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Schizophrenia Research Jul 2020Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic... (Review)
Review
BACKGROUND
Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic experiences (paranoia and hallucinations). Hence sleep disruption may be a potential treatment target to prevent the onset of psychosis and reduce persistent psychotic experiences. The aim of this review is to describe developments in understanding the nature, causal role, and treatment of sleep disruption in psychosis.
METHOD
A systematic literature search was conducted to identify studies, published in the last five years, investigating subjective sleep disruption and psychotic experiences.
RESULTS
Fifty-eight papers were identified: 37 clinical and 21 non-clinical studies. The studies were correlational (n = 38; 20 clinical, 18 non-clinical), treatment (n = 7; 1 non-clinical), qualitative accounts (n = 6 clinical), prevalence estimates (n = 5 clinical), and experimental tests (n = 2 non-clinical). Insomnia (50%) and nightmare disorder (48%) are the most prevalent sleep problems found in patients. Sleep disruption predicts the onset and persistence of psychotic experiences such as paranoia and hallucinations, with negative affect identified as a partial mediator of this relationship. Patients recognise the detrimental effects of disrupted sleep and are keen for treatment. All psychological intervention studies reported large effect size improvements in sleep and there may be modest resultant improvements in psychotic experiences.
CONCLUSIONS
Sleep disruption is a treatable clinical problem in patients with psychosis. It is important to treat in its own right but may also lessen psychotic experiences. Research is required on how this knowledge can be implemented in clinical services.
Topics: Delusions; Hallucinations; Humans; Paranoid Disorders; Psychotic Disorders; Schizophrenia; Sleep
PubMed: 31831262
DOI: 10.1016/j.schres.2019.11.014 -
Biological Psychiatry. Cognitive... Nov 2022
Topics: Humans; Paranoid Disorders; Uncertainty; Emotions; Self Concept
PubMed: 36344038
DOI: 10.1016/j.bpsc.2022.09.011 -
Scientific Reports Oct 2022The present study investigated the effect of urban (traffic noise) vs. natural (birdsongs) soundscapes on mood, state paranoia, and cognitive performance, hypothesizing... (Randomized Controlled Trial)
Randomized Controlled Trial
The present study investigated the effect of urban (traffic noise) vs. natural (birdsongs) soundscapes on mood, state paranoia, and cognitive performance, hypothesizing that birdsongs lead to significant improvements in these outcomes. An additional goal was to explore the differential impact of lower vs. higher diversity of the soundscapes by manipulating the number of different typical traffic sounds or songs of different bird species within the respective soundscapes. In a randomized online experiment, N = 295 participants were exposed to one out of four conditions for 6 min: traffic noise low, traffic noise high, birdsong low, and birdsong high diversity soundscapes. Before and after the exposure, participants performed a digit-span and dual n-back task, and filled out depression, anxiety, and paranoia questionnaires. The traffic noise soundscapes were associated with a significant increase in depression (small effect size in low, medium effect size in high diversity condition). Concerning the birdsong conditions, depression exclusively decreased after exposure to the high diversity soundscape (small effect size). Anxiety and paranoia significantly decreased in both birdsong conditions (medium effect sizes). For cognition, no effects were observed. In sum, the present study suggests that listening to birdsongs regardless of diversity improves anxiety, while traffic noise, also regardless of diversity, is related to higher depressiveness. Moreover, for the first time, beneficial, medium-sized effects of birdsong soundscapes were demonstrated, reducing paranoia. Overall, the results bear interesting implications for further research, such as actively manipulating soundscapes in different environments or settings (e.g., psychiatric wards) and testing their effect on subclinical or even clinical manifestations of anxiety and paranoia.
Topics: Anxiety; Healthy Volunteers; Humans; Noise; Paranoid Disorders; Sound
PubMed: 36229489
DOI: 10.1038/s41598-022-20841-0 -
Respiratory Care Dec 2018Smoking tobacco is believed to be common among patients with psychiatric disorders like anxiety, depression, schizophrenia, and affective disorders. The aim of this... (Observational Study)
Observational Study
BACKGROUND
Smoking tobacco is believed to be common among patients with psychiatric disorders like anxiety, depression, schizophrenia, and affective disorders. The aim of this study was to investigate the psychological symptoms of people without known psychiatric diseases who have freely decided to quit smoking.
METHODS
A cross-sectional study was designed, and 124 healthy active-smokers (66 female) and 127 healthy non-smokers (61 female) were recruited. The symptom check list and Fagerström Test for Nicotine Dependence (FTND) were used to assess psychological symptoms and nicotine addiction level. Smokers were divided into 3 groups: light smokers (0-9 cigarettes/d), moderate smokers (10-19 cigarettes/d), and heavy smokers (> 20 cigarettes/d).
RESULTS
When subjects were compared by daily levels of cigarette consumption, somatic findings were more prominent in the mild smoker group (1.61 ± 0.72 vs 0.77 ± 0.56, < .001), while depression and hostility were similar across all groups. When subjects were compared by nicotine addiction ratio, the general symptom index of the group with high-grade nicotine addiction was found to be significantly higher than that of the control group (1.34 ± 0.72 vs 0.79 ± 0.49, < .001). In addition, the high-grade nicotine addiction group had higher scores than the other groups for somatization, anxiety, depression, paranoid symptoms, hostility, and other symptoms.
CONCLUSION
This study examined the association between psychological symptoms and smokers' daily cigarette consumption and nicotine addiction levels. Psychiatric symptoms (ie, somatization, anxiety, depression, hostility, and paranoia) were observed more frequently in people with high-grade nicotine addiction (FTND score 7-10 points).
Topics: Adult; Anxiety; Cigarette Smoking; Cross-Sectional Studies; Depression; Female; Hostility; Humans; Male; Middle Aged; Paranoid Disorders; Smokers; Smoking Cessation; Somatoform Disorders; Tobacco Use Disorder; Young Adult
PubMed: 30065079
DOI: 10.4187/respcare.06287 -
Social Psychiatry and Psychiatric... Apr 2021Parenting behaviours-including the extent to which parents are protective, hostile, or caring-likely impacts whether a child develops a sense of vulnerability that...
PURPOSE
Parenting behaviours-including the extent to which parents are protective, hostile, or caring-likely impacts whether a child develops a sense of vulnerability that carries forward into adulthood. Ideas of vulnerability are a contributory factor to the occurrence of paranoia. Our aim was to assess whether there is an association between specific parenting behaviours and paranoia.
METHOD
We examined cross-sectional associations of parenting and paranoia in an epidemiologically representative cohort of 10,148 adolescents (National Comorbidity Survey-Adolescents; NCS-A) and a second dataset of 1286 adults in Oxfordshire. Further, a network analysis was conducted with paranoia, parenting behaviours, and cognitive-affective variables (compassion, self-esteem, anxiety, and depression). Overprotectiveness, verbal abuse, physical abuse, and amount of care were assessed in mothers and fathers separately.
RESULTS
Nearly all parenting variables were significantly associated with paranoia, with parental verbal and physical abuse showing the largest associations. For example, the odds of reporting paranoia was over four times higher for those in the adult sample reporting a lot of paternal verbal abuse, compared to those reporting none (OR = 4.12, p < 0.001, CI 2.47-6.85). Network analyses revealed high interconnectivity between paranoia, parenting behaviours, and cognitive-affective variables. Of the parenting variables, paranoia most strongly interacted with paternal abuse and maternal lack of care.
CONCLUSION
There are associations between participants' self-reported experiences of parental behaviours and paranoia. Despite being associated with paranoia, cognitive-affective variables did not appear to mediate the relationship between parenting and paranoia, which is surprising. What might explain the link therefore remains to be determined.
Topics: Adolescent; Adult; Child; Comorbidity; Cross-Sectional Studies; Fathers; Female; Humans; Male; Paranoid Disorders; Parenting
PubMed: 32812085
DOI: 10.1007/s00127-020-01933-6 -
Acta Psychiatrica Scandinavica Dec 2018An evidence-base is emerging indicating detrimental and beneficial effects of social media. Little is known about the impact of social media use on people who experience...
OBJECTIVE
An evidence-base is emerging indicating detrimental and beneficial effects of social media. Little is known about the impact of social media use on people who experience psychosis.
METHOD
Forty-four participants with and without psychosis completed 1084 assessments of social media use, perceived social rank, mood, self-esteem and paranoia over a 6-day period using an experience sampling method (ESM).
RESULTS
Social media use predicted low mood, but did not predict self-esteem and paranoia. Posting about feelings and venting on social media predicted low mood and self-esteem and high paranoia, whilst posting about daily activities predicted increases in positive affect and self-esteem and viewing social media newsfeeds predicted reductions in negative affect and paranoia. Perceptions of low social rank when using social media predicted low mood and self-esteem and high paranoia. The impact of social media use did not differ between participants with and without psychosis; although, experiencing psychosis moderated the relationship between venting and negative affect. Social media use frequency was lower in people with psychosis.
CONCLUSION
Findings show the potential detrimental impact of social media use for people with and without psychosis. Despite few between-group differences, overall negative psychological consequences highlight the need to consider use in clinical practice.
Topics: Adult; Affect; Ecological Momentary Assessment; Female; Hierarchy, Social; Humans; Male; Middle Aged; Paranoid Disorders; Psychotic Disorders; Schizophrenia; Self Concept; Social Behavior; Social Media; Young Adult
PubMed: 30203454
DOI: 10.1111/acps.12953 -
Schizophrenia Bulletin Sep 2019Adolescence can be a challenging time, characterized by self-consciousness, heightened regard for peer acceptance, and fear of rejection. Interpersonal concerns are...
BACKGROUND
Adolescence can be a challenging time, characterized by self-consciousness, heightened regard for peer acceptance, and fear of rejection. Interpersonal concerns are amplified by unpredictable social interactions, both online and offline. This developmental and social context is potentially conducive to the emergence of paranoia. However, research on paranoia during adolescence is scarce.
METHOD
Our aim was to examine the prevalence, structure, and probabilistic causal mechanisms of adolescent paranoia. A representative school cohort of 801 adolescents (11-15 y) completed measures of paranoia and a range of affective, cognitive, and social factors. A Bayesian approach with Directed Acyclic Graphs (DAGs) was used to assess the causal interactions with paranoia.
RESULTS
Paranoid thoughts were very common, followed a continuous distribution, and were hierarchically structured. There was an overall paranoia factor, with sub-factors of social fears, physical threat fears, and conspiracy concerns. With all other variables controlled, DAG analysis identified paranoia had dependent relationships with negative affect, peer difficulties, bullying, and cognitive-affective responses to social media. The causal directions could not be fully determined, but it was more likely that negative affect contributed to paranoia and paranoia impacted peer relationships. Problematic social media use did not causally influence paranoia.
CONCLUSIONS
There is a continuum of paranoia in adolescence and occasional suspicions are common at this age. Anxiety and depression are closely connected with paranoia and may causally contribute to its development. Paranoia may negatively impact adolescent peer relationships. The clinical significance of paranoia in adolescents accessing mental health services must now be established.
Topics: Adolescent; Affect; Bayes Theorem; Bullying; Causality; Child; Cognition; Cohort Studies; Female; Humans; Interpersonal Relations; Male; Paranoid Behavior; Paranoid Disorders; Peer Group; Prevalence; Social Media; United Kingdom
PubMed: 30534970
DOI: 10.1093/schbul/sby180 -
Schizophrenia Research Mar 2023There is a dearth of research examining how individual-level and systemic racism may lead to elevated diagnostic and symptom rates of paranoia in Black Americans. The...
There is a dearth of research examining how individual-level and systemic racism may lead to elevated diagnostic and symptom rates of paranoia in Black Americans. The present study employed item response theory methods to investigate item- and subscale-level functioning in the Schizotypal Personality Questionnaire (SPQ) in 388 Black and 450 White participants across the schizophrenia-spectrum (i.e., non-psychiatric controls, individuals with schizophrenia, schizoaffective disorder, or schizotypal personality disorder). It was predicted that (1) Black participants would score significantly higher than Whites on the Suspiciousness and Paranoid Ideation subscale of the SPQ, while controlling for total SPQ severity and relevant demographics and (2) Black participants would endorse these subscale items at a lower latent severity level (i.e., total SPQ score) compared to Whites. Generalized linear modeling showed that Black participants endorsed higher scores on subscales sampling paranoia (e.g., Suspiciousness and Paranoid Ideation), while White participants endorsed higher rates within disorganized/positive symptomatology subscales (e.g., Odd or Eccentric Behavior). IRT analyses showed that Black individuals also endorse items within the Suspiciousness and Paranoid Ideation subscale at lower latent severity levels, leading to inflated subscale scores when compared to their White counterparts. Results indicate prominent race effects on self-reported paranoia as assessed by the SPQ. This study provides foundational data to parse what could be normative endorsements of paranoia versus indicators of clinical risk in Black Americans. Implications and recommendations for paranoia research and assessment are discussed.
Topics: Humans; Self Report; Paranoid Disorders; Psychotic Disorders; Schizotypal Personality Disorder; Surveys and Questionnaires; Personality
PubMed: 34895794
DOI: 10.1016/j.schres.2021.11.034 -
Nature Human Behaviour Sep 2021The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the...
The COVID-19 pandemic has made the world seem less predictable. Such crises can lead people to feel that others are a threat. Here, we show that the initial phase of the pandemic in 2020 increased individuals' paranoia and made their belief updating more erratic. A proactive lockdown made people's belief updating less capricious. However, state-mandated mask-wearing increased paranoia and induced more erratic behaviour. This was most evident in states where adherence to mask-wearing rules was poor but where rule following is typically more common. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable. People who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines and the QAnon conspiracy theories. These beliefs were associated with erratic task behaviour and changed priors. Taken together, we found that real-world uncertainty increases paranoia and influences laboratory task behaviour.
Topics: Attitude to Health; COVID-19; Culture; Health Policy; Humans; Infection Control; Masks; Pandemics; Paranoid Disorders
PubMed: 34316049
DOI: 10.1038/s41562-021-01176-8 -
BMJ Mental Health Nov 2023Paranoia-incorrectly thinking that others are deliberating trying to harm you-causes distress, undermines social interactions and leads to withdrawal. It presents across...
BACKGROUND
Paranoia-incorrectly thinking that others are deliberating trying to harm you-causes distress, undermines social interactions and leads to withdrawal. It presents across multiple psychiatric diagnoses.
OBJECTIVE
The primary aim was to determine the extent that cognitive and social processes may explain paranoia. The secondary aim was to identify explanatory factors that distinguished paranoia and social anxiety.
METHODS
10 382 UK adults, quota sampled to match the population for age, gender, ethnicity, income and region, participated in a non-probability survey. All participants completed a paranoia measure and assessments of cognitive and social processes. Structural equation modelling was conducted.
FINDINGS
2586 (24.9%) participants described being mistrustful of other people. 1756 (16.9%) participants wanted help to trust more. 66.7% of variance in paranoia was explained by a model comprising (in descending order of importance): within-situation defence behaviours, negative images, negative self-beliefs, discrimination, dissociation, aberrant salience, anxiety sensitivity, agoraphobic distress, worry, less social support, agoraphobic avoidance, less analytical reasoning and alcohol use. All explanatory factors were associated with paranoia and social anxiety. Ten factors were more closely associated with paranoia than social anxiety, including discrimination, hallucinations, negative images, aberrant salience and alcohol use. Nine factors were more closely associated with social anxiety, including less positive self-belief, an external locus of control, worry and less analytical reasoning.
CONCLUSIONS
Multiple causes are likely to be involved in paranoia. Cognitive and social processes may explain a high degree of paranoia.
CLINICAL IMPLICATIONS
Multiple clear targets for intervention to reduce paranoia are identified.
Topics: Adult; Humans; Paranoid Disorders; Anxiety; Anxiety Disorders; Fear; Cognition
PubMed: 37945313
DOI: 10.1136/bmjment-2023-300880