Paranoid Thoughts Research Articles

Virtual Reality: A Step Forward In Diagnosing Schizophrenia

: Diagnosing a heterogeneous disorder like schizophrenia is still based on patients’ report of their subjective experiences. Recently, the utilization of innovative, computer-based technologies such as virtual reality (VR) to objectify these experiences has gained experts’ attention. VR provides a multidimensional, interactive environment, in which the formation of paranoid thoughts in different settings, as well as patients’ reaction to virtual characters, can be assessed. VR also offers a milieu to evaluate other aspects of the disorder such as cognitive deficits and negative symptoms. Trying to objectify the diagnosis not only can help specialists to have a more goal-directed management approach but also benefits patients with receiving better care. Herein, we briefly report the new advances of applying VR in the evaluation and diagnosis of schizophrenia, a novel approach that in turn can accelerate the rehabilitation and the treatment of the disorder.

Experimentally induced social threat increases paranoid thinking.

The ability to attribute intentions to others is a hallmark of human social cognition but is altered in paranoia. Paranoia is the most common positive symptom of psychosis but is also present to varying degrees in the general population. Epidemiological models suggest that psychosis risk is associated with low social rank and minority status, but the causal effects of status and group affiliation on paranoid thinking remain unclear. We examined whether relative social status and perceived group affiliation, respectively, affect live paranoid thinking using two large-N (N = 2030), pre-registered experiments. Interacting with someone from a higher social rank or a political out-group led to an increase in paranoid attributions of harmful intent for ambiguous actions. Pre-existing paranoia predicted a general increase in harmful intent attribution, but there was no interaction with either type of social threat: highly paranoid people showed the same magnitude of increase as non-paranoid people, although from a higher baseline. We conclude social threat in the form of low social status and out-group status affects paranoid attributions, but ongoing paranoia represents a lowered threshold for detecting social threat rather than an impaired reactivity to it.

Moment-to-moment associations between negative affect, aberrant salience, and paranoia

ABSTRACTIntroduction: There is an ongoing debate about whether negative affect are consequences or triggers of paranoid thinking. It has also been suggested that aberrant salience is central to the development of delusions. This study modelled the moment-to-moment relationships between negative affect, aberrant salience, and paranoia in acute inpatients with psychosis.Methods: Participants with active paranoid delusions were assessed using clinical rating scales and experience sampling method (ESM) over 14 days. ESM data were analysed using time-lagged multilevel regression modelling.Results: Both negative affect and aberrant salience predicted an increase in paranoia at the next time point. Conversely, the level of paranoia did not predict subsequent changes in negative affect or aberrant salience. Negative affect predicted an increase in aberrant salience at the next time point, and vice versa.Conclusions: Negative affect and aberrant salience appear to drive and exacerbate paranoia, rather than being merely the sequelae of the symptom. Our results suggest both direct and indirect (via aberrant salience) pathways from negative affect to paranoia.

Paranoid Delusions as an Adaptive Response to Social Evaluative Stress?

Abstract. Learning mechanisms may serve as a framework for understanding the formation of paranoia. Specifically, if paranoid thoughts after social stressors produce a short-term benefit for coping (e.g., downregulating arousal), the encountered negative reinforcement could lead to their excessive application and subsequently to long-term maladaptive convictions. The Trier Social Stress Test was utilized in healthy participants to examine this putative benefit. Participants rated paranoia at baseline and after the stressor. Subjective stress levels, negative affect, heart rate, and heart rate variability were assessed in the following rest phase (N = 59). Semipartial correlations showed that participants who responded with larger increases in paranoia were characterized by a lower heart rate in the subsequent rest phase. No associations were found with heart rate variability or psychological measures. Thus, paranoid thinking in healthy individuals could be an adaptive means for reestablishing some aspects of physiological homeostasis after a social stressor but further research is needed.

An experimental manipulation of negative metacognitive beliefs in non-clinical paranoia

Metacognitive beliefs implicated in the Self-Regulatory Executive Function (S-REF) model (Wells & Matthews, 1994, 1996) have demonstrated significant positive relationships with experiences of psychosis. This study aimed to investigate the effect of manipulating metacognitive beliefs relating to the uncontrollability and danger of thoughts on paranoia frequency and negative affect in a non-clinical sample. Seventy-six students participated in a randomised experiment. All participants were falsely informed they were taking part in an EEG study about thought processes in paranoia. Following a paranoia induction, participants in the experimental condition were told that the EEG could detect paranoid thoughts and may make a loud noise in response to detecting them; participants in the control condition were told the EEG could detect paranoid thoughts and may make a loud noise at random. Validity checks confirmed the paranoia prime was effective and there was a significant change in metacognitive beliefs following the manipulation. Overall no significant differences between the two groups on measures of intrusions or anxiety emerged following the manipulation. However, changes in physiological anxiety approached significance. The results demonstrate it is feasible to manipulate metacognitive beliefs and induce paranoia. A recommendation for further research to use a refined paradigm with a clinical sample is discussed.

Virtual Reality May Soon Become Clinical Reality in Psychosis Care

Virtual Reality May Soon Become Clinical Reality in Psychosis Care

T213. THE EFFECT OF ACUTE STRESS ON PARANOID THINKING AND CORTISOL DURING SOCIAL INTERACTION IN HIGH AND LOW SCHIZOTYPES

BackgroundParanoid thinking, a common symptom of psychosis and schizophrenia, manifests as a sense of threat and may also be indexed by a lack of trust. Stress, in turn, exacerbates psychosis and paranoia, and is a well-established risk factor for schizophrenia as well as a component in several models of psychosis. The present study aimed to determine the impact that acute stress has on paranoid thinking during social interaction in vivo in high (HSZ) vs low (LSZ) schizotypy using an iterated social reciprocity game. The main hypothesis was that HSZ would anticipate grerater social threat and paranoia at baseline compared to LSZ, and moreover that experimentally-induced stress would exacerbate those differences, and thus show that stress differentially modulates how HSZ model the intentions of others.MethodsMatched healthy participants were stratified into HSZ (N=17) and LSZ (N=17) groups and were administered a non-financial, social-reciprocity game against benevolent and malevolent opponents under both stress and no-stress conditions. Stress was manipulated using the MIST (Dedovic et al., 2005) stress paradigm. Cortisol was measured from saliva samples acquired before and after the MIST stress task. Anticipation of threat and trust scores were derived from the social interaction task.ResultsAt baseline, cortisol levels were not significantly different between HSZ and LSZ but were significantly raised by the stressor task in HSZ (p<.05) but not in LSZ. Higher cortisol at baseline (pre-stress) predicted greater initial and average anticipation of threat (both r=.5, p<.05) (no-stress) to other players; and lower initial trust ratings of malevolent, but not benevolent, players. The MIST task significantly elevated stress ratings compared to baseline (p<.001) and following stress, greater change in cortisol from baseline to post-MIST was associated with lower trust ratings (r=.51, p<.05). In HSZ greater stressor-related cortisol levels correlated with greater anticipation of threat (r=.58, p<.05) and lower trust levels (r=.57, p<.05) which was not apparent in low schizotypes.DiscussionAcute stress elevates cortisol and paranoia in HSZ – in the form of greater anticipation of threat, and lower trust compared to LSZ. The study adds evidence to the role of stress in exacerbating schizophrenia-like experiences in those who are sub-threshold for schizophrenia and psychosis.

S75. MALADAPTIVE SOCIAL-EVALUATIVE AND SELF-BELIEFS INFORMING THE RELATION BETWEEN PARANOIA AND SOCIAL ANXIETY

BackgroundParanoid delusions are reported among those with positive symptoms of schizophrenia (Bentall et al., 2009), those at high-risk for the development of psychosis (Addington et al., 2015; Salokangas et al., 2016), and in the general population (i.e., Freeman et al., 2005). Paranoia is related to functional impairment in multiple domains (i.e. Pinkham et al., 2016; McGurk et al., 2013). Given the presence of paranoia at both clinical and non-clinical levels, paranoia may be best conceptualized dimensionally. Further, robust relations between paranoia and social anxiety suggest that the two may exist together on one spectrum, with paranoia reflecting the most extreme end of this continuum (i.e. Gilbert, Boxall, Cheung, & Irons, 2005; Lim, Rodebaugh, Zyphur & Gleeson, 2016).Evidence suggests that several factors may influence the development of paranoia, including social cognitive biases such as diminished trust, increased hostility, and increased tendency to blame others (Pinkham et al., 2014). These types of social cognitive biases do not seem to be unique to paranoia and are also observed among those with social anxiety (i.e., Green & Phillips, 2004). Additional research suggests that paranoia and social anxiety may share other relevant attributes, such as need for approval from others (Rector, 2004), desire for closeness (Lim, Rodebaugh, Zyphur & Gleeson, 2016), and worry about and expectation of social rejection (Freeman, 2014). Despite literature to support overlap between paranoia and social anxiety, there is less research examining whether core beliefs of social anxiety contribute to the development and maintenance of paranoia. Specifically, core beliefs of social anxiety include (1) conditional beliefs: negative self-appraisals dependent on performance (2) unconditional beliefs: negative self-appraisals independent of behavior, and (3) high-standard beliefs: the attribution of self-worth based on performance (Wong, Moulds & Rapee, 2014). There is a need for research to determine the association between paranoia and beliefs related to social anxiety.The aim of the current study is to identify whether cognitions thought to be central to social anxiety are also related to paranoia in a sample of those with psychosis. We hypothesize that (1) social anxiety and paranoia will be related, and (2) heightened maladaptive self-beliefs of social anxiety will be associated with increased paranoia.MethodsWe will use the Social Interaction Anxiety Scale (Heimberg, Mueller, Holt, Hope & Liebowitz, 1992) to measure social anxiety symptomatology. We will use the Self-Beliefs Related to Social Anxiety Scale (Wong, Moulds & Rapee, 2014) including three subscales: conditional beliefs, unconditional beliefs, and high standard beliefs, to quantify cognitions of social anxiety. To measure paranoia, we will use the Green Paranoid Thoughts Scale (Green et al., 2008).ResultsPreliminary analyses (N = 14) indicate that the social anxiety is robustly related to paranoia (r = 0.59, p < 0.05). Unconditional beliefs were related to paranoid thoughts (r = 0.62, p < 0.05) and paranoia was moderately correlated to conditional beliefs (r = 0.35, p = 0.24) and total self-beliefs related to social anxiety scores (r = 0.39, p = 0.19), but these relations were not statistically significant. Additional data will be available at the time of presentation.DiscussionResults of this research will both inform the development of paranoia and allow for a better understanding of the relation between paranoia and social anxiety. Specifically, cognitive mechanisms underlying their relation will be illuminated.

S26. HERITABILITY OF SOCIAL MISTRUST IN CHILD AND ADOLESCENT NON-CLINICAL SAMPLES: A HEALTHY TWINS STUDY

BackgroundParanoia, or excessive suspiciousness of others, has been one of the core psychotic symptoms of schizophrenia. Recent studies have extended the study of psychotic symptoms in clinical groups to psychotic-like experiences in the general population. Few studies have systematically examined the prevalence of paranoid thinking or its attenuated form, social mistrust, in young children in the community. The present study examined the Social Mistrust Scale (SMS) and utilized it to examine the structure, prevalence, and heritability of social mistrust in a large sample of Chinese children and adolescents.MethodsWe administered the SMS to 1047 pairs of healthy twins aged 8 to 14 years and conducted structural equation modelling (SEM) to assess the structure of the SMS. Heritability of social mistrust was estimated in a sub-sample of twins (n=959 pairs). Finally, we examined administered the SMS to 32 adolescents with childhood-onset schizophrenia and 34 healthy controls to examine the convergent validity between the SMS and the Positive and Negative Syndrome Scale (PANSS).ResultsThe SEM showed a three-factor structure for social mistrust (home, school, and general mistrust). Social mistrust was moderately heritable (39%, 95% CI [21%-59%]) with context-dependent sex differences. The SMS exhibited good discriminant validity in distinguishing adolescents with childhood-onset schizophrenia from healthy controls (AUC=0.80), and good convergent validity with the Positive and Negative Syndrome Scale (rs = 0.33–0.45).DiscussionTaken together, the present findings showed a stable latent structure of the SMS in a large-scale non-clinical sample of children and adolescents. We found a moderate heritability estimate for social mistrust (39%) in a large healthy-twin sample. In addition, significant gender differences were found, where home mistrust was heritable for males (58%) but not for females, and school mistrust was heritable for females (54%) but not for males. Finally, we also demonstrated that the SMS possesses good discriminate validity in identifying adolescents with childhood-onset schizophrenia from healthy controls and convergent validity with standardized clinical measures of schizophrenia symptoms.

F113. IMPACT OF NEIGHBORHOOD CHARACTERISTICS ON PARANOIA, LONELINESS, AND PERCEIVED REJECTION IN A TRANSDIAGNOSTIC SAMPLE WITH PSYCHOSIS

BackgroundParanoia is unsubstantiated thinking that others want to cause harm, and it exists on a spectrum ranging from suspicion to delusions both in the general population and in individuals with psychosis (Freeman et al., 2011; Freeman, 2016). Paranoia is interpersonal in nature, and research has shown that individuals with paranoid delusions use person attributions more than depressed or healthy controls during a task with interpersonal vignettes (Bentall, Kaney, & Dewey, 1991). Therefore, it is important to explore how other interpersonal or social factors may affect paranoia. Neighborhood characteristics, such as reduced social cohesion and crime, perceived rejection, and loneliness have been associated with paranoia (Lamster, Nittel, Rief, Mehl, & Lincoln, 2017; Newbury et al., 2017; Wickham, Taylor, Shevlin, & Bentall, 2014). However, it is still unclear whether these factors affect paranoia independently or have a more additive influence. Some researchers have proposed that perceived rejection and loneliness reduce community engagement and the size of social networks in this population (Cechnicki & Wojciechowska, 2008; Kidd et al., 2016), but others have not supported these findings (Trémeau et al., 2016). The current study will try to clarify the literature by exploring the associations between neighborhood characteristics, social factors (namely, perceived rejection and loneliness), social network, and paranoia.MethodsThe current study will examine how paranoia correlates with neighborhood characteristics, loneliness, perceived rejection, and social network size in a transdiagnostic sample with psychosis. We will utilize the Neighborhood Environment Scale (Mujahid et al., 2007) to assess social cohesion, safety, violence, and activities with neighbors within participants’ residencies. We will use the Paranoid Thought Scales (Green et al., 2008) to assess paranoid ideation and the Adult Social Relationship Scales (Cyranowski et al., 2013) to assess perceived rejection and loneliness over the past month. In addition, we will use the Social Network Index (Cohen et al., 1997) to investigate the correlation between participants’ social network and paranoia, social rejection, and loneliness.ResultsPreliminary results (N = 13) indicate a significant correlation between paranoia and perception of neighborhood social cohesion (r = -0.57, p < 0.05). In addition, loneliness (r = 0.60, p < 0.05) and perceived social rejection (r = 0.52, p < 0.05) were the largest correlates of paranoia. We will conduct formal analyses with a larger N to further explore these and other associations.DiscussionDiscussion will be included in the poster after more data has been collected.

Interpersonal processes in paranoia: a systematic review.

Paranoid ideation is a core feature of psychosis, and models of paranoia have long proposed that it arises in the context of disturbances in the perception of the self. However, to develop targeted interventions, there is a benefit in clarifying further, which aspects of self-perception are implicated. Interpersonal sensitivity is a personality trait which has been associated with the risk of paranoid thinking in the general population. However, not all studies have found this link. We aimed to review the empirical literature assessing the association between interpersonal sensitivity and paranoia in both general population and clinical samples; and to explore if associations found differed depending on whether state or trait paranoia was assessed. The review followed PRISMA guidelines. Articles were identified through a literature search in OVID (PsychINFO, MEDLINE) and Web of Science up to December 2016. Fourteen studies with a total of 12 138 participants were included. All studies were of 'fair' or 'good' quality. A robust association was found between interpersonal sensitivity and paranoia in clinical and general population samples alike, regardless of the method of assessment of both paranoia and interpersonal sensitivity. Although this finding was more pronounced in studies of trait paranoia, it is likely that differences in study purpose, measurement, and power explain these differences. Findings from this review support the hypothesis that feelings of personal vulnerability and exaggerated socially evaluative concerns are central for both onset and maintenance of paranoid symptoms, suggesting avenues for future research in targeted interventions.

Paranoid beliefs and realistic expectations of victimization: Data from the survey of police-public encounters

BackgroundThe anticipation of threat or victimization is a core feature of paranoia. Cognitive theories of paranoia suggest that paranoid thoughts may arise as a psychological response to trauma exposure, which likewise may lead to greater anticipation of subsequent victimization. Little is known, however, about the relation between paranoid beliefs and anticipated victimization when accounting for past victimization experience. The present study aimed to address whether the experiences of past victimization contribute to the link between paranoid beliefs and the anticipation of threat or victimization, with a particular focus on exposure to police violence. MethodsData were collected through the Survey of Police-Public Encounters (N=1615), a cross-sectional, general population survey study conducted in four Eastern U.S. cities. Associations between paranoia and anticipated victimization were assessed using linear regression models, with and without adjustment for past victimization exposure. ResultsParanoid beliefs were positively associated with police victimization expectations (β=0.19, p<0.001), but these associations were statistically better explained by past exposures to similar victimization such that paranoia was no longer associated with anticipated victimization in adjusted models (β=0.02, p=0.451). To assess for the specificity of past exposures to victimization, adjusting for past exposure to intimate partner violence (as a control condition) did not eliminate the association between paranoia and expected police victimization. ConclusionsThe overall findings are consistent with cognitive theories of paranoia in which paranoid beliefs may be a severe but normative reaction to past victimization exposures in some cases.

P.2.009 - Dopamine modulates belief updating but not surprise in the midbrain and ventral striatum

Dopamine may be critical for processing the meaningful information content of observations, which drives belief updating about the (hidden) states of the world [1–3]. In human functional magnetic resonance imaging (fMRI) studies, neuronal activity encoding the magnitude of belief updates has been detected in dopamine-rich midbrain regions, namely the substantia nigra and ventral tegmental area (SN/VTA) [1-3]. Yet, there is no direct evidence linking dopamine function to belief updating signals in humans. This question is relevant to our understanding of the relationship between dopamine, aberrant inference and the generation of psychotic symptoms such as paranoia [4]. We investigated the dopaminergic basis of belief update signals using fMRI and positron emission tomography (PET) imaging. 39 healthy participants (mean age 26y, 22 male) performed an fMRI task that decomposed sensory information into information-theoretic surprise (unexpected but not necessarily meaningful information content) and Bayesian surprise (magnitude of belief updates due to meaningful information) [1]. A Bayesian observer computational model was fitted to participants’ behavior, allowing the derivation of trial-wise regressors for information-theoretic and Bayesian surprise for fMRI analysis. 36 participants also had a [11C]-(+)-4-propyl-9-hydroxy-naphthoxazine ([11C]-(+)-PHNO) PET scan to quantify dopamine-2/3 receptor (D2/3R) availability. 17 participants additionally had a second [11C]-(+)-PHNO PET scan 3hrs following 0.5mg/kg oral dexamphetamine, to quantify striatal dopamine release capacity. Our analyses focused on the relationship between measures of neuronal activity (fMRI) and dopamine function (PET) in the bilateral SN/VTA complex and ventral striatum (VS). Our computational model closely predicted participant behaviour (R2= .67), and there was a negative correlation between subclinical paranoid thoughts and the degree to which participant behavior approximated the predictions of an ideal Bayesian observer (rho = -0.60, P Our results indicate that the SN/VTA and VS are involved in processing the meaningful information of observations, as reflected in Bayesian belief updating [1-3]. Crucially, we provide direct evidence that neuronal signals encoding (unsigned) belief updates depend on dopaminergic activity, at variance with classical interpretations of dopamine function in terms of (signed) reward prediction errors. Moreover, our results suggest that a reduced behavioural sensitivity to meaningful information is related to subclinical paranoia. Together, these results are highly relevant for dopaminergic theories of psychosis, such as the aberrant salience hypothesis, which posit that mesostriatal dopamine dysfunction results in the formation of false beliefs about the causes of sensory information, leading to hallucinations and delusions [4].

The effect of arousal and eye gaze direction on trust evaluations of stranger's faces: A potential pathway to paranoid thinking

Background and objectivesWhen asked to evaluate faces of strangers, people with paranoia show a tendency to rate others as less trustworthy. The present study investigated the impact of arousal on this interpersonal bias, and whether this bias was specific to evaluations of trust or additionally affected other trait judgements. The study also examined the impact of eye gaze direction, as direct eye gaze has been shown to heighten arousal. MethodsIn two experiments, non-clinical participants completed face rating tasks before and after either an arousal manipulation or control manipulation. Experiment one examined the effects of heightened arousal on judgements of trustworthiness. Experiment two examined the specificity of the bias, and the impact of gaze direction. ResultsExperiment one indicated that the arousal manipulation led to lower trustworthiness ratings. Experiment two showed that heightened arousal reduced trust evaluations of trustworthy faces, particularly trustworthy faces with averted gaze. The control group rated trustworthy faces with direct gaze as more trustworthy post-manipulation. There was some evidence that attractiveness ratings were affected similarly to the trust judgements, whereas judgements of intelligence were not affected by higher arousal. LimitationsIn both studies, participants reported low levels of arousal even after the manipulation and the use of a non-clinical sample limits the generalisability to clinical samples. ConclusionsThere is a complex interplay between arousal, evaluations of trustworthiness and gaze direction. Heightened arousal influences judgements of trustworthiness, but within the context of face type and gaze direction.

Virtual-reality-based cognitive behavioural therapy versus waiting list control for paranoid ideation and social avoidance in patients with psychotic disorders: a single-blind randomised controlled trial

Many patients with psychotic disorders have persistent paranoid ideation and avoid social situations because of suspiciousness and anxiety. We investigated the effects of virtual-reality-based cognitive behavioural therapy (VR-CBT) on paranoid thoughts and social participation. In this randomised controlled trial at seven Dutch mental health centres, outpatients aged 18-65 years with a DSM-IV-diagnosed psychotic disorder and paranoid ideation in the past month were randomly assigned (1:1) via block randomisation to VR-CBT (in addition to treatment as usual) or the waiting list control group (treatment as usual). VR-CBT consisted of 16 individual therapy sessions (each 1 h long). Assessments were done at baseline, after treatment (ie, 3 months from baseline), and at a 6 month follow-up visit. The primary outcome was social participation, which we operationalised as the amount of time spent with other people, momentary paranoia, perceived social threat, and momentary anxiety. Analysis was by intention to treat. This trial was retrospectively registered with ISRCTN, number 12929657. Between April 1, 2014, and Dec 31, 2015, 116 patients with a psychotic disorder were randomly assigned, 58 to the VR-CBT group and 58 to the waiting list control group. Compared with the control, VR-CBT did not significantly increase the amount of time spent with other people at the post-treatment assessment. Momentary paranoid ideation (b=-0·331 [95% CI -0·432 to -0·230], p<0·0001; effect size -1·49) and momentary anxiety (-0·288 [-0·438 to -0·1394]; p=0·0002; -0·75) were significantly reduced in the VR-CBT group compared with the control group at the post-treatment assessment, and these improvements were maintained at the follow-up assessment. Safety behaviour and social cognition problems were mediators of change in paranoid ideation. No adverse events were reported relating to the therapy or assessments. Our results suggest that the addition of VR-CBT to standard treatment can reduce paranoid ideation and momentary anxiety in patients with a psychotic disorder. Fonds NutsOhra, Stichting tot Steun VCVGZ.

Affective disorders in Iraq.

A retrospective study of clinical features of 98 Iraqi patients suffering from affective disorders of various degrees was presented. The incidence of various symptoms and signs was rated on a two-point scale. Certain demographic data were also collected. Ideally, to draw valid conclusions from these data they should be compared to data derived from an identical sample of patients in a western society; however, as such a study with a control western population is not known to the author, the conclusions that are made here are based solely on clinical judgement. Essentially, there are a few select areas where affective disorders in Iraq seem to differ from the same group in England. There appears to be a lesser incidence of ideas of unworthiness even in the more severely depressed patients. The same can be said about suicidal thoughts and attempts. The affect does not seem to follow the classical western descriptions of this illness. In depression, patients do not feel nor show the sadness of western depressed patients, and in mania they lack the infective joyous mood. Depression is conspicuously coloured by physical symptomatology and hysterical behaviour. Paranoid thinking and projection of responsibility in depression are not uncommon. Mania, on the other hand, is more often characterized by aggression and anti-social behaviour than in the West. These differences, in the author's opinion, can only be explained by recourse to the differences in personality structure as moulded by cultural influences and child rearing. The disorder in affective illness is seen as a manifestation of a defence mechanism that has gone too far. It is an emotional equivalent to the instincts of fight or flight in the animal kingdom, but complicated and exalted by the presence of such faculties as the mind, the affect and the other higher acquisitions of man in his evolution.

Le regard paranoïaque à l’épreuve du visage neutre

ObjectivesFor paranoid patients, the confrontation with a neutral face is a perceptual and interpretative challenge. Since birth, faces seem to be the favorite visual stimulus of humans, and unexpressive faces tend to provoke discomfort (according to the still face paradigm). Considering their symptoms, this discomfort might be particularly strong for paranoid adult patients. Images of neutral faces are often used in eye-tracking studies to mesure scanpath impairments, but almost only draw a comparison with expressive faces. A short review of eye-tracking studies, in which neutral faces are presented to paranoid patients, could allow a first interpretation of visual exploration impairments and their relational consequences, through the prism of the paranoid symptoms revealed by the unexpressivity of the face. Materials and methodsStudies focusing on the relationship between delusional symptomatology (in schizophrenia or in the general population) and visual exploration of neutral faces, seem to offer an interesting area of research. According to those studies, and to others showing the existence of varying degrees of delusional paranoid thoughts in healthy subjects, we have selected eye-tracking studies including clinical (schizophrenic) and non clinical subjects with paranoid delusions, looking at images of neutral faces. Those eye-tracking data were then confronted with clinical elements of paranoia, such as threat anticipation, or jumping to conclusion biais. ResultsThe confrontation with a neutral face begins with hypervigilance toward ambiguity (extensive visual scanning style to the neutral face features). Then the pattern becomes similar to a visual exploration of a threatening face, to end up with a gaze avoidance. The need to avoid ambiguity, which is unbearable for paranoid patients, is influenced by a hasty and conclusive information processing, focused on proattitudinal, threat-related informations. Contradictory results concerning the extent of the exploration, the duration or the number of fixations could be related to a fluctuating dimension of the paranoid clinic. The gaze on a neutral face seems to represent, at a basic level, the frequent failure of relational interactions of those patients. The visual exploration of healthy patient's first degree relatives is similarly impaired, which might show pathological shared cognitions on which the attention of patients and their relatives risk to rely. ConclusionSocial isolation due to those interactional failures is a major problem for paranoid patients. Building a therapeutic relationship represents the possibility of a gaze change, that might help those patients to stay in a relational world.

Validation studies of the Paranoia Checklist (Portuguese version) in mixed sample of patients and healthy controls

IntroductionParanoid ideation has been consistently found as a phenomenon presented across the population continuum, and a theme that most people find in their everyday thoughts. ObjectiveTo validate and study the psychometric properties of the Paranoia Checklist in a mixed (clinical and non-clinical) sample, in an extension of the study by Freeman et al. (2005). MethodSelf-report questionnaire were completed by 392 individuals, with the aid of a psychologist when necessary. ResultsThe PC has shown to be a measure capable of distinguishing between clinical and non-clinical group of participants regarding the two dimensions of paranoid thoughts: frequency and conviction. Scores fitted an exponential curve, similar to the initial studies with the original version of the checklist. ConclusionThe assessment of paranoia has shown to be a continuum process common to clinical and non-clinical groups. The PC is a psychometrically sound measure to assess different paranoid thoughts on a multidimensional perspective and with sensitivity to distinguish groups of patients and healthy individuals, being suitable for use both in clinical and research settings.

A genetic locus for paranoia.

The psychological effects of brain-expressed imprinted genes in humans are virtually unknown. Prader-Willi syndrome (PWS) is a neurogenetic condition mediated by genomic imprinting, which involves high rates of psychosis characterized by hallucinations and paranoia, as well as autism. Altered expression of two brain-expressed imprinted genes, MAGEL2 and NDN, mediates a suite of PWS-related phenotypes, including behaviour, in mice. We phenotyped a large population of typical individuals for schizophrenia-spectrum and autism-spectrum traits, and genotyped them for the single-nucleotide polymorphism rs850807, which is putatively functional and linked with MAGEL2 and NDN Genetic variation in rs850807 was strongly and exclusively associated with the ideas of reference subscale of the schizophrenia spectrum, which is best typified as paranoia. These findings provide a single-locus genetic model for analysing the neurological and psychological bases of paranoid thinking, and implicate imprinted genes, and genomic conflicts, in human mentalistic thought.

Dışavurumcu Sanat Terapisinin Psikolojik Belirtiler İle Bilişsel İşlevlere Etkisi

This study was conducted to investigate the impact of expressive arts therapy program on psychological symptoms, hopelessness, automatic thoughts and dysfunctional attitudes of individuals. The study group consisted of 11 participants (2 men, 9 women), ages ranging from 24 to 62. Brief Symptom Inventory (BSI), Beck Hopelessness Scale (BHS), Automatic Thoughts Scale (SAS) and Dysfunctional Attitude Scale (DAS) have been applied to all participants initially and after nine weeks of therapy. An expressive arts therapy program lasting a total of 180 minutes in 9 sessions was implemented. One group pretest - posttest control study design was used and data were analyzed using the Wilcoxon Signed Rank test. The results suggested that expressive art therapy program had positive effects on individuals' despair, automatic thoughts, dysfunctional attitudes and Brief Symptom Inventory (BSI) somatization subscale, obsessive-compulsive disorder, interpersonal sensitivity, depression, anxiety, phobic anxiety, paranoid thinking and psychotism; but it was not effective at reducing anger levels.