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Current Opinion in Psychology Oct 2022Paranoia and conspiracy thinking share many risk factors, such as victimization, poverty and social isolation. They also have many phenomenological features in common,... (Review)
Review
Paranoia and conspiracy thinking share many risk factors, such as victimization, poverty and social isolation. They also have many phenomenological features in common, including heightened tendency to attribute negative outcomes to malevolent agents and idiosyncratic pattern detection. Nevertheless, paranoia and conspiracy thinking also differ in key respects. Specifically, paranoid thoughts tend to be held in isolation and involve perceptions of harm to the self. Conspiracy beliefs, on the other hand, are shared by others and involve the perception of collective rather than personal harm. We discuss the similarities and differences between paranoia and conspiracy thinking and outline fruitful avenues for future research.
Topics: Bullying; Crime Victims; Humans; Paranoid Disorders
PubMed: 35767934
DOI: 10.1016/j.copsyc.2022.101362 -
PLoS Computational Biology Oct 2021Self-deception, paranoia, and overconfidence involve misbeliefs about the self, others, and world. They are often considered mistaken. Here we explore whether they might...
Self-deception, paranoia, and overconfidence involve misbeliefs about the self, others, and world. They are often considered mistaken. Here we explore whether they might be adaptive, and further, whether they might be explicable in Bayesian terms. We administered a difficult perceptual judgment task with and without social influence (suggestions from a cooperating or competing partner). Crucially, the social influence was uninformative. We found that participants heeded the suggestions most under the most uncertain conditions and that they did so with high confidence, particularly if they were more paranoid. Model fitting to participant behavior revealed that their prior beliefs changed depending on whether the partner was a collaborator or competitor, however, those beliefs did not differ as a function of paranoia. Instead, paranoia, self-deception, and overconfidence were associated with participants' perceived instability of their own performance. These data are consistent with the idea that self-deception, paranoia, and overconfidence flourish under uncertainty, and have their roots in low self-esteem, rather than excessive social concern. The model suggests that spurious beliefs can have value-self-deception is irrational yet can facilitate optimal behavior. This occurs even at the expense of monetary rewards, perhaps explaining why self-deception and paranoia contribute to costly decisions which can spark financial crashes and devastating wars.
Topics: Bayes Theorem; Computational Biology; Deception; Decision Making; Humans; Models, Psychological; Paranoid Disorders; Reward; Self Concept; Uncertainty
PubMed: 34618805
DOI: 10.1371/journal.pcbi.1009453 -
The Lancet. Psychiatry Oct 2017Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological... (Comparative Study)
Comparative Study Randomized Controlled Trial
BACKGROUND
Sleep difficulties might be a contributory causal factor in the occurrence of mental health problems. If this is true, improving sleep should benefit psychological health. We aimed to determine whether treating insomnia leads to a reduction in paranoia and hallucinations.
METHODS
We did this single-blind, randomised controlled trial (OASIS) at 26 UK universities. University students with insomnia were randomly assigned (1:1) with simple randomisation to receive digital cognitive behavioural therapy (CBT) for insomnia or usual care, and the research team were masked to the treatment. Online assessments took place at weeks 0, 3, 10 (end of therapy), and 22. The primary outcome measures were for insomnia, paranoia, and hallucinatory experiences. We did intention-to-treat analyses. The trial is registered with the ISRCTN registry, number ISRCTN61272251.
FINDINGS
Between March 5, 2015, and Feb 17, 2016, we randomly assigned 3755 participants to receive digital CBT for insomnia (n=1891) or usual practice (n=1864). Compared with usual practice, the sleep intervention at 10 weeks reduced insomnia (adjusted difference 4·78, 95% CI 4·29 to 5·26, Cohen's d=1·11; p<0·0001), paranoia (-2·22, -2·98 to -1·45, Cohen's d=0·19; p<0·0001), and hallucinations (-1·58, -1·98 to -1·18, Cohen's d=0·24; p<0·0001). Insomnia was a mediator of change in paranoia and hallucinations. No adverse events were reported.
INTERPRETATION
To our knowledge, this is the largest randomised controlled trial of a psychological intervention for a mental health problem. It provides strong evidence that insomnia is a causal factor in the occurrence of psychotic experiences and other mental health problems. Whether the results generalise beyond a student population requires testing. The treatment of disrupted sleep might require a higher priority in mental health provision.
FUNDING
Wellcome Trust.
Topics: Adolescent; Adult; Cognitive Behavioral Therapy; Female; Hallucinations; Humans; Male; Mental Health; Paranoid Disorders; Sleep; Sleep Initiation and Maintenance Disorders; Students; Treatment Outcome; United Kingdom; Young Adult
PubMed: 28888927
DOI: 10.1016/S2215-0366(17)30328-0 -
Clinical Medicine (London, England) Apr 2009Two weeks after starting the oral contraceptive pill, a 16-year-old girl developed increasingly violent chorea and an evolving psychosis with prominent hallucinations,...
Two weeks after starting the oral contraceptive pill, a 16-year-old girl developed increasingly violent chorea and an evolving psychosis with prominent hallucinations, ideas of reference, and paranoia. An erythematous skin rash subsequently developed and Sydenham's chorea (SC) was diagnosed. Following neuroleptic medication and steroids, her chorea and psychosis subsided. This case illustrates that severe psychotic features can occur in SC. It is recommended that antistreptolysin O titres and antibasal ganglia antibodies are checked early in patients with evolving movement disorders and prominent neuropsychiatric features, as the window for modifying the course of this immune-mediated disorder may be narrow.
Topics: Adolescent; Antipsychotic Agents; Antistreptolysin; Basal Ganglia; Chorea; Contraceptives, Oral; Dibenzothiazepines; Female; Hallucinations; Humans; Methylprednisolone; Neuroprotective Agents; Paranoid Disorders; Psychotic Disorders; Quetiapine Fumarate; Risk Factors; Steroids; Streptococcal Infections
PubMed: 19435132
DOI: 10.7861/clinmedicine.9-2-188 -
Biological Psychiatry. Cognitive... Nov 2022
Topics: Humans; Paranoid Disorders; Uncertainty; Emotions; Self Concept
PubMed: 36344038
DOI: 10.1016/j.bpsc.2022.09.011 -
Schizophrenia Research Mar 2009Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are...
Insomnia is a potential cause of anxiety, depression, and anomalies of experience; separate research has shown that anxiety, depression and anomalies of experience are predictors of paranoia. Thus insomnia may contribute to the formation and maintenance of persecutory ideation. The aim was to examine for the first time the association of insomnia symptoms and paranoia in the general population and the extent of insomnia in individuals with persecutory delusions attending psychiatric services. Assessments of insomnia, persecutory ideation, anxiety, and depression were completed by 300 individuals from the general population and 30 individuals with persecutory delusions and a diagnosis of non-affective psychosis. Insomnia symptoms were clearly associated with higher levels of persecutory ideation. Consistent with the theoretical understanding of paranoia, the association was partly explained by the presence of anxiety and depression. Moderate or severe insomnia was present in more than 50% of the delusions group. The study provides the first direct evidence that insomnia is common in individuals with high levels of paranoia. It is plausible that sleep difficulties contribute to the development of persecutory ideation. The intriguing implication is that insomnia interventions for this group could have the added benefit of lessening paranoia.
Topics: Adult; Anxiety; Depression; Female; Humans; Male; Middle Aged; Paranoid Disorders; Psychiatric Status Rating Scales; Residence Characteristics; Severity of Illness Index; Sleep Initiation and Maintenance Disorders; Surveys and Questionnaires
PubMed: 19097752
DOI: 10.1016/j.schres.2008.12.001 -
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 -
The British Journal of Clinical... Nov 2022This study aimed to investigate associations between proximity seeking, stress and paranoia in the context of daily life, and whether these relationships are moderated...
OBJECTIVES
This study aimed to investigate associations between proximity seeking, stress and paranoia in the context of daily life, and whether these relationships are moderated by trait attachment styles.
METHODS
Sixty non-clinical participants completed 3423 assessments of state stress, proximity seeking and paranoia over a 6-day period using an experience sampling method. Multilevel linear regression was performed to evaluate relationships between variables.
RESULTS
The post-hoc analysis showed antecedent events subjectively appraised as very unpleasant or very pleasant predicted greater levels of momentary proximity seeking at the subsequent timepoint. Greater stress predicted greater subsequent shifts or variability in proximity seeking. Changes in proximity seeking were not associated with momentary paranoia. However, for individuals with an avoidant attachment style, greater shifts in proximity seeking resulted in greater subsequent reports of paranoia.
CONCLUSIONS
These findings suggest that, in daily life, the attachment system may become active in response to stress. For those with an avoidant attachment style, an active attachment system may exacerbate paranoid thoughts possibly due to the activation of attachment-related beliefs that one should be fearful of unavailable others and instead rely on one's autonomy to regulate affect. These findings highlight the need to consider attachment in the assessment and formulation of paranoia.
Topics: Ecological Momentary Assessment; Emotions; Humans; Paranoid Disorders
PubMed: 35570710
DOI: 10.1111/bjc.12372 -
Biological Psychiatry. Cognitive... Nov 2022Persecutory delusions are among the most common delusions in schizophrenia and represent the extreme end of the paranoia continuum. Paranoia is accompanied by...
BACKGROUND
Persecutory delusions are among the most common delusions in schizophrenia and represent the extreme end of the paranoia continuum. Paranoia is accompanied by significant worry and distress. Identifying cognitive mechanisms underlying paranoia is critical for advancing treatment. We hypothesized that aberrant belief updating, which is related to paranoia in human and animal models, would also contribute to persecutory beliefs in individuals with schizophrenia.
METHODS
Belief updating was assessed in 42 participants with schizophrenia and 44 healthy control participants using a 3-option probabilistic reversal learning task. Hierarchical Gaussian Filter was used to estimate computational parameters of belief updating. Paranoia was measured using the Positive and Negative Syndrome Scale and the revised Green et al. Paranoid Thoughts Scale. Unusual thought content was measured with the Psychosis Symptom Rating Scale and the Peters et al. Delusions Inventory. Worry was measured using the Dunn Worry Questionnaire.
RESULTS
Paranoia was significantly associated with elevated win-switch rate and prior beliefs about volatility both in schizophrenia and across the whole sample. These relationships were specific to paranoia and did not extend to unusual thought content or measures of anxiety. We observed a significant indirect effect of paranoia on the relationship between prior beliefs about volatility and worry.
CONCLUSIONS
This work provides evidence that relationships between belief updating parameters and paranoia extend to schizophrenia, may be specific to persecutory beliefs, and contribute to theoretical models implicating worry in the maintenance of persecutory delusions.
Topics: Humans; Paranoid Disorders; Schizophrenia; Delusions; Anxiety; Surveys and Questionnaires
PubMed: 35430406
DOI: 10.1016/j.bpsc.2022.03.013 -
Schizophrenia Research. Cognition Sep 2022Paranoid ideation is a core feature of psychosis and is associated with impaired social functioning. Severity of paranoia can fluctuate across time as symptoms wax and...
BACKGROUND
Paranoid ideation is a core feature of psychosis and is associated with impaired social functioning. Severity of paranoia can fluctuate across time as symptoms wax and wane; however, no study has systematically investigated how this intra-individual variability in paranoia may relate to social impairments and social functioning.
METHODS
Fifty-five patients with DSM-5 diagnoses and recent paranoia were followed for up to one year and completed the suspiciousness/persecution section (P6) of the Positive and Negative Symptom Scale (PANSS) on a monthly basis to monitor fluctuations in paranoia. Categorical changes between paranoid and non-paranoid status were monitored and tallied. Participants self-reported current paranoia and anxiety levels as well as social functioning when demonstrating paranoia changes.
RESULTS
Most patients showed changes between paranoid categories (60%). Individuals with no paranoia change showed higher current paranoia and lower independence-competence subscores of the Birchwood Social Functioning Scale (SFS) compared with those with one change. Current paranoia and state anxiety explained significant variance in the prosocial activities subscore of SFS, and importantly, paranoia changes accounted for variance above and beyond these effects. Individuals with higher current paranoia participated less in prosocial activities, however those with higher paranoia variability were more involved in social activities. Similarly, individuals with more paranoia variability demonstrated better overall social functioning as measured by the averaged SFS total score.
CONCLUSION
Paranoia fluctuation is prevalent across time, and both paranoia severity and variability impact social functioning, in that lower levels of paranoia severity and higher levels of paranoia variability are associated with better interpersonal functioning.
PubMed: 35620385
DOI: 10.1016/j.scog.2022.100258