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European Psychiatry : the Journal of... Jan 2019Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional...
BACKGROUND
Even if neurocognition is known to affect functional outcomes in schizophrenia, no previous study has explored the impact of cognition on functionality in delusional disorder (DD). We aimed to assess the effect of clinical characteristics, symptom dimensions and neuropsychological performance on psychosocial functioning and self-perceived functional impairment in DD.
METHODS
Seventy-five patients with a SCID-I confirmed diagnosis of DD underwent neurocognitive testing using a neuropsychological battery examining verbal memory, attention, working memory and executive functions. We assessed psychotic symptoms with the Positive and Negative Syndrome Scale, and calculated factor scores for four clinical dimensions: Paranoid, Cognitive, Affective and Schizoid. We conducted hierarchical linear regression models to identify predictors of psychosocial functioning, as measured with the Global Assessment of Functioning scale, and self-perceived functional impairment, as measured with the Sheehan's Disability Inventory.
RESULTS
In the final linear regression models, higher scores in the Paranoid (β= 0.471, p < .001, r = 0.273) and Cognitive (β = 0.325, p < .001, r = 0.180) symptomatic dimensions and lower scores in verbal memory (β = -0.273, p < .05, r = 0.075) were significantly associated with poorer psychosocial functioning in patients with DD. Lower scores in verbal memory (β= -0.337, p < .01, r = 0.158) and executive functions (β= -0.323, p < .01, r = 0.094) were significantly associated with higher self-perceived disability.
CONCLUSIONS
Impaired verbal memory and cognitive symptoms seem to affect functionality in DD, above and beyond the severity of the paranoid idea. This suggests a potential role for cognitive interventions in the management of DD.
Topics: Adult; Attention; Cognition; Cognitive Behavioral Therapy; Disability Evaluation; Executive Function; Female; Humans; Male; Memory; Middle Aged; Neuropsychological Tests; Paranoid Disorders; Psychotic Disorders; Schizophrenia, Paranoid; Self-Assessment; Social Skills
PubMed: 30388425
DOI: 10.1016/j.eurpsy.2018.09.010 -
Schizophrenia Bulletin Mar 2017This review traces, through psychiatric textbooks, the history of the Kraepelinian concept of paranoia in the 20th century and then relates the common reported symptoms... (Review)
Review
This review traces, through psychiatric textbooks, the history of the Kraepelinian concept of paranoia in the 20th century and then relates the common reported symptoms and signs to the diagnostic criteria for paranoia/delusional disorder in DSM-III through DSM-5. Clinical descriptions of paranoia appearing in 10 textbooks, published 1899 to 1970, revealed 11 prominent symptoms and signs reported by 5 or more authors. Three symptoms (systematized delusions, minimal hallucinations, and prominent ideas of reference) and 2 signs (chronic course and minimal affective deterioration) were reported by 8 or 9 of the authors. Four textbook authors rejected the Kraepelinian concept of paranoia. A weak relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern DSM manuals. Indeed, the diagnostic criteria for paranoia/delusional disorder shifted substantially from DSM-III to DSM-5. The modern operationalized criteria for paranoia/delusional disorder do not well reflect the symptoms and signs frequently reported by historical experts. In contrast to results of similar reviews for depression, schizophrenia and mania, the clinical construct of paranoia/delusional disorder has been somewhat unstable in Western Psychiatry since the turn of the 20th century as reflected in both textbooks and the DSM editions.
Topics: Diagnostic and Statistical Manual of Mental Disorders; History, 20th Century; Humans; Paranoid Disorders; Schizophrenia, Paranoid
PubMed: 28003468
DOI: 10.1093/schbul/sbw161 -
Psychiatry Research Jan 2018Recent evidence suggests that sleep problems are associated with psychotic like experiences including paranoia. However, the mechanisms underpinning this association are...
Recent evidence suggests that sleep problems are associated with psychotic like experiences including paranoia. However, the mechanisms underpinning this association are not well understood and thus studies modelling hypothesised mediating factors are required. Alexithymia, the inability to recognise and describe emotions within the self may be an important candidate. In two separate studies we sought to investigate factors mediating the relationship between sleep quality and paranoia using a cross-sectional design. Healthy volunteers without a mental health diagnosis were recruited (study 1, N = 401, study 2, N = 402). Participants completed a series of measures assessing paranoia, negative emotions, alexithymia and perceptual anomalies in an online survey. In study 1, regression and mediation analyses showed that the relationship between sleep quality and paranoia was partially mediated by alexithymia, perceptual anomalies and negative affect. In contrast, study 2 found that the relationship between sleep quality and paranoia was fully mediated by negative affect, alexithymia and perceptual anomalies. The link between sleep quality and paranoia is unclear and reasons for discrepant results are discussed. Novel findings in this study include the link between alexithymia and paranoia.
Topics: Adolescent; Adult; Affective Symptoms; Aged; Cross-Sectional Studies; Emotions; Female; Healthy Volunteers; Humans; Male; Middle Aged; Paranoid Disorders; Perceptual Disorders; Regression Analysis; Sleep; Sleep Wake Disorders; Surveys and Questionnaires; Young Adult
PubMed: 29080493
DOI: 10.1016/j.psychres.2017.09.066 -
Biology Letters Jan 2018The psychological effects of brain-expressed imprinted genes in humans are virtually unknown. Prader-Willi syndrome (PWS) is a neurogenetic condition mediated by genomic...
The psychological effects of brain-expressed imprinted genes in humans are virtually unknown. Prader-Willi syndrome (PWS) is a neurogenetic condition mediated by genomic imprinting, which involves high rates of psychosis characterized by hallucinations and paranoia, as well as autism. Altered expression of two brain-expressed imprinted genes, and , mediates a suite of PWS-related phenotypes, including behaviour, in mice. We phenotyped a large population of typical individuals for schizophrenia-spectrum and autism-spectrum traits, and genotyped them for the single-nucleotide polymorphism rs850807, which is putatively functional and linked with and Genetic variation in rs850807 was strongly and exclusively associated with the ideas of reference subscale of the schizophrenia spectrum, which is best typified as paranoia. These findings provide a single-locus genetic model for analysing the neurological and psychological bases of paranoid thinking, and implicate imprinted genes, and genomic conflicts, in human mentalistic thought.
Topics: Adult; Female; Genotype; Humans; Male; Models, Genetic; Paranoid Disorders; Polymorphism, Single Nucleotide; Proteins; Surveys and Questionnaires; Tumor Suppressor Proteins; Young Adult
PubMed: 29343559
DOI: 10.1098/rsbl.2017.0694 -
Frontiers in Psychology 2023Reliable and valid assessment of paranoia is important in forensic psychiatry for providing adequate care. VR technology may add to current assessment procedures, as it...
BACKGROUND
Reliable and valid assessment of paranoia is important in forensic psychiatry for providing adequate care. VR technology may add to current assessment procedures, as it enables observation within realistic (social) situations resembling the complexity of everyday life. VR constitutes a promising tool within forensics, due to the restricted nature of forensic psychiatric hospitals and ethical challenges arising from observing potentially dangerous behaviors in real life.
OBJECTIVE
To investigate the feasibility of VR assessment for paranoid ideation in forensic psychiatric inpatients qualitatively by assessing the experiences of patients and a clinician, and to explore how the VR measures relate to established clinical measures.
METHODS
One clinician (experienced psychiatrist) and 10 forensic psychiatric inpatients with a history or suspicion of paranoid ideation were included. Patients participated in two immersive VR scenarios (bus and supermarket) during which paranoia was assessed by the clinician. Qualitative interviews were performed with patients and the clinician performing the assessment to investigate experiences and feasibility. Further, measures of paranoia, social anxiety, and positive symptoms were obtained.
RESULTS
Nine out of 10 participants with varying levels of paranoid ideation completed the assessment. Manifest inductive content analyses of the interviews revealed general experiences, advantages such as enabling observing participants from a different perspective, and challenges of the VR assessment, such as a lack of objectivity and the laboriousness of the assessment for the clinician. Although more paranoia was experienced during the supermarket scenario, correlates with classical measures were only significant for the bus scenario.
DISCUSSION
The VR assessment was appreciated by most patients and the clinician. Based on our results short, standardized VR assessment scenarios are feasible, however, they do not appear reliable or objective for assessing paranoia. The clinical usefulness is most likely as a collaborative tool and add-on measure to existing methods.
PubMed: 38130966
DOI: 10.3389/fpsyg.2023.1242243 -
Psychiatria Polska Apr 2018The purpose of the study was to investigate the dependence between the sense of coherence (SOC) and symptomatic improvement as it is the determinant of recovery process...
OBJECTIVES
The purpose of the study was to investigate the dependence between the sense of coherence (SOC) and symptomatic improvement as it is the determinant of recovery process of patients with schizophrenia spectrum disorders.
METHODS
The group of 134 patients was surveyed. 118 of them suffered from paranoid schizophrenia and 16 suffered from schizoaffective disorders, all were hospitalized in psychiatric clinics. Mean age was 36.22 years (SD = 8.51). Research was based on the Orientation to Life Questionnaire by A. Antonovsky. The level of psychopathological symptoms intensity was investigated twice, at the start and at the end of hospitalization with the Positive and Negative Syndrome Scale (PANSS). The rate of recovery was the margin between psychopathological symptoms intensification at the beginning and at the end of hospitalization.
RESULTS
The analysis show that higher sense of comprehensibility (SOCCOM) favors lesser intensity of negative symptoms and overall psychiatric symptomatology in PANSS while starting the hospitalization. Also patients with higher level of sense of coherence (SOC) show less negative symptoms escalation during hospital admission. Results show that higher level of sense of coherence (SOC) and higher level of sense of comprehensibility (SOCCOM) coexist with lesser difference in the intensification of psychopathological symptoms.
CONCLUSIONS
This article tries to show the role of sense of coherence in the recovery process among people with schizophrenic disorders. Coexistence of higher sense of coherence with greater negative symptoms and psychopathological symptoms can be perceived as an insight to the illness, which can be recognized as an expression of recovery.
Topics: Adaptation, Psychological; Adult; Female; Humans; Male; Quality of Life; Schizophrenia; Schizophrenic Psychology; Sense of Coherence; Surveys and Questionnaires; Young Adult
PubMed: 29975362
DOI: 10.12740/PP/OnlineFirst/69697 -
Royal Society Open Science Jan 2022Paranoia and conspiracy thinking are known to be distinct but correlated constructs, but it is unknown whether certain types of conspiracy thinking are more common in...
Paranoia and conspiracy thinking are known to be distinct but correlated constructs, but it is unknown whether certain types of conspiracy thinking are more common in paranoia than others. In a large ( = 1000), pre-registered online study we tested if endorsement of items on a new Components of Conspiracy Ideation Questionnaire varied according to whether harm was described as being (a) intentional and (b) self-referential. Our predictions were supported: paranoia was positively associated with endorsement of items on this questionnaire overall and more paranoid individuals were more likely to endorse items describing intentional and self-referential harm. Belief in any item on the Components of Conspiracy Ideation Questionnaire was associated with belief in others and items describing incidental harm and harm to others were found to be more believable overall. Individuals who endorsed conspiracy theory items on the questionnaire were more likely to state that people similar to them would as well, although this effect was not reduced in paranoia, counter to our expectations.
PubMed: 35116159
DOI: 10.1098/rsos.211555 -
Psychiatric Services (Washington, D.C.) Dec 2023Black adults in the United States are more likely to be diagnosed as having schizophrenia spectrum disorders and to report experiences of paranoia than are White adults....
Black adults in the United States are more likely to be diagnosed as having schizophrenia spectrum disorders and to report experiences of paranoia than are White adults. Cultural mistrust, or marginalized groups' adaptive skepticism toward dominant historically White institutions, is associated with paranoia among Black individuals, suggesting that experiences of paranoia may be culturally mediated. The authors aimed to explore thematic differences between Black and White adults with schizophrenia spectrum disorders in their experiences of paranoia, including potential differences in persecutory content, cultural mistrust, and related themes. The authors conducted a thematic content analysis of archival qualitative data on experiences of paranoia reported by Black and White adults with schizophrenia spectrum disorders (N=21) in a structured clinical interview. Distinct themes related to cultural mistrust and persecutory paranoia emerged among the participants, suggesting that lived experiences of persecution and discrimination may affect how Black adults with schizophrenia spectrum disorders interpret threat and express paranoia. These findings highlight the importance of culturally responsive approaches in assessment and conceptualization of clinical paranoia versus cultural mistrust.
Topics: Adult; Humans; Paranoid Disorders; Schizophrenia; White; Interpersonal Relations
PubMed: 37254507
DOI: 10.1176/appi.ps.20220089 -
PeerJ 2023Paranoid thinking, that others are hostile, can be seen even in the general population. Paranoia is considered the expectation that others are competitors who aim to...
Paranoid thinking, that others are hostile, can be seen even in the general population. Paranoia is considered the expectation that others are competitors who aim to maximize the differences in payoffs rather than maximize their own payoffs. This study examined whether paranoia reflects the irrational belief that others have a competitive intention and is associated with avoiding perceived competition. We recruited 884 US residents the Internet and conducted a modified Dictator Game, in which monetary allocation was carried out between the Dictator and the Recipient. The Dictator chooses either fair or competitive allocation while selecting the competitive allocation is irrelevant to increasing the Dictator's payoffs. The Recipient decides whether to accept the Dictator's decision or receive sure but low rewards. We found that Recipients with high-level paranoid thinking expected their opponent to select competitive allocation more than those with low levels, even when selecting it was costly for Dictators. Paranoid thinking was not associated with selecting sure rewards or competitive allocations. The results suggest that paranoia reflects the belief that others have a competitive intention but is not related to avoidance behavior against perceived threats and unilateral attacks.
Topics: Humans; Intention; Paranoid Disorders; Hostility; Avoidance Learning
PubMed: 36923500
DOI: 10.7717/peerj.15003 -
European Archives of Psychiatry and... Sep 2022Paranoia is a frequent and highly distressing experience in psychosis. Models of paranoia suggest limbic circuit pathology. Here, we tested whether resting-state...
Paranoia is a frequent and highly distressing experience in psychosis. Models of paranoia suggest limbic circuit pathology. Here, we tested whether resting-state functional connectivity (rs-fc) in the limbic circuit was altered in schizophrenia patients with current paranoia. We collected MRI scans in 165 subjects including 89 patients with schizophrenia spectrum disorders (schizophrenia, schizoaffective disorder, brief psychotic disorder, schizophreniform disorder) and 76 healthy controls. Paranoia was assessed using a Positive And Negative Syndrome Scale composite score. We tested rs-fc between bilateral nucleus accumbens, hippocampus, amygdala and orbitofrontal cortex between groups and as a function of paranoia severity. Patients with paranoia had increased connectivity between hippocampus and amygdala compared to patients without paranoia. Likewise, paranoia severity was linked to increased connectivity between hippocampus and amygdala. Furthermore, paranoia was associated with increased connectivity between orbitofrontal and medial prefrontal cortex. In addition, patients with paranoia had increased functional connectivity within the frontal hubs of the default mode network compared to healthy controls. These results demonstrate that current paranoia is linked to aberrant connectivity within the core limbic circuit and prefrontal cortex reflecting amplified threat processing and impaired emotion regulation. Future studies will need to explore the association between limbic hyperactivity, paranoid ideation and perceived stress.
Topics: Amygdala; Hippocampus; Humans; Magnetic Resonance Imaging; Neural Pathways; Paranoid Disorders; Prefrontal Cortex; Schizophrenia
PubMed: 34636951
DOI: 10.1007/s00406-021-01337-w