-
Psychiatry Research Dec 2017Paranoia builds upon feelings of vulnerability. Our clinical experience indicates that negative body image, including concerns regarding weight, may be one source of...
Paranoia builds upon feelings of vulnerability. Our clinical experience indicates that negative body image, including concerns regarding weight, may be one source of feeling vulnerable and hence raise the risk of paranoia. There has been no empirical test of an association between body image and paranoia. Our aim was to provide the first test of this issue by examining in epidemiologically representative cohorts the cross-sectional associations between paranoia and a proxy measure of body image. This was an initial exploration of a potentially important but overlooked issue. Data were used from 5515 participants in the US National Comorbidity Survey-Replication (NCS-R). To validate the findings, the analyses were replicated with 10,113 participants in the US National Comorbidity Survey-Adolescents (NCS-A). Concerns about weight were associated with paranoia in the NCS-R (OR = 1.48, p = 0.006, CI = 1.123, 1.955) and NCS-A (OR = 1.67, p < 0.001, CI = 1.490, 1.873). The associations remained significant after controlling for gender and body mass index. The results show that negative body image and paranoia are associated in the general population, consistent with the idea that paranoia may build upon feelings of vulnerability arising from body image concerns. Studies are needed to examine whether there is a causal relationship.
Topics: Adolescent; Adult; Body Image; Body Mass Index; Body Weight; Comorbidity; Cross-Sectional Studies; Emotions; Female; Humans; Male; Paranoid Disorders; Reproducibility of Results; United States
PubMed: 29020647
DOI: 10.1016/j.psychres.2017.10.007 -
Journal of Psychopathology and Clinical... Feb 2022Evidence suggests that self-esteem is an important mechanism in pathways to psychosis. However, whether low or high self-esteem is associated with psychotic experiences...
Evidence suggests that self-esteem is an important mechanism in pathways to psychosis. However, whether low or high self-esteem is associated with psychotic experiences remains unclear. Besides, a limited number of studies has investigated fluctuations in state self-esteem in psychotic patients. This study investigated cross-sectional and temporal associations of momentary self-esteem and fluctuations in self-esteem with psychotic symptoms in three groups with different levels of (familial) liability to psychotic disorder. Using the Experience Sampling Method (ESM), momentary self-esteem, fluctuations in self-esteem (i.e., variability and instability), and psychotic experiences, paranoia, negative symptoms (i.e., event anhedonia and social anhedonia), intensity of negative affect and altered affective experiences (instability and variability in negative affect) were assessed in 147 psychotic patients, 131 of their siblings and 113 controls. Lower levels of momentary self-esteem were associated with an increased intensity of psychotic experiences, paranoia and negative affect, with the magnitude of the associations for momentary self-esteem being greatest in patients, followed by relatives. Variability in self-esteem was associated with psychotic and paranoid experiences, the magnitudes were greatest in relatives. Furthermore, we found reciprocal effects between momentary self-esteem and psychotic experiences, paranoia, negative affect, and instability in negative affect. These findings suggest that individuals with familial liability to psychosis (patients and their first-degree relatives) might benefit from targeting momentary self-esteem and variability in self-esteem to decrease the intensity of psychotic experiences, paranoia, and negative affect in daily life. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Topics: Cross-Sectional Studies; Ecological Momentary Assessment; Humans; Paranoid Disorders; Psychotic Disorders; Self Concept
PubMed: 35230860
DOI: 10.1037/abn0000722 -
Frontiers in Psychiatry 2023Wherever psychopathology operates with the concept of (disorders of) the self and personality, it can address the role of the intuitive access we have toward ourselves,... (Review)
Review
Wherever psychopathology operates with the concept of (disorders of) the self and personality, it can address the role of the intuitive access we have toward ourselves, others, and the world. This study discusses the concept of . It examines its role in explaining paranoia as a change in self-and-world relatedness. In the first , symptomatic features of paranoid personality disorder are sketched, with a focus on the explanatory role of attentional and interpretative biases, which correlate with significant changes in intuitive processing. In the second , the prototypical phenomenality of feelings of unfamiliarity and mistrust are discussed against the backdrop of changes of oikeiôsis in paranoid personality disorder. In the , the main therapeutic challenge in treating paranoid personality disorder-building a trustful relationship-is explored. It is concluded that the notion of oikeiôsis resonates particularly with introspection-based therapeutic approaches.
PubMed: 38268566
DOI: 10.3389/fpsyt.2023.1307629 -
Psychological Medicine Sep 2023The term 'pandemic paranoia' has been coined to refer to heightened levels of mistrust and suspicion towards other people specifically due to the COVID-19 pandemic. In...
BACKGROUND
The term 'pandemic paranoia' has been coined to refer to heightened levels of mistrust and suspicion towards other people specifically due to the COVID-19 pandemic. In this study, we examine the international prevalence of pandemic paranoia in the general population and its associated sociodemographic profile.
METHODS
A representative international sample of general population adults ( = 2510) from five sites (USA = 535, Germany = 516, UK = 512, Australia = 502 and Hong Kong = 445) were recruited using stratified quota sampling (for age, sex, educational attainment) and completed the Pandemic Paranoia Scale (PPS).
RESULTS
The overall prevalence rate of pandemic paranoia was 19%, and was highest in Australia and lowest in Germany. On the subscales of the PPS, prevalence was 11% for persecutory threat, 29% for paranoid conspiracy and 37% for interpersonal mistrust. Site and general paranoia significantly predicted pandemic paranoia. Sociodemographic variables (lower age, higher population size and income, being male, employed and no migrant status) explained additional variance and significantly improved prediction of pandemic paranoia.
CONCLUSIONS
Pandemic paranoia was relatively common in a representative sample of the general population across five international sites. Sociodemographic variables explained a small but significant amount of the variance in pandemic paranoia.
Topics: Adult; Humans; Male; Female; Paranoid Disorders; Pandemics; Prevalence; COVID-19; Interpersonal Relations
PubMed: 36065655
DOI: 10.1017/S0033291722002975 -
Schizophrenia Research Apr 2023The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to...
The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness to perceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis.
Topics: Humans; Paranoid Disorders; Retrospective Studies; Psychotic Disorders; Interpersonal Relations; Loneliness; Self Concept
PubMed: 36931182
DOI: 10.1016/j.schres.2023.03.006 -
The Australian and New Zealand Journal... Dec 2021Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for...
OBJECTIVE
Paranoia may be particularly prevalent during adolescence, building on the heightened social vulnerabilities at this age. Excessive mistrust may be corrosive for adolescent social relationships, especially in the context of mental health disorders. We set out to examine the prevalence, symptom associations, and persistence of paranoia in a cohort of young people attending child and adolescent mental health services.
METHOD
A total of 301 patients (11-17 years old) completed measures of paranoia, affect, peer difficulties and behavioural problems. Clinicians also rated each participant's psychiatric symptoms. Patterns of association were examined using linear regressions and network analyses. In total, 105 patients repeated the measures several months later.
RESULTS
Most of the adolescents had affective disorders ( = 195), self-harm/suicidality ( = 82), or neurodevelopmental conditions ( = 125). Few had suspected psychosis ( = 7). Rates of paranoia were approximately double compared with previous reports from the general population. In this patient sample, 35% had at least elevated paranoia, 15% had at least moderate paranoia, and 6% had high paranoia. Paranoia had moderate associations with clinician-rated peer difficulties, self-harm, and trauma, and small associations with clinician-rated social anxiety, depression, generalised anxiety, and educational problems. Network analyses showed paranoia had the strongest unique relationship with peer difficulties. Paths from peer difficulties to anxiety, self-harm, post-traumatic stress disorder symptoms, and behavioural problems were all via paranoia. Both self-harm and post-traumatic stress disorder were solely associated with paranoia in the network. Paranoia remained persistent for three-quarters and was associated with greater psychological problems over time.
CONCLUSION
Paranoia is relatively common and persistent across a range of clinical presentations in youth. When paranoia occurs alongside emotional problems, important peer interactions may be adversely affected. Wider consideration of paranoia in adolescent patients is needed.
Topics: Adolescent; Anxiety; Child; Humans; Mental Health Services; Paranoid Disorders; Psychotic Disorders; Social Vulnerability
PubMed: 33423520
DOI: 10.1177/0004867420981416 -
Journal of Psychiatric Research Jun 2021Paranoia significantly contributes to social impairments across clinical diagnoses, and amygdala dysfunction has been identified as a neurobiological marker of paranoia...
BACKGROUND
Paranoia significantly contributes to social impairments across clinical diagnoses, and amygdala dysfunction has been identified as a neurobiological marker of paranoia among individuals with schizophrenia. Therefore, we aimed to investigate amygdala functional connectivity (FC) in paranoia across diagnoses.
METHODS
Forty-five patients with recent history of clinically significant paranoid ideation and a current DSM-5 diagnosis of any disorder underwent resting-state functional magnetic resonance imaging either in a paranoid (N = 23) or non-paranoid (N = 22) state. Amygdala FC were compared between paranoid and non-paranoid patients. Supplemental correlation analyses between amygdala FC and paranoia score were performed separately in patients and a non-equivalent healthy control (HC; N = 60) group.
RESULTS
Increased FC was found between right amygdala and the prefrontal cortex (PFC) [bilateral medial superior frontal gyrus, anterior cingulate, medial frontal gyrus, the triangular part and the opercular part of the inferior frontal gyrus (IFG); right orbital part of IFG], the frontal cortex (bilateral median cingulate, left precentral gyrus), and subcortical areas (right insula) in the paranoid group compared with the non-paranoid group. No significant between-group differences were observed in left amygdala FC. FC between right amygdala and PFC and frontal cortex was positively correlated with paranoia in patient and HC groups.
CONCLUSION
Paranoia is associated with right amygdala hyperconnectivity with PFC, frontal cortex, and insula. This hyperconnectivity was evident regardless of diagnosis and therefore identify a likely transdiagnostic neural mechanism, which may help to identify treatment targets that could potentially improve the social functioning of individuals with clinical diagnoses.
Topics: Amygdala; Cerebral Cortex; Gyrus Cinguli; Humans; Magnetic Resonance Imaging; Paranoid Disorders
PubMed: 33848967
DOI: 10.1016/j.jpsychires.2021.03.049 -
Schizophrenia Research Jul 2018Worry processes are implicated in paranoia and anxiety. However, clinical studies focused on patients with co-occurring paranoia and anxiety. As both paranoia and...
BACKGROUND
Worry processes are implicated in paranoia and anxiety. However, clinical studies focused on patients with co-occurring paranoia and anxiety. As both paranoia and anxiety are distributed across clinical and non-clinical groups, an investigation on worry processes among non-clinical individuals will allow us to delineate the specific worry mechanisms in paranoia and anxiety respectively.
AIMS
To identify clusters of non-clinical individuals who report varied levels of paranoia and anxiety, and to compare worry processes across clusters.
METHOD
An online survey, consisting of self-report questionnaires on generalized anxiety, paranoia, and worry processes, was completed by 2796 undergraduate students. A multiple-step validity check procedure resulted in a subsample of 2291 students, upon which cluster analyses and multivariate analyses of variance were conducted.
RESULTS
Four clusters of individuals were identified: (1) high paranoia/moderate anxiety, (2) average paranoia/high anxiety, (3) average paranoia/average anxiety, and (4) low paranoia/low anxiety. A unique cluster of individuals with high paranoia but low/average level of anxiety was not found. Cluster 1 reported a significantly higher intensity of day-to-day worries, a higher level of meta-worry, and more extreme meta-cognitive beliefs about worry than other clusters.
CONCLUSIONS
Individuals with high paranoia tended to report anxiety as well, but not vice versa. Our findings supported a hierarchical structure of anxiety and paranoia. All worry processes were exacerbated in individuals with paranoia and anxiety than those with anxiety alone.
Topics: Adolescent; Adult; Anxiety; Anxiety Disorders; Cluster Analysis; Comorbidity; Female; Hong Kong; Humans; Male; Metacognition; Paranoid Disorders; Students; Universities; Young Adult
PubMed: 29398206
DOI: 10.1016/j.schres.2018.01.024 -
Psychological Medicine Apr 2023Globally, the corona virus disease 2019 (COVID-19) pandemic has created an interpersonally threatening context within which other people have become a source of possible...
BACKGROUND
Globally, the corona virus disease 2019 (COVID-19) pandemic has created an interpersonally threatening context within which other people have become a source of possible threat. This study reports on the development and validation of a self-report measure of pandemic paranoia; that is, heightened levels of suspicion and mistrust towards others due to the COVID-19 pandemic.
METHODS
An international consortium developed an initial set of 28 items for the Pandemic Paranoia Scale (PPS), which were completed by participants from the UK ( = 512), USA ( = 535), Germany ( = 516), Hong Kong ( = 454) and Australia ( = 502) using stratified quota sampling (for age, sex and educational attainment) through Qualtrics and translated for Germany and Hong Kong.
RESULTS
Exploratory factor analysis in the UK sample suggested a 25-item, three-factor solution (persecutory threat; paranoid conspiracy and interpersonal mistrust). Confirmatory factor analysis (CFA) on the remaining combined sample showed sufficient model fit in this independent set of data. Measurement invariance analyses suggested configural and metric invariance, but no scalar invariance across cultures/languages. A second-order factor CFA on the whole sample indicated that the three factors showed large loadings on a common second-order pandemic paranoia factor. Analyses also supported the test-retest reliability and internal and convergent validity.
CONCLUSION
The PPS offers an internationally validated and reliable method for assessing paranoia in the context of a pandemic. The PPS has the potential to enhance our understanding of the impact of the pandemic, the nature of paranoia and to assist in identifying and supporting people affected by pandemic-specific paranoia.
Topics: Humans; Paranoid Disorders; Pandemics; Psychometrics; Reproducibility of Results; COVID-19; Translating; Factor Analysis, Statistical; Surveys and Questionnaires
PubMed: 34879896
DOI: 10.1017/S0033291721004633 -
Psychiatry Research Aug 2018Consistent with a continuum approach to mental health, a growing body of research has established that paranoia occurs in the general population. The...
Consistent with a continuum approach to mental health, a growing body of research has established that paranoia occurs in the general population. The stress-vulnerability model would predict an association between environments high in threat and the presence of state paranoia, even in those with low dispositional trait paranoia. The present research examines whether urban cycling, a naturalistic environment high in interpersonal threat, is associated with state paranoia - operationalised as an explicit perception that other road users intend the agent harm. 323 members of the general population who regularly cycled in London completed measures of state and trait paranoia, anxiety, depression and stress. The majority of the general population sample (70%) reported experiencing state paranoia during urban cycling, and there was no association between state paranoia and trait paranoia. Reported state paranoia was higher during urban cycling than when using the London underground (a lower threat environment) and reported state paranoia on the underground was associated with trait paranoia. The findings are consistent with the stress-vulnerability model of everyday paranoia.
Topics: Adolescent; Adult; Aged; Anxiety; Bicycling; Depression; Female; Humans; London; Male; Middle Aged; Paranoid Disorders; Perception; Stress, Psychological; Urban Population; Young Adult
PubMed: 29609986
DOI: 10.1016/j.psychres.2018.03.035