Paranoid Constructive Defense Hypothesis (PCDH): Delusion as a Miswired Protective Order Against Anxiety

Paranoid Constructive Defense Hypothesis (PCDH): Delusion as a Miswired Protective Order Against Anxiety | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 24 February 2026 V1 Latest version Share on Paranoid Constructive Defense Hypothesis (PCDH): Delusion as a Miswired Protective Order Against Anxiety Author : Alexander Dimitriev 0009-0000-0077-7168 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.177196348.87570186/v1 109 views 176 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Paranoid Constructive Defense Hypothesis (PCDH) reconceptualizes persecutory delusion as a miswired protective order against anxiety. We propose that when anxious arousal remains high and unresolved, the salience system over-tags neutral events while prefrontal reappraisal fails to flexibly dampen threat; to reduce ambiguity the mind consolidates a rigid, self-sealing narrative-stability is gained at the cost of accuracy. Within a network framework, hyperactive salience (insula/dACC) couples to self-referential default-mode processing under weakened frontoparietal control, and in predictive-coding terms inflated threat priors and mis-weighted precision drive threat-consistent inferences. PCDH yields testable predictions across levels. Neuroimaging: stronger salience capture and tighter SN-DMN coupling with reduced top-down PFC→limbic influence. Electrophysiology: diminished MMN and P50 sensory gating, reduced P300, variable ERN; cognitive markers include jumpingto-conclusions and bias against disconfirmatory evidence. Biomarkers: lower heartrate variability and alterations of HPA/inflammatory indices (e.g., cortisol, IL-6/CRP) covary with conviction and distress. Clinically, mechanism-aligned care should target both the fuel and the form of delusion: (i) reduce arousal/worry and intolerance of uncertainty (SSRIs/SNRIs, CBT-Anxiety), (ii) loosen aberrant salience (antipsychotics when indicated), and (iii) provide structured alternative meanings (CBTp, metacognitive and reasoning-focused interventions). Rather than an 'attack on belief,' PCDH motivates an 'offer of safer order'-a competing, reality-congruent structure that restores tolerance for uncertainty while improving conviction, distress, and functioning. Supplementary Material File (pcdh_manuscript-1 (5).pdf) Download 368.23 KB Information & Authors Information Version history V1 Version 1 24 February 2026 Copyright This work is licensed under a Creative Commons Attribution 4.0 International License Keywords aberrant salience anxiety cbtp delusion intolerance of uncertainty metacognitive training paranoia predictive coding Authors Affiliations Alexander Dimitriev 0009-0000-0077-7168 [email protected] View all articles by this author Metrics & Citations Metrics Article Usage 109 views 176 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Alexander Dimitriev. Paranoid Constructive Defense Hypothesis (PCDH): Delusion as a Miswired Protective Order Against Anxiety. Authorea . 24 February 2026. DOI: https://doi.org/10.22541/au.177196348.87570186/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. 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