Abstract

The sensitization model suggests that paranoia is explained by over-sensitivity to social threat. However, this has been difficult to test experimentally. We report two preregistered social interaction studies that tested (i) whether paranoia predicted overall attribution and peak attribution of harmful intent and (ii) whether anxiety, interpersonal sensitivity and worry predicted the attribution of harmful intent. In Study 1, we recruited a large general population sample (N = 987) who serially interacted with other participants in multi-round dictator games and matched to fair, partially fair or unfair partners. Participants rated attributions of harmful intent and self-interest after each interaction. In Study 2 (N = 1011), a new sample of participants completed the same procedure and additionally completed measures of anxiety, worry and interpersonal sensitivity. As predicted, prior paranoid ideation was associated with higher and faster overall harmful intent attributions, whereas attributions of self-interest were unaffected, supporting the sensitization model. Contrary to predictions, neither worry, interpersonal sensitivity nor anxiety was associated with harmful intent attributions. In a third exploratory internal meta-analysis, we combined datasets to examine the effect of paranoia on trial-by-trial attributional changes when playing fair and unfair dictators. Paranoia was associated with a greater reduction in harmful intent attributions when playing a fair but not unfair dictator, suggesting that paranoia may also exaggerate the volatility of beliefs about the harmful intent of others.

Highlights

  • Paranoia is a common feature in psychosis and involves an unfounded belief that others intend harm, or in the future [1]

  • Mean baseline paranoid ideation in the excluded participants was higher than participants that were included in the analysis (t153 = −2.41, 95% CI: −10.85, −1.09) by a small amount

  • Paranoia predicted an increase in harmful intent (HI) attributions for both dictators in these models, but not in SI attributions

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Summary

Introduction

Paranoia is a common feature in psychosis and involves an unfounded belief that others intend harm, or in the future [1]. Paranoid beliefs are maintained by several personal and interpersonal factors. Worry, insomnia [9], anxiety [10,11], probabilistic reasoning biases [12], belief inflexibility [13] and safety behaviours (avoiding the source of perceived threat) [11] all contribute to paranoia. Trait interpersonal sensitivity has been associated with paranoid thinking. Those at high risk of developing psychosis report increased paranoid thinking following simulated interactions in a virtual social environment which was predicted [15] or mediated [16] by interpersonal sensitivity

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