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Scientific Reports Dec 2023Although mostly considered distinct, conspiracy mentality and paranoia share conceptual similarities (e.g., persecutory content, resistance to disconfirming evidence)....
Although mostly considered distinct, conspiracy mentality and paranoia share conceptual similarities (e.g., persecutory content, resistance to disconfirming evidence). Using self-report data from a large and multinational online sample (N = 2510; from the UK, the US, Hong Kong, Germany, and Australia), we examined whether paranoia and conspiracy mentality represent distinct latent constructs in exploratory and confirmatory factor analyses. Utilising network analysis, we then explored common and unique correlates of paranoia and conspiracy mentality while accounting for their shared variance. Across sites, paranoia and conspiracy mentality presented distinct, yet weakly correlated (r = 0.26), constructs. Both were associated with past traumatic experiences, holding negative beliefs about the self and other people, sleep problems, and a tendency to worry. However, paranoia was related to increased negative affect (i.e., anxiety) and decreased social support, whereas the opposite pattern was observed for conspiracy mentality (i.e., decreased anxiety and depression, increased social support). Paranoia and conspiracy mentality are related but not the same constructs. Their similar and distinct correlates point to common and unique risk factors and underlying mechanisms.
Topics: Humans; Paranoid Disorders; Anxiety; Anxiety Disorders; Self Report; Interpersonal Relations
PubMed: 38123615
DOI: 10.1038/s41598-023-47923-x -
Frontiers in Psychiatry 2023Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is...
INTRODUCTION
Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is unclear. Mentalization may underlie this relationship, as impaired mentalizing is found in various stages of the psychosis continuum. Nonetheless, the differential roles of self- and other-mentalizing in psychosis are not well understood.
METHODS
Parallel multiple mediation was conducted for the relationship between a diverse range of childhood adversity types, including intentional and nonintentional harm, and schizotypy (positive, negative, disorganized), psychotic-like experiences (PLE) and paranoia via self-mentalizing (attention to emotions and emotional clarity) and other-mentalizing in = 1,156 nonclinically ascertained young adults.
RESULTS
Significant parallel multiple mediation models were found for all psychotic outcomes except negative schizotypy. The associations between intentionally harmful childhood adversity and psychotic outcomes were significantly mediated by increased attention to emotions for most models and decreased emotional clarity for some models. No significant mediation was found for parental loss. Paternal abuse was only mediated by attention to emotions whereas the effects of maternal abuse were mediated by attention to emotions and emotional clarity. Other-mentalizing only showed mediating effects on one of thirty models tested.
CONCLUSION
Results highlight the mediating role of impaired self-mentalizing in the association between childhood adversity and psychosis. This is consistent with disturbances of self-concept and self-boundary characterizing, in particular, the positive dimension of psychosis. Maternal versus paternal figures may contribute differentially to the development of mentalizing. These results could inform future preventative interventions, focusing on the development and maintenance of self-mentalizing.
PubMed: 38098634
DOI: 10.3389/fpsyt.2023.1268247 -
JMIR Human Factors Dec 2023Paranoia is a highly debilitating mental health condition. One novel intervention for paranoia is cognitive bias modification for paranoia (CBM-pa). CBM-pa comes from a...
BACKGROUND
Paranoia is a highly debilitating mental health condition. One novel intervention for paranoia is cognitive bias modification for paranoia (CBM-pa). CBM-pa comes from a class of interventions that focus on manipulating interpretation bias. Here, we aimed to develop and evaluate new therapy content for CBM-pa for later use in a self-administered digital therapeutic for paranoia called STOP ("Successful Treatment of Paranoia").
OBJECTIVE
This study aimed to (1) take a user-centered approach with input from living experts, clinicians, and academics to create and evaluate paranoia-relevant item content to be used in STOP and (2) engage with living experts and the design team from a digital health care solutions company to cocreate and pilot-test the STOP mobile app prototype.
METHODS
We invited 18 people with living or lived experiences of paranoia to create text exemplars of personal, everyday emotionally ambiguous scenarios that could provoke paranoid thoughts. Researchers then adapted 240 suitable exemplars into corresponding intervention items in the format commonly used for CBM training and created 240 control items for the purpose of testing STOP. Each item included newly developed, visually enriching graphics content to increase the engagement and realism of the basic text scenarios. All items were then evaluated for their paranoia severity and readability by living experts (n=8) and clinicians (n=7) and for their item length by the research team. Items were evenly distributed into six 40-item sessions based on these evaluations. Finalized items were presented in the STOP mobile app, which was co-designed with a digital health care solutions company, living or lived experts, and the academic team; user acceptance was evaluated across 2 pilot tests involving living or lived experts.
RESULTS
All materials reached predefined acceptable thresholds on all rating criteria: paranoia severity (intervention items: ≥1; control items: ≤1, readability: ≥3, and length of the scenarios), and there was no systematic difference between the intervention and control group materials overall or between individual sessions within each group. For item graphics, we also found no systematic differences in users' ratings of complexity (P=.68), attractiveness (P=.15), and interest (P=.14) between intervention and control group materials. User acceptance testing of the mobile app found that it is easy to use and navigate, interactive, and helpful.
CONCLUSIONS
Material development for any new digital therapeutic requires an iterative and rigorous process of testing involving multiple contributing groups. Appropriate user-centered development can create user-friendly mobile health apps, which may improve face validity and have a greater chance of being engaging and acceptable to the target end users.
Topics: Humans; Paranoid Disorders; User-Centered Design; User-Computer Interface; Telemedicine; Mobile Applications
PubMed: 38064256
DOI: 10.2196/45453 -
Cureus Oct 2023Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to... (Review)
Review
Our review paper delves into the intricate and multifaceted realm of cannibalism, with a focused exploration of its manifestations in Wendigo psychosis. We aim to explore the implications of cannibalism within the realms of psychiatry, anthropology, psychology, and sociology by navigating the complexities of cultural beliefs, psychological underpinnings, historical contexts, and contemporary significance surrounding cannibalism. Cannibalism is deeply ingrained in the cultural and mythological heritage of Algonquian-speaking tribes; it is closely associated with the symbolic figure of the Wendigo. The Wendigo serves as a warning about the potential loss of one's humanity in dire circumstances like starvation. Wendigo psychosis, characterized by psychiatric manifestations such as paranoia, anxiety, hallucinations, and cannibalistic urges, often emerges as a result of a fusion of cultural narratives and psychological vulnerabilities. This may provide an outlet for individuals experiencing internal distress. Historical records show that instances of Wendigo psychosis and cannibalism were more prevalent during periods of extreme scarcity and famine among Algonquian tribes, but they can also manifest in non-famine contexts. Cannibalism assumes diverse forms and meanings across various cultures, encompassing ritualistic, sacrificial, or survival cannibalism. Acknowledging these nuances is paramount to avoiding perpetuating harmful stereotypes and to appreciating the significance of these practices within specific cultures. Engaging in discussions about cannibalism necessitates cultural sensitivity and respect for diverse cultural practices and beliefs to foster open dialogue and enhance cross-cultural understanding. Although cannibalism is often associated with psychiatric disorders, it is not exclusively rooted in mental illness. Factors like substance abuse, antisocial traits, and environmental upbringing can also contribute to cannibalistic acts. In some cases, cannibalism may be linked to survival instincts stemming from trauma and abuse. Therefore, it is vital to distinguish between various forms of cannibalism and understand their underlying motivations. Analyzing cannibalistic fantasies from a psychoanalytic perspective involves exploring mechanisms such as melancholia and oral fixation, shedding light on the psychological underpinnings of these thoughts and urges. Moreover, the influence of media portrayals of cannibalism on public perceptions cannot be underestimated. Sensationalism and romanticization in popular culture can distort our understanding of the motivations and mental states of individuals involved in cannibalistic acts. In essence, cannibalism remains an intriguing and multidimensional topic deeply entrenched in cultural narratives and psychological complexities. A comprehensive understanding necessitates a multidisciplinary approach, taking into account how historical context, cultural beliefs, psychological experiences, and societal dimensions shape human behavior and our comprehension of the human condition. To navigate this complex subject with sensitivity and respect, it is essential to recognize the diverse manifestations and motivations behind cannibalistic behavior, whether in the context of Wendigo psychosis or other cultural practices.
PubMed: 38034155
DOI: 10.7759/cureus.47962 -
Frontiers in Public Health 2023The pandemic of COVID-19 had a profound impact on our community and healthcare system. This study aims to assess the impact of COVID-19 on psychiatric care in Croatia by...
BACKGROUND
The pandemic of COVID-19 had a profound impact on our community and healthcare system. This study aims to assess the impact of COVID-19 on psychiatric care in Croatia by comparing the number of acute psychiatric cases before coronavirus disease (2017-2019) and during the pandemic (2020-2022).
MATERIALS AND METHODS
The paper is a retrospective, comparative analyzes of the hospital admission rate in Diagnosis Related Group (DRG) classes related to mental diseases, and organic mental disorders caused by alcohol and drug use. This study used DRG data from all acute hospitals in Croatia accredited to provide mental health care services and relevant publicly available data from the Croatian Institute of Public Health (CIPH) and the Croatian Health Insurance Fund (CHIF). All hospital admissions for acute psychiatric patients in Croatia were tracked during both periods under study.
RESULTS
During the pandemic, the average number of all such cases decreased by 28% in secondary and tertiary hospitals, and by 11% in specialist psychiatric hospitals. It was also found that during COVID-19, there was a decrease in case numbers in DRG classes related to major affective disorders and anxiety, alcohol, and drug intoxication (31, 48, 34 and 45%, respectively). However, the same period saw an increase in hospital activity for eating disorders and for involuntary admissions related to schizophrenia and paranoia (30, 34 and 39% respectively). There were no changes in the admission rate for cases related to opioid use.
CONCLUSION
The COVID-19 pandemic resulted in both a steep decrease in the overall number of psychiatric cases inpatient treatment at mental health facilities and their DRG casemix. Increasing our understanding of how pandemics and isolation affect demand for psychiatric care will help us better plan for future crises and provide more targeted care to this vulnerable group.
Topics: Humans; COVID-19; Mental Health; Pandemics; Croatia; Retrospective Studies
PubMed: 38026363
DOI: 10.3389/fpubh.2023.1231796 -
Scientific Reports Nov 2023Social anxiety and paranoia often co-occur and exacerbate each other. While loneliness and negative schemas contribute to the development of social anxiety and paranoia...
Social anxiety and paranoia often co-occur and exacerbate each other. While loneliness and negative schemas contribute to the development of social anxiety and paranoia separately, their role in the development of the two symptoms co-occurring is rarely considered longitudinally. This study examined the moment-to-moment relationship between social anxiety and paranoia, as well as the effects of loneliness and negative schemas on both experiences individually and coincidingly. A total of 134 non-clinical young adults completed experience sampling assessments of momentary social anxiety, paranoia, and loneliness ten times per day for six consecutive days. Participants' negative-self and -other schemas were assessed with the Brief Core Schema Scale. Dynamic structural equation modelling revealed a bidirectional relationship between social anxiety and paranoia across moments. Loneliness preceded increases in both symptoms in the next moment. Higher negative-self schema was associated with a stronger link from paranoia to social anxiety; whereas higher negative-other schema was associated with a stronger link from social anxiety to paranoia. Our findings support the reciprocal relationship between social anxiety and paranoia. While loneliness contributes to the development of social anxiety and paranoia, negative self and other schemas appear to modify the relationships between the two symptoms.
Topics: Young Adult; Humans; Paranoid Disorders; Loneliness; Anxiety
PubMed: 38008774
DOI: 10.1038/s41598-023-47912-0 -
BMC Psychiatry Nov 2023Suicidal thoughts, acts, plans and deaths are considerably more prevalent in people with non-affective psychosis, including schizophrenia, compared to the general...
BACKGROUND
Suicidal thoughts, acts, plans and deaths are considerably more prevalent in people with non-affective psychosis, including schizophrenia, compared to the general population. Social isolation and interpersonal difficulties have been implicated in pathways which underpin suicidal experiences in people with severe mental health problems. However, the interactions between psychotic experiences, such as hallucinations and paranoia, suicidal experiences, and the presence, and indeed, absence of interpersonal relationships is poorly understood and insufficiently explored. The current study sought to contribute to this understanding.
METHODS
An inductive thematic analysis was conducted on transcripts of 22, individual, semi-structured interviews with adult participants who had both non-affective psychosis and recent suicidal experiences. A purposive sampling strategy was used. Trustworthiness of the analysis was assured with researcher triangulation.
RESULTS
Participants relayed both positive and negative experiences of interpersonal relationships. A novel conceptual model is presented reflecting a highly complex interplay between a range of different suicidal experiences, psychosis, and aspects of interpersonal relationships. Three themes fed into this interplay, depicting dynamics between perceptions of i. not mattering and mattering, ii. becoming disconnected from other people, and iii. constraints versus freedom associated with sharing suicidal and psychotic experiences with others.
CONCLUSION
This study revealed a detailed insight into ways in which interpersonal relationships are perceived to interact with psychotic and suicidal experiences in ways that can be both beneficial and challenging. This is important from scientific and clinical perspectives for understanding the complex pathways involved in suicidal experiences.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT03114917), 14 April 2017. ISRCTN (reference ISRCTN17776666 .); 5 June 2017). Registration was recorded prior to participant recruitment commencing.
Topics: Adult; Humans; Suicidal Ideation; Psychotic Disorders; Interpersonal Relations; Schizophrenia; Hallucinations
PubMed: 38001403
DOI: 10.1186/s12888-023-05164-2 -
Journal of Psychiatric Research Jan 2024It has been reported that cumulative measures of risk factors for psychosis might help to predict its development. However, it remains unknown as to whether these...
It has been reported that cumulative measures of risk factors for psychosis might help to predict its development. However, it remains unknown as to whether these measures are also associated with the extended psychosis phenotype that refers to a continuum of features bridging subclinical symptoms with clinically relevant outcomes. In this study, we aimed to investigate the association of the exposome score (ES) with psychosis risk in a non-clinical population. A total of 1100 non-clinical adults (aged 18-35 years, 51.4% females) with a negative history of psychiatric treatment were recruited. The Prodromal Questionnaire-16 (PQ-16) was used to screen for psychosis risk. Self-reports were used to record environmental exposures. The ES was significantly higher in participants with the positive PQ-16 screening. Specifically, the prevalence of obstetric complications, non-right handedness, all categories of childhood trauma, and problematic cannabis use was significantly higher in this group of participants. A network analysis demonstrated that the ES was directly connected not only to items representing psychotic experiences ("paranoid thoughts", "a lack of control over own ideas or thoughts", "thought echo", and "being distracted by distant sounds") but also those covering depressive or anxiety symptoms ("uninterested in things used to enjoy" and "feeling anxious when meeting people for the first time"). In conclusion, the ES is associated with the extended psychosis phenotype, suggesting its potential to identify individuals who may benefit from further psychosis risk assessment. The ES appears to contribute to non-specific psychopathology, which may, in some cases, progress to psychosis.
Topics: Adult; Female; Humans; Male; Exposome; Psychotic Disorders; Psychopathology; Surveys and Questionnaires; Risk Factors
PubMed: 37995498
DOI: 10.1016/j.jpsychires.2023.11.022 -
Psychiatria Danubina 2023Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed...
BACKGROUND
Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed increased subjective experience of emotional arousal (EA) to neutral social stimuli in paranoid schizophrenia psychosis, suggesting a misattribution of emotional salience to them. We examined this phenomenon directly by quantifying the level of EA subjectively attributed to low-arousal, neutral-valenced faces.
SUBJECTS AND METHODS
Patients with remitted schizophrenia (PG) (n=26), first-degree relatives of schizophrenic patients (RG) (n=25), and healthy controls (HCG) (n=36) were compared in terms of oxidative stress parameters -serum Superoxide Dismutase, Catalase, Glutathione Peroxidase (GPx), Nitrite, Nitrate, Malondialdehyde, and Total Glutathione levels-, social cognition measured by the Reading the Mind in the Eyes Test and working memory measured by the N-back Task. Groups were compared, assuming that HCG had a genetically lower risk of schizophrenia compared to PG and RG.
RESULTS
HCG performed significantly better than PG and RG, who were genetically at high risk, in terms of social cognition (respectively p=0.000, p=0.014), working memory (respectively p=0.001, p=0.003), and had statistically lower Glutathione Peroxidase (GPX) level than the PG and RG (both p:0.000). After controlling for the effect of the general intellectual abilities measured by the Raven Standard Progressive Matrices Test and working memory the differences between groups on the Eyes Test disappeared (p=0.057). However, this value tended to be significant.
CONCLUSION
It was concluded that social cognition and working memory and GPx level may be used as endophenotypes and social cognition, working memory, and general intellectual skills are different but strongly related constructs. Endophenotypes guide treatment targets even after the disease has developed. The results of our study showed that in addition to psychopharmacological treatments, interventions to reduce oxidative stress and approaches to improve cognitive skills will have a positive impact on the disease's progression.
Topics: Humans; Social Cognition; Psychotic Disorders; Cognition; Schizophrenia, Paranoid; Oxidative Stress; Glutathione Peroxidase; Neuropsychological Tests
PubMed: 37992097
DOI: 10.24869/psyd.2023.523 -
MISATTRIBUTION OF EMOTIONAL OVER-AROUSAL TO NEUTRAL FACES IN ACUTE PARANOID SCHIZOPHRENIA PSYCHOSIS.Psychiatria Danubina 2023Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed...
INTRODUCTION
Misattribution of motivational salience to non-salient (neutral) stimuli could be viewed as a hallmark of psychosis in schizophrenia. Studies have recently revealed increased subjective experience of emotional arousal (EA) to neutral social stimuli in paranoid schizophrenia psychosis, suggesting a misattribution of emotional salience to them. We examined this phenomenon directly by quantifying the level of EA subjectively attributed to low-arousal, neutral-valenced faces.
SUBJECTS AND METHODS
A task for EA attribution to neutral (in the context of affective) facial expressions was applied to 44 actively psychotic paranoid schizophrenia inpatients and 44 well-matched healthy controls.
RESULTS
Psychotic patients, compared with healthy controls, rated the neutral faces as more aroused (t (86) = 3.15, p =.001) thus misattributing emotional salience to them.
DISCUSSION
This finding supports the hypothesis that over-assignment of EA to neutral faces could be viewed as a subclinical affective mechanism of the clinically manifested experience of delusional perception.
CONCLUSION
The study provides the first direct empirical evidence for misattribution of emotional salience in terms of over-attribution of EA to neutral faces during acute paranoid schizophrenia psychosis.
Topics: Humans; Schizophrenia, Paranoid; Emotions; Psychotic Disorders; Arousal; Social Perception; Facial Expression
PubMed: 37992096
DOI: 10.24869/psyd.2023.512