in Amnesic Patients’ , Journal of Clinical and Experimental Psychology11 (5): 724–744 .
33.
KOPELMAN, M. D. , WILSON, B. A. & BADDELEY, A. D. (1990) The Autobiographical Memory Interview. Suffolk: Thames Valley Test Company .
34.
LORD, C. (1995) ‘Treatment of a High-Functioning Adolescent with Autism: A Cognitive-Behavioural Approach’, in M. A. REINECKE & F. M. DATTILIO (eds) Cognitive Therapy with Children and Adolescents: A Casebook for Clinical Practice, pp. 394–404. New York: Guilford .
35.
NEWSON, E., DAWSON, M. & EVERARD, P. (1982) The Natural History of Able Autistic People: Their Management and Functioning in a Social Context. Unpublished report to the Department of Health and Social Security, London.
36.
PETERS, E. , DAY, S. & GARETY, P. (1997) ‘From Preconscious to Conscious Processing: Where Does the Abnormality Lie in Delusions?’ , Schizophrenia Research24: 120-120 .
37.
PETERS, E. R. , JOSEPH, S. R. & GARETY, P. A. (1999a) ‘The Measurement of Delusional Ideation in the Normal Population: Introducing the PDI (Peters et al. Delusions Inventory)’ , Schizophrenia Bulletin25 (3): 553–576 .
38.
PETERS, E. R. , DAY, S. , MCKENNA, J. & ORBACH, G. (1999b) ‘The Incidence of Delusional Ideation in Religious and Psychotic Populations’ , British Journal of Clinical Psychology38: 83–96 .
39.
POWELL, S. D. & JORDAN, R. R. (1992) ‘Using Photographs to Develop Autobiographical Memory in Children with Autism’ , in Proceedings of the International Conference on Living with Autism. Autism Research Unit: University of Sunderland.
40.
SMARI, J. , STEFANSSON, S. & THORGILSSON, H. (1994) ‘Paranoia, Self-Consciousness and Social Cognition in Schizophrenics’ , Cognitive Therapy and Research18 (4): 387–399 .
41.
SZATMARI, P. (1991) ‘Asperger's Syndrome: Diagnosis, Treatment and Outcome’ , Psychiatric Clinics of North America14 (1): 81–93 .
42.
TAGER-FLUSBERG, H. (1991) ‘Semantic Processing in the Free Recall of Autistic Children: Further Evidence for a Cognitive Deficit’ , British Journal of Developmental Psychology9 (3): 417–430 .
43.
TANTAM, D. (1986) ‘Eccentricity and Autism’, unpublished PhD thesis, University of London.
44.
TANTAM, D. (1991) ‘Asperger Syndrome in Adulthood’, in U. FRITH (ed.) Autism and Asperger Syndrome. Cambridge: Cambridge University Press .
45.
WECHSLER, D. (1999) Wechsler Abbreviated Scale of Intelligence. San Antonio, TX: Psychological Corporation .
46.
WELLS, A. & MATTHEWS, G. (1994) Attention and Emotion: A Clinical Perspective. Hove: Erlbaum .
47.
WING, L. (1981) ‘Asperger's Syndrome: A Clinical Account’ , Psychological Medicine11 (1): 115–129 .
48.
WING, J. K. , COOPER, J. E. & SARTORIUS, N. (1974) Measurement and Classification of Psychiatric Symptoms. Cambridge: Cambridge University Press .
49.
ZIGMOND, A. S. & SNAITH, R. P. (1983) ‘The Hospital Anxiety and Depression Scale’ , Acta Psychiatrica Scandinavica67 (6): 361–370 .
