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Schizophrenia Research. Cognition Sep 2020It is common, among clinical and non-clinical populations alike, for paranoia and anxiety to co-occur. It has been suggested that anxiety and its related appraisal...
OBJECTIVES
It is common, among clinical and non-clinical populations alike, for paranoia and anxiety to co-occur. It has been suggested that anxiety and its related appraisal styles may contribute to development of paranoia. We aimed to evaluate different aspects of risk perception in relation to paranoia and anxiety and to identify specific aspects that may differentiate paranoia from anxiety. This paper consists of two inter-related studies.
METHODS
Study 1 compared 30 patients with persecutory delusions, 21 patients with generalized anxiety disorder and 52 healthy controls. Study 2 compared 30 non-clinical individuals with high levels of paranoia and anxiety, 28 individuals with high anxiety only and 36 healthy controls. Within each study, the two symptomatic groups were matched on level of anxiety. Four dimensions of risk perception (i.e. likelihood, harm, controllability, and intentionality) were compared across groups, as measured by the locally validated Risk Perception Questionnaire.
RESULTS
In both studies, the paranoia and the anxiety groups reported an elevated perceived likelihood of negative events than controls respectively. Only the paranoia groups reported an elevated perceived harm of neutral events than controls. In Study 2, the two at-risk groups attributed more harm and intentionality to negative events than controls.
CONCLUSION
Although perception of negative events was characteristic in anxiety (with or without paranoia), a biased perception of neutral events as risky was unique to the addition of paranoia. Implications to the transdiagnostic and continual view of psychopathology, and mechanism-based interventions were discussed.
PubMed: 32547929
DOI: 10.1016/j.scog.2020.100176 -
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 -
Ideggyogyaszati Szemle May 2023
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small...
BACKGROUND AND PURPOSE
Although rumination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small number of research has been carried out on the topic involving both patient and non clinical participants. The aim of this study is to examine the relationship between schizotypal traits and rumination using a transdiagnostic approach, involving participants living with psychotic disorders and sine morbo individuals.
.METHODS
We recruited participants living with psychotic disorders (paranoid schizophrenia, hebephrenia, schizoaffective disorder, etc.) (n = 30) and controls who had not been diagnosed with any mental illnesses (n = 67). The connection between rumination and schizotypal traits was examined by self-report questionnaire method in a cross-sectional arrangement. The Oxford-Liverpool Inventory was used to measure schizotypal traits, and the Ruminative Thought Style Questionnaire was used to determine the level of rumination.
.RESULTS
Schizotypal symptoms (β = 0.575; p < 0.001), especially cognitive disorganization (β = 0.459; p < 0.001) and unusual experiences (β = 0.221; p = 0.029) significantly explained the degree of rumination.
.CONCLUSION
Our results support the hypothesis that the association between rumination and schizotypic traits is due to decreased cognitive inhibitory functions.
.Topics: Humans; Schizotypal Personality Disorder; Cross-Sectional Studies; Psychotic Disorders; Surveys and Questionnaires; Personality
PubMed: 37294028
DOI: 10.18071/isz.76.0149 -
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 -
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 -
Psychiatrike = Psychiatriki 2018The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally The Delusional Misidentification Syndromes (DMSs) are...
The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally The Delusional Misidentification Syndromes (DMSs) are characterized by defective integration of the normally fused functions of perception and recognition. The classical sub-types are: the syndromes of Capgras, Fregoli,Intermetamorphosis (mentioned in 3) and Subjective doubles. These syndromes occur in a clear sensorium and shouldbe differentiated from the banal transient misidentifications occurring in confusional states and in mania and from thenon-delusional misidentifications (e.g. prosopagnosia). Joseph Capgras, who described the best-known sub-type, was indecisive on its pathogenesis. In his original report he defined the syndrome as "agnosia of identification" produced by a conflict between affective accompaniments ofsensory and mnemonic images. In his subsequent two publications, he considered the syndrome as a restitution delusionand as a psychopathological mechanism to hide incestuous desires. For more details see the chapter by J.P. Luaute in avolume on DMS. Psychodynamic approaches are, essentially, variants of the formulation that DMSs result from ambivalent feelings resolvedby directing hate feelings onto an imagined double in order to retain the original intact (and thus avoid guilt).These views have been voiced by David Enoch [relevant chapter in (3)] and with variations by many other investigatorsreviewed by Oyebode. Regression to archaic modes of thought (like thinking in terms of doubles and dualisms) due to personality disintegrationproduced by psychotic illness is a fascinating hypothesis by John Todd [mentioned in (1)]. However, if this was thecase, DMS should be much more frequent. Mayer-Gross and Ackner (mentioned in 9) had observed that when there is a delusional development, depersonalization-derealization experiences tend to be included within the delusional system. Such experiences usually precede orcoincide with the onset of DMS. In view of this, Christodoulou suggested that DMSs may represent delusional evolutions of depersonalization-derealization experiences. Similar mechanisms were proposed for false memories of familiarity,reduplicative paramnesia and autoscopy. Cerebral "dysrhythmia" has also been noted in patients with DMS. In view of clinical and prognostic similarities of DMSpatients with patients suffering from psychotic states occurring in an epileptic setting, many of these patients have beenconsidered as suffering from broadly speaking "epileptic" psychoses. Joseph [mentioned in (6)] suggested that organiccauses produce disconnection between right and left cortical areas that decode afferent sensory information. This resultsin the creation of a separate image in each hemisphere leading to an awareness of two, physically identical images. Ellis and Young [mentioned in (1) and (6)] have maintained that DMS may result from defects at different stages of aninformation processing chain. More specifically, the Capgras Syndrome appears when the route for unconscious recognitionis damaged. Similar mechanisms have been proposed for the rest of the subtypes. Margariti and Kontaxakis8 have considered that in DMS there is disruption of the ability to recognize identities ratherthan superficial appearance. Others have maintained that DMSs are multimodal neuropathologies and cannot be linkedto a single cognitive defect. Lastly, in view of the marked organic abnormalities detected in all DMS subtypes, DMSs have been linked with a greatnumber of organic conditions [reviewed in detail by Oyebode (5)]. According to Greek mythology, Procrustes was a bandit who stretched or amputated the limbs of his guests to fit hisiron bed. The DMSs do not deserve such treatment. Submitting them to the procrustean bed of uniformity should be avoided. People develop DMS for a variety of reasons. Most subjects have right hemisphere dysfunction but not exclusively.Their condition is associated not with one but with diverse phenomena (depersonalization - derealization, prosopagnosia,false memories of familiarity, autoscopy, reduplicative paramnesia etc.) similarities with psychotic phenomena associatedwith epilepsy have been suggested but this refers to some patients only. Additionally, the charged emotionalrelationship of the patient with the misidentified person(s) is neither necessary nor sufficient. Diagnostically speaking, many roads lead to DMS, ranging from the monosymptomatic and monothematic one (consideredas par excellence DMS) to that associated with disorders mainly of the schizophrenic or organic spectrum. DMScan also be reached by a more "superficial" road, the one of depression, in which the delusion is secondary and often dependenton the self-depreciation ideation. Speculating on these syndromes is a fascinating journey in psychopathologybut, although in most cases an organic contributor is present, yet the great diversity of conditions in the setting of whichDMSs occur renders the possibility of a unifying hypothesis unlikely.
Topics: Cognition Disorders; Delusions; Humans; Neuropsychological Tests; Psychotherapy, Psychodynamic; Schizophrenia, Paranoid
PubMed: 29754115
DOI: 10.22365/jpsych.2018.291.15 -
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