Higher Levels Of Paranoia Research Articles

Multiple complex developmental disorder (MCDD): Did we throw the baby out with the bathwater too fast? A systematic review

Background Multiple complex developmental disorder (MCDD) manifests as early-onset impairment across different domains. Although it could appear as a transitional condition between autism and childhood-onset schizophrenia, interest in MCDD has progressively waned. This study attempts to discern MCDD current relevance to avoid “throwing the baby out with the bathwater” too fast. Methods All available studies published up to January 2024 were retrieved and evaluated following on the PRISMA guidelines for systematic reviews using the term “multiple complex developmental disorder” or “MCDD”, without any filter for study design nor year of publication. Results Only 16 studies were included and analyzed. Overall, a variable heterogeneity was observed in terms of country of investigation, study design, and clinical groups. Most of the included studies explored the construct of MCDD in developmental age, comparing MCDD mostly with autistic patients, and observing how the former group had higher levels of paranoia, illusions, and psychotic thoughts, whereas the latter showed more frequently difficulties in social interactions and stereotypical behaviors. Conclusion Overall, these results showed how progressive changes in diagnostic criteria over time led MCDD to be abandoned as nosographic construct, leaving perhaps a diagnostic void between autism and psychotic disorders that needs to be further studied. A systematic review on the Multiple Complex Developmental Disorder (MCDD): a forgotten diagnosis between autism and schizophrenia.

Symptoms of Paranoia Experienced by Students of Pakistani Heritage in England: The Role of Explicit and Implicit Identities and Perceived Discrimination.

Individuals belonging to ethnic minority groups are less likely to experience symptoms of psychosis, such as paranoia, if they live in areas with high proportions of people from the same ethnic background. This effect may be due to processes associated with group belonging (social identification). We examined whether the relationship between perceived discrimination and paranoia was moderated by explicit and implicit Pakistani/English identification among students of Pakistani heritage (N = 119). Participants completed measures of explicit and implicit Pakistani and English identity, a measure of perceived discrimination, and a measure of paranoia. Perceived discrimination was the strongest predictor of paranoia (0.31). Implicit identities moderated the relationship between perceived discrimination and paranoia (−0.17). The findings suggest that higher levels of implicit Pakistani identity were most protective against high levels of paranoia (0.26, with low implicit English identity; 0.78, with medium English identity; 1.46, with high English identity). Overall, a complex relationship between identity and paranoia was apparent.

A population-based cross-sectional study of cognitive deficits in paranoia

This study sought to investigate the association between paranoia and performance in a range of neurocognitive domains using a large community sample. We conducted a cross-sectional survey of 4507 individuals within the PISMA-ep Study. We used a large community sample selected after multistage sampling using standard stratification techniques. Socio-demographic variables such as age, gender, educational level, urbanicity, and geographical region were recorded. The Spanish version of the Green Paranoid Thought Scale (S-GPTS) was used to assess paranoid thoughts. The Screening for Cognitive Impairment in Psychiatry (SCIP) was used to assess neurocognitive performance both globally and by domains (i.e., immediate and delayed verbal learning, working memory, verbal fluency and processing speed). Individuals with high S-GPTS paranoia scores showed significantly lower performance on global cognitive function and also on immediate (but not delayed) verbal learning, working memory, verbal fluency and processing speed. These results held statistical significance even after controlling for the effects of education and estimated IQ. We propose that cognitive deficits may be mediators of paranoid thinking formation and need to be considered when assessing patients with high levels of paranoia.

Risk perception in paranoia and anxiety: Two investigations across clinical and non-clinical populations

ObjectivesIt is common, among clinical and non-clinical populations alike, for paranoia and anxiety to co-occur. It has been suggested that anxiety and its related appraisal styles may contribute to development of paranoia. We aimed to evaluate different aspects of risk perception in relation to paranoia and anxiety and to identify specific aspects that may differentiate paranoia from anxiety. This paper consists of two inter-related studies. MethodsStudy 1 compared 30 patients with persecutory delusions, 21 patients with generalized anxiety disorder and 52 healthy controls. Study 2 compared 30 non-clinical individuals with high levels of paranoia and anxiety, 28 individuals with high anxiety only and 36 healthy controls. Within each study, the two symptomatic groups were matched on level of anxiety. Four dimensions of risk perception (i.e. likelihood, harm, controllability, and intentionality) were compared across groups, as measured by the locally validated Risk Perception Questionnaire. ResultsIn both studies, the paranoia and the anxiety groups reported an elevated perceived likelihood of negative events than controls respectively. Only the paranoia groups reported an elevated perceived harm of neutral events than controls. In Study 2, the two at-risk groups attributed more harm and intentionality to negative events than controls. ConclusionAlthough perception of negative events was characteristic in anxiety (with or without paranoia), a biased perception of neutral events as risky was unique to the addition of paranoia. Implications to the transdiagnostic and continual view of psychopathology, and mechanism-based interventions were discussed.

Mindfulness and Paranoia: A Cross-Sectional, Longitudinal and Experimental Analysis

ObjectivesThe purpose of this article was to examine the role of mindfulness, and its facets, in predicting (Studies 1 and 2) and attenuating (Study 3) paranoia in students.MethodsStudy 1 used cross-sectional questionnaire-based methodology (N = 410) to examine the association between mindfulness and paranoia whilst controlling for their shared association with anxiety and depression. Study 2 used longitudinal design to test the prospective influence of mindfulness facets on state paranoia over a 2-week period (N = 84). Study 3 used a single-blind between-group experimental design to examine the effects of 1-week self-administered mindfulness training (N = 34) versus 1-week self-administered guided visual imagery (GVI) training (N = 34) on state paranoia.ResultsIn study 1, controlling for anxiety and depression, low levels of non-judgement were significantly associated with high levels of paranoia (p < .001). In study 2, high levels of non-judgement buffered the impact of trait paranoia on daily experiences of state paranoia, whilst statistically controlling for the influence of rumination (interaction: p = .02). In study 3, both mindfulness and GVI significantly reduced state paranoia (p < .001).ConclusionFindings highlight the importance of mindfulness, and non-judgement specifically, in understanding paranoia in students and provide further evidence for mindfulness and relaxation as effective methods for reducing paranoia. Across studies, participants were predominantly white female students. Findings cannot, therefore, be assumed to generalise to other populations.

Reduced scanning of salient facial features mediates the association between paranoia and emotion recognition

The vigilance-avoidance hypothesis of paranoia states that in paranoia visual attention is shifted away from threat-related stimuli. This may be an explanation for reduced scanning of salient facial features in psychosis and subsequently impaired emotion recognition. Here, we explored whether higher levels of paranoia would predict reduced visual attention to salient facial features and impaired emotion recognition and whether reduced visual attention to salient facial features mediates the association between paranoia and errors in emotion recognition.Participants with schizophrenia (SZ, n = 22) and healthy controls (HC, n = 19) completed questionnaire assessments of paranoia and negative symptoms and conducted an emotion recognition task comprised of dynamic facial stimuli. Additionally, visual attention (number of fixations) to salient facial features was assessed using eye-tracking.SZ made more errors in affect recognition than HC. Visual attention to salient facial features did not differ between SZ and HC but significantly mediated the significant association between paranoia and errors in the emotion recognition task in the complete sample. Negative symptoms also predicted errors in emotion recognition but this association was not mediated by visual attention.Our findings are in line with the avoidance-assumption of a vigilance-avoidance hypothesis of paranoia, in which correct facial emotion recognition is prevented due to an avoidance of salient facial features.

Adversity and persecutory ideation: A moderated mediational model

Adversity has been identified as an important factor in models of psychopathology and can help in understanding persecutory ideation, although potential moderators and mediators for adult psychopathology have not been sufficiently examined. Experiential avoidance (EA) and Self-esteem (SE) are relevant factors to understand how adversity leads to persecutory ideation. This study hypothesized that adversity would be associated with persecutory ideation through heightened EA, and that this association would be strengthened in individuals with a discrepant high SE. Participants with persecutory ideation (n = 52), with depression (n = 35) and healthy controls (n = 51) were assessed with the Trauma History Screen, the Paranoia and Deservedness Scale, and the Beck Depression Inventory. A SE discrepancy index was calculated subtracting the normalized explicit SE score from the normalized implicit SE score (measured by a version of a Go/No-go association task). Our analysis revealed that adversity was associated with higher levels of paranoia and was mediated by EA. In addition, we found that the relationship between adversity and EA was moderated by SE discrepancy. Identification of moderating and mediating variables allows for increased understanding of persecutory ideation and the processes that should be targeted in the course of recovery.

Worry processes in patients with persecutory delusions.

Worry may be common in patients with paranoia and a contributory causal factor in the occurrence of the delusions. A number of psychological mechanisms have been linked to the occurrence of worry in emotional disorders but these are yet to be investigated in psychosis. The primary aim of the study was to test the links between five main worry mechanisms - perseverative thinking, catastrophizing, stop rules, metacognitive beliefs, and intolerance of uncertainty - and the cognitive style of worry in patients with persecutory delusions. One hundred and fifty patients with persecutory delusions completed assessments of paranoia, worry, and worry mechanisms. Worry in patients with psychosis was associated with the following: a perseverative thinking style, an 'as many as can' stop rule, a range of metacognitive beliefs (cognitive confidence, worry as uncontrollable and the need to control thoughts), and intolerance of uncertainty. Higher levels of worry were associated with higher levels of paranoia. There was also evidence that intolerance of uncertainty and the metacognitive belief concerning the need to control thoughts were independently associated with paranoia. Worry in patients with persecutory delusions may well be understood by similar underlying mechanisms as worry in emotional disorders. This supports the use of interventions targeting worry, suitably modified, for patients with psychosis. Worry is a significant concern for patients with paranoia Worry in paranoia is likely to be caused by similar mechanisms as worry in emotional disorders The results support the recent trial findings that standard techniques for treating worry in anxiety, suitably modified, are applicable for patients with paranoia LIMITATIONS: The findings are limited by the self-report nature of measures and by the study design which precludes any assumptions about the direction of causality between the psychological mechanisms and worry.

Self-Confidence and Paranoia: An Experimental Study Using an Immersive Virtual Reality Social Situation.

Paranoia may build directly upon negative thoughts about the self. There have been few direct experimental tests of this hypothesis. The aim of the study was to test the immediate effects of manipulating self-esteem in individuals vulnerable to paranoia. A two condition cross-over experimental test was conducted. The participants were 26 males reporting paranoid ideation in the past month. Each participant experienced a neutral immersive virtual reality (VR) social environment twice. Before VR participants received a low self-confidence manipulation or a high self-confidence manipulation. The order of manipulation type was randomized. Paranoia about the VR avatars was assessed. The low self-confidence manipulation, relative to the high self-confidence manipulation, led to significantly more negative social comparison in virtual reality and higher levels of paranoia. Level of self-confidence affects the occurrence of paranoia in vulnerable individuals. The clinical implication is that interventions designed to improve self-confidence may reduce persecutory ideation.

Depersonalization in patients with persecutory delusions.

Delusions are, in part, attempts to explain confusing anomalous experience. Depersonalization, a key subset of anomalous experience, has been little studied in relation to persecutory delusions. The aims of this study were to assess the presence of depersonalization in patients with persecutory delusions and to examine associations with levels of paranoia and worry. Fifty patients with a current persecutory delusion completed measures of depersonalization, psychotic symptoms, and worry. Depersonalization experiences were common: 30 patients (60%) each reported at least 10 different depersonalization symptoms occurring often. A greater number of depersonalization experiences were associated with higher levels of paranoia and worry. The positive association of worry and paranoia became nonsignificant when controlling for depersonalization. Overall, depersonalization may be common in patients with persecutory delusions and is associated with the severity of paranoia. The results are consistent with the view that worry may cause depersonalization experiences that contribute to the occurrence of paranoid thoughts.

Being there: a brief visit to a neighbourhood induces the social attitudes of that neighbourhood

There are differences between human groups in social behaviours and the attitudes that underlie them, such as trust. However, the psychological mechanisms that produce and reproduce this variation are not well understood. In particular, it is not clear whether assimilation to the social culture of a group requires lengthy socialization within that group, or can be more rapidly and reversibly evoked by exposure to the group’s environment and the behaviour of its members. Here, we report the results of a two-part study in two neighbourhoods of a British city, one economically deprived with relatively high crime, and the other affluent and lower in crime. In the first part of the study, we surveyed residents and found that the residents of the deprived neighbourhood had lower levels of social trust and higher levels of paranoia than the residents of the affluent neighbourhood. In the second part, we experimentally transported student volunteers who resided in neither neighbourhood to one or the other, and had them walk around delivering questionnaires to houses. We surveyed their trust and paranoia, and found significant differences according to which neighbourhood they had been sent to. The differences in the visitors mirrored the differences seen in the residents, with visitors to the deprived neighbourhood reporting lower social trust and higher paranoia than visitors to the affluent one. The magnitudes of the neighbourhood differences in the visitors, who only spent up to 45 min in the locations, were nearly as great as the magnitudes of those amongst the residents. We discuss the relevance of our findings to differential psychology, neighbourhood effects on social outcomes, and models of cultural evolution.

Knowledge corruption for visual perception in individuals high on paranoia

Studies revealed that patients with paranoid schizophrenia display overconfidence in errors for memory and social cognition tasks. The present investigation examined whether this pattern holds true for visual perception tasks.Nonclinical participants were recruited via an online panel. Individuals were asked to complete a questionnaire that included the Paranoia Checklist and were then presented with 24 blurry pictures; half contained a hidden object while the other half showed snowy (visual) noise. Participants were asked to state whether the visual items contained an object and how confident they were in their judgment. Data from 1966 individuals were included following a conservative selection process.Participants high on core paranoid symptoms showed a poor calibration of confidence for correct versus incorrect responses. In particular, participants high on paranoia displayed overconfidence in incorrect responses and demonstrated a 20% error rate for responses made with high confidence compared to a 12% error rate in participants with low paranoia scores. Interestingly, paranoia scores declined after performance of the task.For the first time, overconfidence in errors was demonstrated among individuals with high levels of paranoia using a visual perception task, tentatively suggesting it is a ubiquitous phenomenon. In view of the significant decline in paranoia across time, bias modification programs may incorporate items such as the one employed here to teach patients with clinical paranoia the fallibility of human cognition, which may foster subsequent symptom improvement.

A prospective examination of the stability of hostile-dominance and its relationship to paranoia over a one-year follow-up

A hostile-dominant interpersonal style and paranoia increase the risk of aggression in psychiatric in-patients. Paranoia is also associated with hostile-dominance; however, the nature of this relationship is unclear. This study evaluated the relationship between hostile-dominance and paranoia over a one-year period. One hundred and twenty-two patients admitted to hospital for psychiatric treatment were recruited, 43 were available for follow-up. Forty-two participants provided usable data, including 20 men and 22 women, with an age range of 18–63 (M=41.02years, SD=13.00years). At recruitment and follow-up, the psychiatric symptomatology and interpersonal style of each patient was assessed using the Brief Psychiatric Rating Scale-18 and the Impact Message Inventory-Circumplex. Results showed that hostile-dominance was relatively stable over time even though symptoms of paranoia subsided. Higher levels of hostile-dominance were associated with higher levels of paranoia at both recruitment and follow-up. The implications of this research for understanding the relationship between interpersonal style, paranoia and aggression during psychiatric hospitalisation are discussed.

Mobile Assessment in Schizophrenia: A Data-Driven Momentary Approach

In this article, a data-driven approach was adopted to demonstrate how real-life diary techniques [ie, the experience sampling method (ESM)] could be deployed for assessment purposes in patients with psychotic disorder, delivering individualized and clinically relevant information. The dataset included patients in an acute phase of psychosis and the focus was on paranoia as one of the main psychotic symptoms (30 patients with high levels of paranoia and 34 with low levels of paranoia). Based on individual cases, it was demonstrated how (1) symptom and mood patterns, (2) patterns of social interactions or activities, (3) contextual risk profiles (eg, is being among strangers, as opposed to family, associated with higher paranoia severity?), and (4) temporal dynamics between mood states and paranoia (eg, does anxiety precipitate or follow the onset of increased paranoia severity?) substantially differ within individual patients and across the high vs low paranoid patient group. Most striking, it was shown that individual findings are different from what is found on overall group levels. Some people stay anxious after a paranoid thought came to mind. For others, paranoia is followed by a state of relaxation. It is discussed how ESM, surfacing the patient's implicit knowledge about symptom patterns, may provide an excellent starting point for person-tailored psychoeducation and for choosing the most applicable therapeutic intervention.

Heterogeneity of the Jealousy Phenomenon in the General Population: An Italian Study

Despite the general agreement that normal jealousy is heterogenous, little is known about this specific topic. In the present study, we explored the possibility of distinguishing between four subtypes of "normal" jealousy (depressive, anxious, obsessive, and paranoid) amongst a cohort of 500 healthy university students by means of a specifically designed questionnaire, "Ouestionario della gelosia" (QUEGE). QUEGE is a self-report instrument of 30 items which explores the presence, frequency, and duration of feelings and behaviors related to jealousy. It was devised to investigate four hypothetical psychopathological profiles: depressive, paranoid, obsessive, and anxious. The factor analysis identified five rather than four clear-cut factors: self-esteem, paranoia, interpersonal Sensitivity, fear of being abandoned, and obsessionality. Women showed statistically significant lower levels of self-esteem and higher levels of obsessionality than men. Younger age (<25 years) was associated with lower self-esteem and higher levels of paranoia and obsessionality, while being single was associated with lower self-esteem and higher levels of obsessionality. The present study provides evidence of the reliability and validity of the QUEGE instrument, which seems to identify the presence of five psychopathological dimensions within the jealousy phenomenon in the general population.

Insomnia and paranoia

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.

Paranoia and emotion perception across the continuum

Persons with high levels of paranoid ideation may be more sensitive to emotional stimuli, particularly negative emotions, reflecting the operation of a paranoid schema. However, this finding has not been consistently supported and needs further study. This study examined the effect of paranoia, as measured on a continuum, on emotion perception. It was predicted that higher levels of paranoia would be associated with improved emotion perception scores with better recognition for negative emotions than positive. A four-group ANOVA design was used to compare participants with clinical and sub-clinical paranoia to reflect the continuum view of paranoia. A group with persecutory delusions (N=30) was compared with three sub-clinical groups (N=88) on two posed emotion perception tasks. The sub-clinical participants were divided into high, moderate, and low groups based on scores from the Paranoia Scale, a widely used measure of sub-clinical paranoia. Persons with persecutory delusions had lower overall emotion perception scores than all of the sub-clinical groups. For negative emotions, persons with persecutory delusions had lower identification scores than the moderate and low sub-clinical groups, but were no different than the high sub-clinical group. Anger was especially problematic for clinical participants. There were no differences for positive emotions. Instead of an enhanced sensitivity for the recognition of emotional states, higher levels of paranoia were linked to a performance deficit on emotion perception tasks. The deficits in emotion perception may reflect the increased skepticism and scrutiny associated with posed emotion tasks (Davis & Gibson, 2000). Research should begin to focus on the underlying mechanisms of emotion perception deficits in paranoia.

Psychological investigation of the structure of paranoia in a non-clinical population

Previous studies of paranoia have assessed only limited numbers of paranoid thoughts, and have not considered the experience from a multidimensional perspective or examined the relationship between different suspicious thoughts. To assess a wide range of paranoid thoughts multidimensionally and examine their distribution, to identify the associated coping strategies and to examine social-cognitive processes and paranoia. Six questionnaire assessments were completed by 1202 individuals using the internet. Paranoid thoughts occurred regularly in approximately a third of the group. Increasing endorsement of paranoid thoughts was characterised by the recruitment of rarer and odder ideas. Higher levels of paranoia were associated with emotional and avoidant coping, less use of rational and detached coping, negative attitudes to emotional expression, submissive behaviours and lower social rank. Suspiciousness is common and there may be a hierarchical arrangement of such thoughts that builds on common emotional concerns.