Feelings Of Paranoia Research Articles

Increased structural connectivity of the medial forebrain bundle in schizophrenia spectrum disorders is associated with delusions of paranoid threat and grandiosity.

In many cases delusions in schizophrenia spectrum disorders (SSD) are driven by strong emotions such as feelings of paranoia or grandiosity. We refer to these extreme emotional experiences as psychotic affectivity. We hypothesized that increased structural connectivity of the supero-lateral medial forebrain bundle (slMFB), a major tract of the reward system, is associated with delusional psychotic affectivity. Forty-six patients with SSD and 44 healthy controls (HC) underwent diffusion weighted magnetic resonance imaging (DW-MRI)-scans. The slMFB and a comparison tract (corticospinal tract) were reconstructed using diffusion tensor imaging (DTI)-based tractography. Fractional anisotropy (FA) was sampled across the tracts. We used a mixed-model analyses of variance controlling for age and gender to compare FA of bilateral slMFB between SSD-patients and HC. Correlations of FA of bilateral slMFB and the PANSS-positive item delusions were calculated. In addition, FA was compared between three clinically homogeneous SSD-subgroups in terms of psychotic affectivity (severe, mild and no PA, sPA, mPA, nPA) and HC. FA of the slMFB did not differ between all SSD-patients and HC. In SSD-patients there was a positive correlation between delusions and FA in bilateral slMFB. Likewise, SSD-subgroups of psychotic affectivity and HC differed significantly in FA of the slMFB. Results were driven by higher FA in the right slMFB in sPA as compared to nPA and to HC. There was no significant effect for the comparison tract. In conclusion, increased structural connectivity of the slMFB may underlie delusional experiences of paranoia and grandiosity in SSD.

Journal Digest

Journal Digest

Effect of virtual reality exposure therapy on social participation in people with a psychotic disorder (VRETp): study protocol for a randomized controlled trial.

BackgroundMany patients with a psychotic disorder participate poorly in society. When psychotic disorders are in partial remission, feelings of paranoia, delusions of reference, social anxiety and self-stigmatization often remain at diminished severity and may lead to avoidance of places and people. Virtual reality exposure therapy (VRET) is an evidence-based treatment for several anxiety disorders. For patients with a psychotic disorder, the VRETp was developed to help them experience exposure to feared social situations. The present study aims to investigate the effects of VRETp on social participation in real life among patients with a psychotic disorder.Methods/designThe study is a single-blind randomized controlled trial with two conditions: the active condition, in which participants receive the virtual reality treatment together with treatment as usual (TAU), and the waiting list condition, in which participants receive TAU only. The two groups are compared at baseline, at 3 months posttreatment and at 6 months follow-up. All participants on the waiting list are also offered the virtual reality treatment after the follow-up measurements are completed. The primary outcome is social participation. Secondary outcomes are quality of life, interaction anxiety, depression and social functioning in general. Moderator and mediator analyses are conducted with stigma, cognitive schemata, cognitive biases, medication adherence, simulator sickness and presence in virtual reality. If effective, a cost-effectiveness analysis will be conducted.DiscussionResults from the posttreatment measurement can be considered strong empirical indicators of the effectiveness of VRETp. The 6-month follow-up data may provide reliable documentation of the long-term effects of the treatment on the outcome variables. Data from pre-treatment and mid-treatment can be used to reveal possible pathways of change.Trial registrationCurrent Controlled Trials: ISRCTN12929657. Date of registration: 8 September 2015

The Paranoia of Everyday Life: Some Personal, Psychological, and Pastoral Thoughts

Freud, early in his writings, makes the argument that paranoia results from the repression of distressing memories, paralleling hysteria and obsessional neurosis. The difference, however, is that paranoia makes use of a special psychic mechanism—projection—whereas hysteria makes use of conversion into somatic innervations and obsessional neurosis makes use of substitution or displacement. Drawing on recent research in paranoia, which suggests that feelings of paranoia are quite common among non-clinical populations, perhaps even as common as feelings of anxiety and depression in non-clinical populations, I suggest that paranoia “in everyday life”—that is, paranoia among non-clinical or so-called “normal” populations—results from the suppression (rather than the repression) of distressing thoughts (rather than memories). The mechanism of projection is still at work, but because paranoia in everyday life results from suppression rather than repression, it is much less severe but also much more common. I have followed the logic of Freud’s writings and I have used the method of introspection to come to this conclusion. I argue that pastors and other such persons would do well in knowing something about paranoia so that (1) they can deal more compassionately with those struggling with paranoia and so that (2) they can deal more compassionately with themselves, since it is likely, I believe, that many pastors often struggle with feelings of paranoia. I note several strategies for coping with paranoia as I deal with religious and psychological aspects of paranoia.

Subtle gene–environment interactions driving paranoia in daily life

It has been suggested that genes impact on the degree to which minor daily stressors cause variation in the intensity of subtle paranoid experiences. The objective of the present study was to test the hypothesis that catechol-O-methyltransferase (COMT) Val(158)Met and brain-derived neurotrophic factor (BDNF) Val(66)Met in part mediate genetic effects on paranoid reactivity to minor stressors. In a general population sample of 579 young adult female twins, on the one hand, appraisals of (1) event-related stress and (2) social stress and, on the other hand, feelings of paranoia in the flow of daily life were assessed using momentary assessment technology for five consecutive days. Multilevel regression analyses were used to examine moderation of daily life stress-induced paranoia by COMT Val(158)Met and BDNF Val(66)Met genotypes. Catechol-O-methyltransferase Val carriers displayed more feelings of paranoia in response to event stress compared with Met carriers. Brain-derived neurotrophic factor Met carriers showed more social-stress-induced paranoia than individuals with the Val/Val genotype. Thus, paranoia in the flow of daily life may be the result of gene-environment interactions that can be traced to different types of stress being moderated by different types of genetic variation.

Hidden in plain sight: bringing terror home

In a world where turning a blind eye has become an art, Michael Haneke's 2005 Caché/Hidden explores the ways in which being made to look – and to think – can be experienced as forms of terror. Both fascinating and profoundly banal, it is a film about waiting and watching – and then not seeing what is right in front of you. The film's deceptively narrow depiction of a world of material privilege corroded by psychic unease opens up broader questions of the political deployment of fear and paranoid fantasy, and the dishonesties and displacements of postcolonialism. The film's narrative unfolds in a European city, showing us members of a bourgeois family who appear to have taken refuge behind the walls of their own home, yet who remain unable to shut out the past and their own feelings of paranoia and persecution. They see themselves as victims of a campaign of terror, which initially takes the form of videotapes pushed through the door. These tapes appear to show little more than the unexceptional surface of their everyday lives, yet they serve to unlock a secret from the past, a hidden story of colonial suffering – and in doing so expose the structures of oppression and complicity on which their lives are built.

Adverse effects of stimulant drugs in a community sample of drug users

A sample of drug users ( n = 158) were contacted and interviewed in non-clinical community settings about their use of Ecstasy, cocaine powder, and amphetamines and the adverse effects of these drugs. Subjects reported a wide range of adverse effects including anxiety problems, depression, mood swings, feelings of paranoia, and panic attacks. Sleep and appetite disturbances were the most commonly reported problems. About half of all subjects reported depression and paranoid feelings associated with their stimulant use. Many of those reporting problems stated that these were mild. However, for all drugs, a substantial minority of users reported adverse effects which they rated as ‘severe’. Between 30 and 55% of the sample reported having had at least one ‘severe’ adverse effect (30% cocaine, 35% Ecstasy and 55% amphetamine). There were clear differences between the different drugs in the likelihood and reported severity of adverse effects. Amphetamine use was associated with significantly more adverse effects and with more severe adverse effects than Ecstasy or cocaine. Cocaine powder was associated with the least severe adverse effects. A common pattern of drug use involved the use of depressant drugs such as opiates and benzodiazepines in addition to stimulants. The stimulant and depressant users were more likely than the stimulants-only users to use stimulants by injection and more likely to report adverse effects associated with stimulant use. The stimulant and depressant users were also more likely to have been treated for a drug problem. Approximately a quarter of the sample stated that they had stopped using stimulants up to the point of interview as a result of their bad experiences.