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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 -
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 -
Schizophrenia Research Jul 2020Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic... (Review)
Review
BACKGROUND
Sleep disturbance is a common clinical issue for patients with psychosis. It has been identified as a putative causal factor in the onset and persistence of psychotic experiences (paranoia and hallucinations). Hence sleep disruption may be a potential treatment target to prevent the onset of psychosis and reduce persistent psychotic experiences. The aim of this review is to describe developments in understanding the nature, causal role, and treatment of sleep disruption in psychosis.
METHOD
A systematic literature search was conducted to identify studies, published in the last five years, investigating subjective sleep disruption and psychotic experiences.
RESULTS
Fifty-eight papers were identified: 37 clinical and 21 non-clinical studies. The studies were correlational (n = 38; 20 clinical, 18 non-clinical), treatment (n = 7; 1 non-clinical), qualitative accounts (n = 6 clinical), prevalence estimates (n = 5 clinical), and experimental tests (n = 2 non-clinical). Insomnia (50%) and nightmare disorder (48%) are the most prevalent sleep problems found in patients. Sleep disruption predicts the onset and persistence of psychotic experiences such as paranoia and hallucinations, with negative affect identified as a partial mediator of this relationship. Patients recognise the detrimental effects of disrupted sleep and are keen for treatment. All psychological intervention studies reported large effect size improvements in sleep and there may be modest resultant improvements in psychotic experiences.
CONCLUSIONS
Sleep disruption is a treatable clinical problem in patients with psychosis. It is important to treat in its own right but may also lessen psychotic experiences. Research is required on how this knowledge can be implemented in clinical services.
Topics: Delusions; Hallucinations; Humans; Paranoid Disorders; Psychotic Disorders; Schizophrenia; Sleep
PubMed: 31831262
DOI: 10.1016/j.schres.2019.11.014 -
Respiratory Care Dec 2018Smoking tobacco is believed to be common among patients with psychiatric disorders like anxiety, depression, schizophrenia, and affective disorders. The aim of this... (Observational Study)
Observational Study
BACKGROUND
Smoking tobacco is believed to be common among patients with psychiatric disorders like anxiety, depression, schizophrenia, and affective disorders. The aim of this study was to investigate the psychological symptoms of people without known psychiatric diseases who have freely decided to quit smoking.
METHODS
A cross-sectional study was designed, and 124 healthy active-smokers (66 female) and 127 healthy non-smokers (61 female) were recruited. The symptom check list and Fagerström Test for Nicotine Dependence (FTND) were used to assess psychological symptoms and nicotine addiction level. Smokers were divided into 3 groups: light smokers (0-9 cigarettes/d), moderate smokers (10-19 cigarettes/d), and heavy smokers (> 20 cigarettes/d).
RESULTS
When subjects were compared by daily levels of cigarette consumption, somatic findings were more prominent in the mild smoker group (1.61 ± 0.72 vs 0.77 ± 0.56, < .001), while depression and hostility were similar across all groups. When subjects were compared by nicotine addiction ratio, the general symptom index of the group with high-grade nicotine addiction was found to be significantly higher than that of the control group (1.34 ± 0.72 vs 0.79 ± 0.49, < .001). In addition, the high-grade nicotine addiction group had higher scores than the other groups for somatization, anxiety, depression, paranoid symptoms, hostility, and other symptoms.
CONCLUSION
This study examined the association between psychological symptoms and smokers' daily cigarette consumption and nicotine addiction levels. Psychiatric symptoms (ie, somatization, anxiety, depression, hostility, and paranoia) were observed more frequently in people with high-grade nicotine addiction (FTND score 7-10 points).
Topics: Adult; Anxiety; Cigarette Smoking; Cross-Sectional Studies; Depression; Female; Hostility; Humans; Male; Middle Aged; Paranoid Disorders; Smokers; Smoking Cessation; Somatoform Disorders; Tobacco Use Disorder; Young Adult
PubMed: 30065079
DOI: 10.4187/respcare.06287 -
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 -
Medical Principles and Practice :... 2008The neural basis of psychosis is yet to be fully elucidated. In this review the contribution of schizophrenia-like psychosis of epilepsy, delusional misidentification... (Review)
Review
The neural basis of psychosis is yet to be fully elucidated. In this review the contribution of schizophrenia-like psychosis of epilepsy, delusional misidentification syndromes and psychotic phenomena, such as auditory and visual hallucinations, to our understanding of the neural basis of psychosis is examined. Schizophrenia-like psychosis of epilepsy is associated with seizures originating from the limbic structures. Reduced seizure frequency, left-sided electrical foci, and neurodevelopmental lesions manifesting as cortical dysgenesis are known to influence the likelihood of developing schizophrenia-like psychosis of epilepsy. The delusional misidentification syndromes are a group of rare psychiatric symptoms in which impairments of face recognition memory are present. These conditions appear also to be associated with organic lesions affecting limbic structures and also involving both the frontal and parietal lobes. There is evidence that right-sided lesions predominate in the aetiology of delusional misidentification syndromes. Thus, the common link between schizophrenia, schizophrenia-like psychosis of epilepsy and delusional misidentification syndromes appears to be involvement of limbic structures in their pathophysiology. Discrete psychotic phenomena such as visual and auditory hallucinations appear to arise from functional changes in the same cortical areas subserving the normal physiological functions of vision and audition but also involving limbic structures. In conclusion, the limbic structures appear to be central to the psychopathology of psychosis but with involvement of frontal and parietal structures. These inquiries are revealing as much about psychosis as they are about the nature of normal brain function.
Topics: Epilepsy; Humans; Psychotic Disorders; Risk Factors; Schizophrenia; Schizophrenia, Paranoid
PubMed: 18523391
DOI: 10.1159/000129603 -
Schizophrenia Bulletin Sep 2022Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We...
BACKGROUND AND HYPOTHESIS
Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype.
STUDY DESIGN
Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions.
STUDY RESULTS
Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found.
CONCLUSIONS
This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments.
Topics: Anxiety; Emotions; Humans; Paranoid Disorders; Psychotic Disorders; Self Concept
PubMed: 35759215
DOI: 10.1093/schbul/sbac071 -
PLoS Computational Biology Jul 2022Theoretical accounts suggest heightened uncertainty about the state of the world underpin aberrant belief updates, which in turn increase the risk of developing a...
Theoretical accounts suggest heightened uncertainty about the state of the world underpin aberrant belief updates, which in turn increase the risk of developing a persecutory delusion. However, this raises the question as to how an agent's uncertainty may relate to the precise phenomenology of paranoia, as opposed to other qualitatively different forms of belief. We tested whether the same population (n = 693) responded similarly to non-social and social contingency changes in a probabilistic reversal learning task and a modified repeated reversal Dictator game, and the impact of paranoia on both. We fitted computational models that included closely related parameters that quantified the rigidity across contingency reversals and the uncertainty about the environment/partner. Consistent with prior work we show that paranoia was associated with uncertainty around a partner's behavioural policy and rigidity in harmful intent attributions in the social task. In the non-social task we found that pre-existing paranoia was associated with larger decision temperatures and commitment to suboptimal cards. We show relationships between decision temperature in the non-social task and priors over harmful intent attributions and uncertainty over beliefs about partners in the social task. Our results converge across both classes of model, suggesting paranoia is associated with a general uncertainty over the state of the world (and agents within it) that takes longer to resolve, although we demonstrate that this uncertainty is expressed asymmetrically in social contexts. Our model and data allow the representation of sociocognitive mechanisms that explain persecutory delusions and provide testable, phenomenologically relevant predictions for causal experiments.
Topics: Delusions; Humans; Learning; Paranoid Disorders; Social Learning; Uncertainty
PubMed: 35877675
DOI: 10.1371/journal.pcbi.1010326 -
Psychology and Psychotherapy Sep 2021Paranoia is known to be associated with insecure attachment, with negative self-esteem as a mediator, but this pathway is insufficient to explain the paranoid...
OBJECTIVES
Paranoia is known to be associated with insecure attachment, with negative self-esteem as a mediator, but this pathway is insufficient to explain the paranoid individual's beliefs about malevolent others. Mistrust is a likely additional factor as it is a core feature of paranoid thinking also associated with insecure attachment styles. In this study, we tested whether mistrust - operationalized as judgements about the trustworthiness of unfamiliar faces - constitutes a second pathway from insecure attachment to paranoia.
DESIGN
The design of the study was cross-sectional.
METHODS
A nationally representative British sample of 1,508 participants aged 18-86, 50.8% female, recruited through the survey company Qualtrics, completed measurements of attachment style, negative self-esteem, and paranoid beliefs. Usable data were obtained from 1,121 participants. Participants were asked to make trustworthiness judgements about computer-generated faces, and their outcomes were analysed by conducting signal detection analysis, which provided measures of bias (the tendency to assume untrustworthiness in conditions of uncertainty) and sensitivity (accuracy in distinguish between trustworthy and untrustworthy faces).
RESULTS
Results using structural equation modelling revealed a good model fit (RMSEA = .071, 95% CI: 0.067-0.075, SRMR = .045, CFI = .93, TLI = .92). We observed indirect effects through bias towards mistrust both for the relationship between attachment anxiety and avoidance (β = .003, 95% CI: 0.001-0.005,p < .001) and attachment anxiety and paranoia (β = .003, 95% CI 0.002-0.006, p < .001). We observed an indirect effect through negative self-esteem only for the relationship between attachment anxiety and paranoia (β = .064, 95% CI: 0.053-0.077, p < .001). Trust judgements and negative self-esteem were not associated with each other.
CONCLUSIONS
We find that a bias towards mistrust is associated with greater paranoia. We also find indirect effects through bias towards mistrust between attachment styles and paranoia. Finally, we reaffirm the strong indirect effect through negative self-esteem between attachment anxiety and paranoia. Limitations of the study are discussed.
PRACTITIONER POINTS
When working with individuals suffering from paranoia, clinicians should consider not only explicit, deliberative cognitive processes of the kind addressed in cognitive behaviour therapy (e.g. cognitive restructuring) but also the way in which their patients make perceptual judgements (e.g., their immediate reactions on encountering new people) and consider interventions targeted at these judgements, for example, bias modification training. Assessment and clinical interventions for people should consider the role of trust judgements and the way in which they combine with low self-esteem to provoke paranoid beliefs. Psychological interventions targeting paranoid beliefs should focus on both attachment anxiety and attachment avoidance.
Topics: Anxiety; Anxiety Disorders; Cross-Sectional Studies; Female; Humans; Male; Paranoid Disorders; Self Concept
PubMed: 33314565
DOI: 10.1111/papt.12314 -
Schizophrenia Bulletin Mar 2014In his textbook from 1838, Esquirol made the first comprehensive psychopathological description of paranoia, which he labeled partial psychosis. This was a condition... (Review)
Review
In his textbook from 1838, Esquirol made the first comprehensive psychopathological description of paranoia, which he labeled partial psychosis. This was a condition with encapsulated, well organized, and persistent delusions. These are defended with a great deal of emotions and sharp argument. The individual appears quite convincing, especially because he or she otherwise behaves rationally. The intellectual capacity is used to achieve defined goals according to the delusional content. This condition is difficult to uncover because of dissimulation and adaptation. The frequency in the population is unknown, but the condition is rare in psychiatric treatment facilities, and usually only when the persons become litigious or criminal. In Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the condition is covered by the concept of delusional disorder, but that concept also comprises benign acute/subacute conditions as well as cases that turn out to have the diagnosis changed to schizophrenia.
Topics: Diagnostic and Statistical Manual of Mental Disorders; Humans; Psychotic Disorders; Schizophrenia, Paranoid
PubMed: 24421383
DOI: 10.1093/schbul/sbt203