A Randomised Comparison of Values and Goals, Versus Goals Only and Control, for High Nonclinical Paranoia

M Davies,L Ellett,J Kingston

doi:10.1007/s10608-021-10226-4

M Davies, L Ellett + Show 1 more

Open Access

https://doi.org/10.1007/s10608-021-10226-4

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Abstract

BackgroundParanoia is common in the general population. Focusing on values and enhancing value-based acts may attenuate it. This study compared three brief (30-min, self-directed) online conditions: focusing on values and value-based goal setting (n = 30), goal setting only (n = 32) and non-values/goals control (n = 32) in a high paranoia sample.MethodsParticipants were randomly assigned to condition. State paranoia (primary outcome) and positive and negative self-views following a difficult interpersonal experience (secondary outcome) were assessed at baseline and two-weeks.ResultsIntention-to-treat: state paranoia was significantly lower following the values condition as compared to non-values/goals control (ηp2 = .148) and goals only (ηp2 = .072). Only the former comparison was significant. Per-protocol: groups did not significantly differ (p = .077). Within-group effect sizes: values and value-based goal setting (intention-to-treat d = .82, per-protocol d = .78), goals only (intention-to-treat d = .41, per-protocol d = .42) non-values/goals control (intention-to-treat d = .25, per-protocol d = .24). Positive self-views increased in all conditions. The increase was largest for the values condition, but not significantly so.LimitationsReliance on self-report, brief follow-up, predominantly White female sample.ConclusionsThe values condition was most effective at reducing non-clinical paranoia. The values condition appeared to increase positive self-views more so than comparison groups, but the sample was small and the difference was non-significant.

Highlights

Paranoia describes the belief that others will intentionally cause one harm (Freeman & Garety, 2014), which can be conceptualised as existing on a continuum ranging from mild concerns of suspicion and distrust of others, to less commonly reported delusions of persecution, which are more typical in clinical presentations
The current findings suggest that individuals with high levels of non-clinical paranoia engaged with these brief online and self-help tasks, with levels of drop-out (30%) comparable to online interventions for other presentations
Results from the ITT analysis indicated that a values clarification and reflection task followed by valuesbased goal setting (i.e., V + G condition) led to lower levels of state paranoia after a 2-week period as compared to goal setting alone and a non-values/goals control

Summary

Introduction

Paranoia describes the belief that others will intentionally cause one harm (Freeman & Garety, 2014), which can be conceptualised as existing on a continuum ranging from mild concerns of suspicion and distrust of others (e.g., others want to cause me harm), to less commonly reported delusions of persecution, which are more typical in clinical presentations (e.g., severe threat from others; Freeman et al, 2019). High paranoia in the general population is associated with distress, poor physical health and suicidal ideation (Freeman & Garety, 2014) It can be a risk factor for future psychotic illness (e.g., Hanssen, 2005; Poulton et al, 2000; van Os et al, 2001). Results Intention-to-treat: state paranoia was significantly lower following the values condition as compared to non-values/ goals control (ηp2 = .148) and goals only (ηp2 = .072). The values condition appeared to increase positive self-views more so than comparison groups, but the sample was small and the difference was non-significant

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