Exploring the typology problem of delusions using qualitative thematic analysis of lived-experience of people with schizophrenia diagnosis

The typology problem of delusions involves determining the type of mental state instantiated by reports labeled as delusional. This paper explores this problem through qualitative thematic analysis (QTA) of phenomenologically guided clinical interviews with eight individuals diagnosed with schizophrenia. The analysis focused on lived experiences related to the formation, development, fixation, and maintenance of delusions. Results show that (1) delusions often emerge from altered perceptual-affective atmospheres and are shaped by auditory hallucinations; (2) people displayed epistemic circularity and intersubjective opacity, including secrecy, anticipated misunderstanding, and ineffability; and, that (3) delusions are frequently accepted passively, yet justified through narrative elaboration and affective salience. We conclude that the typology has inherited oversimplistic notions of belief, and that the lived-experience data supports a plural and graded account, accommodating delusions as atypical and qualitative rich beliefs rather than excluding them from that category. The findings challenge the dichotomy between doxastic and non-doxastic models by showing that delusions instantiate a hybrid structure of propositional commitment shaped by embodied-affective and intersubjective disrupted components.