Background:Negative beliefs about the self, including low self-compassion, have been identified as a putative causal factor in the occurrence of paranoia. Therefore, improving self-compassion may be one route to reduce paranoia.Aims:To assess the feasibility, acceptability, and potential clinical effects of a brief compassionate imagery intervention for patients with persecutory delusions.Method:Twelve patients with persecutory delusions received an individual four-session compassionate imagery intervention. Assessments of self-concept and paranoia were completed before treatment, immediately after treatment, and at 1-month follow-up. A qualitative study exploring participants’ experiences of the treatment was also completed.Results:Twelve out of 14 eligible patients referred to the study agreed to take part. All participants completed all therapy sessions and assessments. Post-treatment, there were improvements in self-compassion (change score –0.64, 95% CI –1.04, –0.24, d = –1.78), negative beliefs about the self (change score 2.42, 95% CI –0.37, 5.20, d = 0.51), and paranoia (change score 10.08, 95% CI 3.47, 16.69, d = 0.61). There were no serious adverse events. Three themes emerged from the qualitative analysis: ‘effortful learning’, ‘seeing change’ and ‘taking it forward’. Participants described a process of active and effortful engagement in therapy which was rewarded with positive changes, including feeling calmer, gaining clarity, and developing acceptance.Conclusion:This uncontrolled feasibility study indicates that a brief compassionate imagery intervention for patients with persecutory delusions is feasible, acceptable, and may lead to clinical benefits.

中文翻译：

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对被害妄想患者进行富有同情心的意象干预

背景：关于自我的消极信念，包括低自我同情心，已被确定为偏执狂发生的推定因果因素。因此，提高自我同情心可能是减少妄想症的一种途径。目的：评估对被害妄想患者进行简短的同情意象干预的可行性、可接受性和潜在临床效果。方法：12 名被害妄想患者分别接受了四-会话富有同情心的图像干预。自我概念和妄想症的评估在治疗前、治疗后立即和 1 个月随访时完成。还完成了一项探索参与者治疗体验的定性研究。结果：在 14 名符合条件的患者中，有 12 名转介该研究的患者同意参加。所有参与者都完成了所有治疗课程和评估。治疗后，自我同情有改善（变化分数 –0.64, 95% CI –1.04, –0.24,d= –1.78)，对自我的消极信念（变化分数 2.42, 95% CI –0.37, 5.20,d= 0.51）和偏执狂（变化分数 10.08, 95% CI 3.47, 16.69,d= 0.61)。没有严重的不良事件。定性分析提出了三个主题：“努力学习”、“看到变化”和“向前推进”。参与者描述了一个积极而努力地参与治疗的过程，该过程带来了积极的变化，包括感觉更平静、变得清晰和发展接受。结论：这项不受控制的可行性研究表明，对患有被害妄想的患者进行简短的富有同情心的意象干预是可行的，可接受，并可能带来临床益处。