State Paranoia Research Articles

The roles of cognitive avoidance, rumination and negative affect in the association between abusive supervision in the workplace and non-clinical paranoia in a sample of workers working in France

This study examined the relationship between abusive supervision and non-clinical paranoia and explored which cognitive mechanisms are mediating this association (i.e. rumination, cognitive avoidance and negative affect). A sample of two hundred and five French-speaking workers currently in employment in France was recruited to fill in a battery of online questionnaires comprising of the French adaptations of the Abusive Supervision Scale, the State Social Paranoia Scales, the Depression and Anxiety and Stress Scales, the Cognitive Avoidance Questionnaire and the Mini-Cambridge Exeter Repetitive Thought Scale. Mediation analyses showed that the experience of supervisory abuse directly influences state paranoia, however, there were significant mediation effects. Abusive supervision impacted on cognitive avoidance that led to more rumination, which in its turn increased negative affect and this increased state paranoia. Rumination impacted on state paranoia but through the effect of negative affect only. This study showed that abusive supervision works together with cognitive and affective factors to impact on non-clinical paranoia. It is recommended that Cognitive and Behavioural therapy (CBT) is tailored to help workers to cope with experiences of supervisory abuse and associated paranoid thoughts by focusing on replacing rumination and cognitive avoidance strategies for more adaptive cognitive strategies and on how to manage depression.

Using Virtual Reality to Assess Associations Between Paranoid Ideation and Components of Social Performance: A Pilot Validation Study.

Virtual reality (VR) enables the real-time assessment of paranoid ideation and of associated social performance. In this two-phase study, we aimed to recruit a general population sample to investigate the association between trait paranoia and cognitive, emotional, and behavioral components of social performance. In phase 1, a general population online survey (N = 609) investigated how trait paranoia related to fear of negative evaluation (FNE), interpersonal sensitivity, social avoidance and distress (SAD), mood, and demographic characteristics. In phase 2, we piloted a new VR social situation paradigm (a party in a bar) with a subsample of participants who scored high or low in trait paranoia. Eighty-nine participants entered the VR party in a bar scenario to evaluate the acceptability of the task and the relationship between paranoid ideation and social performance. As hypothesized, in phase 1, trait paranoia was associated with FNE, SAD, interpersonal sensitivity, mood, and demographics (all small-to-medium effects); in phase 2, participants found the VR environment acceptable and immersive; exposure to the VR environment elicited a range of cognitive, emotional, and behavioral components of social performance; and high trait paranoia participants reported higher state paranoia and greater negative components of social performance (all medium effects). The study tests a novel sample recruited predominantly online and validates the virtual environment for psychological assessment and treatment. This result suggests that the new VR scenario could be used as a psychological assessment and treatment tool for people who experience paranoia in social situations.

An experimental investigation of the impact of critical and warm comments on state paranoia in a non-clinical sample

Background and objectivesInterpersonal stress is key to the development and maintenance of paranoia. Much attention has been given to the impact of interpersonal stressors, such as criticism, on outcomes in psychosis. Less attention has been given to the potentially protective effects of positive interpersonal factors. This study tested experimentally whether criticism and warm comments elicited changes in state paranoia. Whether warm comments provided protective effects when participants faced subsequent social exclusion was also examined. MethodA nonclinical sample (N = 97) was randomised to criticism, warm comments, or neutral comments conditions. Participants then played a virtual ball game (Cyberball), during which they were systematically excluded from the game. State paranoia was measured before and after the affective stimuli and after social exclusion. Self-esteem and trait paranoia were also measured. ResultsParanoia levels increased following exposure to criticism (p = .011). Paranoia was not significantly lower following exposure to warm comments (p = .203). Warm comments did not provide protection against the effects of subsequent social exclusion. The warm comments condition was the only condition in which significant increases in paranoia were seen following social exclusion (p = .004). LimitationsUse of a non-clinical sample limits generalisation to clinical populations. ConclusionsCriticism is sufficient to elicit increases in paranoia in non-clinical participants. Warm comments are insufficient to significantly reduce paranoia or provide protective effects against subsequent negative interpersonal experiences, highlighting the need to balance therapeutic warmth with amelioration of social stressors in paranoia.

Emotion regulation as a predictor of the endocrine, autonomic, affective, and symptomatic stress response and recovery

Stress is associated with the development of mental disorders such as depression and psychosis. The ability to regulate emotions is likely to influence how individuals respond to and recover from acute stress, and may thus be relevant to symptom development. To test this, we investigated whether self-reported emotion regulation predicts the endocrine, autonomic, affective, and symptomatic response to and recovery from a stressor. Social-evaluative stress was induced by the Trier Social Stress Test (TSST) in N = 67 healthy individuals (53.7% female, Mage = 29.9). Self-reported habitual emotion regulation skills were assessed at baseline. We measured salivary cortisol, heart rate, negative affect, state depression and state paranoia at three time points: pre-TSST, post-TSST, and after a 10 min recovery phase. Repeated-measures ANOVA showed all indicators to significantly increase in response to the stressor (p < .001) and decrease during the recovery phase (p < .001), except for salivary cortisol, which showed a linear increase (p < .001). The habitual use of maladaptive emotion regulation (e.g., rumination, catastrophizing) significantly predicted an increased affective and reduced cortisol response. Adaptive emotion regulation (e.g., acceptance, reappraisal) was not predictive of the stress response for any of the indicators. Neither type of emotion regulation predicted response during the stress recovery phase. Individuals who habitually resort to maladaptive emotion regulation strategies show a stronger affective and a blunted endocrine stress response, which may make them vulnerable to mental health problems. However, further research is needed to identify the full scope of skills required for effective stress-regulation before this knowledge can be used to develop effective prevention programs.

State paranoia and urban cycling

Consistent with a continuum approach to mental health, a growing body of research has established that paranoia occurs in the general population. The stress-vulnerability model would predict an association between environments high in threat and the presence of state paranoia, even in those with low dispositional trait paranoia. The present research examines whether urban cycling, a naturalistic environment high in interpersonal threat, is associated with state paranoia – operationalised as an explicit perception that other road users intend the agent harm. 323 members of the general population who regularly cycled in London completed measures of state and trait paranoia, anxiety, depression and stress. The majority of the general population sample (70%) reported experiencing state paranoia during urban cycling, and there was no association between state paranoia and trait paranoia. Reported state paranoia was higher during urban cycling than when using the London underground (a lower threat environment) and reported state paranoia on the underground was associated with trait paranoia. The findings are consistent with the stress-vulnerability model of everyday paranoia.

Expressive suppression is associated with state paranoia in psychosis: An experience sampling study on the association between adaptive and maladaptive emotion regulation strategies and paranoia.

Although emotional instability and problems in emotion regulation (ER) are known to be linked to the formation and maintenance of psychosis and paranoia, it remains unclear whether the use of specific ER strategies is associated with it. The first aim of the study was to explore the association between emotional instability and paranoia. The second and third aims were to investigate whether the use of maladaptive ER strategies leads to paranoia in patients with psychosis in daily life and whether the use of more adaptive ER strategies reduces paranoia. A prospective momentary assessment study over the course of 6days was performed. Participants with psychosis (n=32) reported repeatedly over six consecutive days on the presence and instability of positive and negative emotions, their use of adaptive (reappraisal, acceptance, distraction, social sharing, reflection) and maladaptive ER strategies (rumination, expressive suppression) and momentary paranoia in their daily life. Hierarchical linear regression analysis revealed that patients with psychosis who presented pronounced instability of negative emotions showed more severe levels of state paranoia. In addition, patients with psychosis who used expressive suppression when confronted with negative emotions at one point in time presented more pronounced levels of state paranoia at the following point in time. The results presented here suggest that both emotional instability and the use of expressive suppression might cause state paranoia and thus add to our understanding of causal mechanisms related to paranoia such as instability of negative emotions and the use of less adaptive ER strategies. Maladaptive emotion regulation strategies and more pronounced instability of negative emotions are relevant to paranoia in patients with psychosis and should be a special focus of CBTp interventions. Future interventions designed for patients suffering from paranoia should promote coping with unstable negative emotions and replacing or reducing maladaptive emotion regulation strategies with adaptive ones.

The network structure of paranoia in the general population

PurposeBebbington and colleagues’ influential study on ‘the structure of paranoia in the general population’ used data from the British National Psychiatric Morbidity Survey and latent variable analysis methods. Network analysis is a relatively new approach in psychopathology research that considers mental disorders to be emergent phenomena from causal interactions among symptoms. This study re-analysed the British National Psychiatric Morbidity Survey data using network analysis to examine the network structure of paranoia in the general population.MethodsWe used a Graphical Least Absolute Shrinkage and Selection Operator (glasso) method that estimated an optimal network structure based on the Extended Bayesian Information Criterion. Network sub-communities were identified by spinglass and EGA algorithms and centrality metrics were calculated per item and per sub-community.ResultsWe replicated Bebbington’s four component structure of paranoia, identifying ‘interpersonal sensitivities’, ‘mistrust’, ‘ideas of reference’ and ‘ideas of persecution’ as sub-communities in the network. In line with previous experimental findings, worry was the most central item in the network. However, ‘mistrust’ and ‘ideas of reference’ were the most central sub-communities.ConclusionsRather than a strict hierarchy, we argue that the structure of paranoia is best thought of as a heterarchy, where the activation of high-centrality nodes and communities is most likely to lead to steady state paranoia. We also highlight the novel methodological approach used by this study: namely, using network analysis to re-examine a population structure of psychopathology previously identified by latent variable approaches.

Adult attachment and paranoia: an experimental investigation

Attachment theory may develop understanding of the occurrence and maintenance of persecutory delusions. This study investigates the role of dispositional attachment and contextually primed secure base attachment representations in the occurrence of paranoid thinking. Sixty participants were randomly allocated to one of three conditions: a secure attachment priming condition, a positive affect condition, or a neutral control condition. Following priming, all participants were exposed to a paranoia induction. State paranoia was measured at baseline and following the paranoia induction. Dispositional insecure attachment was associated with both trait and state paranoid thinking. Contrary to predictions, the secure attachment prime did not appear to buffer paranoid thinking and had a negative impact for participants with high levels of attachment anxiety, highlighting the potentially aversive effects of exposure to secure attachment material in those with existing insecure attachment styles.

Social environments and interpersonal distance regulation in psychosis: A virtual reality study

BackgroundExperimentally studying the influence of social environments on mental health and behavior is challenging, as social context is difficult to standardize in laboratory settings. Virtual Reality (VR) enables studying social interaction in terms of interpersonal distance in a more ecologically valid manner. Regulation of interpersonal distance may be abnormal in patients with psychotic disorders and influenced by environmental stress, symptoms or distress. AimsTo investigate interpersonal distance in people with a psychotic disorder and at ultrahigh risk for psychosis (UHR) compared to siblings and controls in virtual social environments, and explore the relationship between clinical characteristics and interpersonal distance. MethodsNineteen UHR patients, 52 patients with psychotic disorders, 40 siblings of patients with a psychotic disorder and 47 controls were exposed to virtual cafés. In five virtual café visits, participants were exposed to different levels of social stress, in terms of crowdedness, ethnicity and hostility. Measures on interpersonal distance, distress and state paranoia were obtained. Baseline measures included trait paranoia, social anxiety, depressive, positive and negative symptoms. ResultsInterpersonal distance increased when social stressors were present in the environment. No difference in interpersonal distance regulation was found between the groups. Social anxiety and distress were positively associated with interpersonal distance in the total sample. ConclusionThis VR paradigm indicates that interpersonal distance regulation in response to environmental social stressors is unaltered in people with psychosis or UHR. Environmental stress, social anxiety and distress trigger both people with and without psychosis to maintain larger interpersonal distances in social situations.

The effect of social exclusion on state paranoia and explicit and implicit self-esteem in a non-clinical sample

Background and objectivesThe relationship between self-esteem and paranoia may be influenced by social stress. This study aimed to replicate previous research on the impact ofsocial exclusion on paranoia and self-esteem in a non-clinical sample and to extend this work by examining the effect of exclusion on self-esteem at the ‘implicit’ level. MethodsNon-clinical participants (N = 85) were randomly allocated to the Inclusion or Exclusion condition of a virtual ball-toss game (‘Cyberball’). They completed self-reportmeasures of state paranoia and self-esteem, and two implicit measures of self-esteem – theImplicit Association Task (IAT) and Implicit Relational Assessment Procedure (IRAP) –prior to and after exposure to Cyberball. ResultsSocial exclusion increased state paranoia. This effect was moderated by distress associated with trait paranoia. Exclusion was also associated with decreased self-reported self-esteem, as well as reduced implicit self-esteem on the IAT. Changes in self-reported self-esteem were associated with state paranoia at post-Cyberball. The IRAP indicated that reductions in implicit self-esteem may be due to increases in ‘Me-Negative’ and ‘Others-Positive’ biases (rather than reductions in ‘Me-Positive’ bias). LimitationsThe current study involved a non-clinical sample and so findings cannot be generalized to clinical paranoia. ConclusionsThese findings are consistent with previous evidence that paranoia is associated with negative self-evaluations, whereas positive self-evaluations can persist in paranoia. They also provide support for the suggestion that investigations of self-esteem in paranoia should extend beyond global self-esteem and might benefit from a distinction between positive and negative components.

Adult attachment and paranoia: an experimental investigation

AbstractAttachment theory may develop understanding of the occurrence and maintenance of persecutory delusions. This study investigates the role of dispositional attachment and contextually primed secure base attachment representations in the occurrence of paranoid thinking. Sixty participants were randomly allocated to one of three conditions: a secure attachment priming condition, a positive affect condition, or a neutral control condition. Following priming, all participants were exposed to a paranoia induction. State paranoia was measured at baseline and following the paranoia induction. Dispositional insecure attachment was associated with both trait and state paranoid thinking. Contrary to predictions, the secure attachment prime did not appear to buffer paranoid thinking and had a negative impact for participants with high levels of attachment anxiety, highlighting the potentially aversive effects of exposure to secure attachment material in those with existing insecure attachment styles.

A randomized-controlled trial of heart rate variability biofeedback for psychotic symptoms

Arousal and the way it is coped with are relevant to the emergence of psychotic symptoms. Heart rate variability (HRV) stems from autonomic responses to environmental demands such as stress and is an index of physiological arousal, adaptability, and homeostatic reflexes forming autonomic balance. A randomized-controlled between-subjects trial that compared HRV-biofeedback (BF) to an active relaxation and to a waiting control condition was conducted in a sample with attenuated subclinical psychotic symptoms (N = 84). A 20-min intervention was preceded and followed by repeated assessments of stress responses. Change scores of the post-stress periods were analyzed using ANOVAs for HRV, subjective stress, perceived control, and state paranoia. As expected, BF participants showed greater improvements in perceived control than waiting controls (p = 0.006). However, no group differences occurred in HRV, paranoid symptoms or subjective stress. In exploratory analyses in a subset of participants who were breathing per protocol, the expected effects were found for total HRV and state paranoia. Thus, this trial of HRV-BF for people with attenuated psychotic symptoms indicates that the intervention may hold potential if conducted per protocol. To reach this, longer training might be inevitable. Future studies are needed to further elucidate efficacy and applicability of HRV-BF in clinical samples.

The impact of loneliness on paranoia: An experimental approach

Background and objectivesLoneliness is a common problem in patients with schizophrenia, and may be particularly linked with persecutory ideation. Nevertheless, its role as a potential risk factor in the formation and maintenance of persecutory delusions is largely unexplored. MethodsLoneliness was experimentally manipulated using a false-feedback paradigm in a non-clinical sample (n = 60). Change in state paranoia was compared between the induction of increased loneliness, the induction of reduced loneliness and a control condition. Distinct associations between pre-post scores of loneliness and state paranoia were examined at three (medium/high/low) levels of proneness to psychosis across the experimental conditions. ResultsReduction of loneliness was associated with a significant reduction of present paranoid beliefs, while induction of loneliness lead to more pronounced paranoia on trend significance level. Moreover, proneness to psychosis significantly moderated the impact of loneliness on paranoia. Persons with a pronounced level of proneness to psychosis showed a stronger reduction of paranoid beliefs as a consequence of a decrease in loneliness, than less prone individuals. LimitationsA limitation is the small size of our sample, which may have limited the power to detect significant within-group changes in state paranoia in the high-loneliness condition and changes in loneliness in the low-loneliness condition. ConclusionsThe findings support the feasibility of the experimental design to manipulate loneliness and suggest that loneliness could be a cause of paranoia. However, the findings need to be confirmed in high risk samples to draw conclusions about the role of loneliness in the genesis of clinically relevant levels of paranoia and derive implications for cognitive behaviour therapy.

Measuring fluctuations in paranoia: Validity and psychometric properties of brief state versions of the Paranoia Checklist

Research increasingly assesses momentary changes in paranoia in order to elucidate causal mechanisms. Observed or manipulated changes in postulated causal factors should result in fluctuations in state paranoid ideation. Previous studies often employed a state-adapted Paranoia Checklist (Freeman et al., 2005) to measure state paranoia. This study examined whether the Paranoia Checklist or subsets of its items are appropriate for this purpose.Thirteen studies (N=860) were subjected to meta-analyses of each Paranoia Checklist item. We selected items based on (1) whether they showed pre-to-post change in the expected direction and (2) whether this effect was larger in experimental vs. control conditions. All resulting item selections were cross-validated on a hold-out sample (n=1893). Finally, we explored how much variation in paranoia was captured by the state-adapted version in a brief ambulatory assessment study (N=32).A thirteen item State Paranoia Checklist as well as a five item and a three item Brief State Paranoia Checklist were extracted. Cross validation revealed better model fit and increased sensitivity to change. Multilevel analysis indicated 25-30% of the variance in the Brief State Paranoia Checklists to be due to intra-individual daily fluctuations in paranoia.Our analyses produced reliable and valid revised scales. Increases in change sensitivity indicate that future assessment of state paranoia in experimental and ambulatory assessment studies can be optimized by using the revised scales.

The role of mental imagery in non-clinical paranoia

Background & objectivesCognitive models of paranoia incorporate many of the processes implicated in the maintenance of anxiety disorders. Despite this, the role of mental imagery in paranoia remains under-researched. The current study examined the impact of a self-imagery manipulation in people with high non-clinical paranoia. MethodsWe used a mixed design with one between-subjects variable (type of self-imagery) and one within-subjects variable (time – pre and post imagery manipulation). Thirty participants with high trait paranoia were allocated alternately to a positive or negative self-imagery condition. Scripts were used to elicit positive and negative self-imagery. All participants completed self-report state measures of paranoia, mood, self-esteem and self-compassion. ResultsGroup by time interaction effects were found for each of the dependent variables. Positive imagery led to less state paranoia, anxiety and negative affect, and more positive affect, self-esteem and self-compassion, compared with the negative imagery group. LimitationsThis was a non-blind study, limited by allocation method and a brief time-frame which did not allow us to assess longevity of effects. We recruited a relatively small and predominantly female sample of people with high non-clinical paranoia. The study did not include a neutral control condition, a low paranoia comparison group, or a manipulation check following the imagery task. ConclusionsSelf-imagery manipulations may affect paranoia, mood and self-beliefs. If the findings are replicated with clinical groups, and maintained over a longer period, this would suggest that imagery-based interventions targeting persecutory delusions might be usefully examined.

Dealing with feeling: Specific emotion regulation skills predict responses to stress in psychosis

Elevated negative affect is an established link between minor stressors and psychotic symptoms. Less clear is why people with psychosis fail to regulate distressing emotions effectively. This study tests whether subjective, psychophysiological and symptomatic responses to stress can be predicted by specific emotion regulation (ER) difficulties. Participants with psychotic disorders (n=35) and healthy controls (n=28) were assessed for ER-skills at baseline. They were then exposed to a noise versus no stressor on different days, during which self-reported stress responses, state paranoia and skin conductance levels (SCL) were assessed. Participants with psychosis showed a stronger increase in self-reported stress and SCL in response to the stressor than healthy controls. Stronger increases in self-reported stress were predicted by a reduced ability to be aware of and tolerate distressing emotions, whereas increases in SCL were predicted by a reduced ability to be aware of, tolerate, accept and modify them. Although paranoid symptoms were not significantly affected by the stressors, individual variation in paranoid responses was also predicted by a reduced ability to be aware of and tolerate emotions. Differences in stress responses in the samples were no longer significant after controlling for ER skills. Thus, interventions that improve ER-skills could reduce stress-sensitivity in psychosis.

Self-affirmation and nonclinical paranoia

Background and ObjectivesThis experiment examined whether reflecting on a core value—value-affirmation—was effective in attenuating state paranoia in students. MethodsUniversity students (N = 55) were randomised to either a value-affirmation or non-affirmation control condition before exposure to a paranoia-induction manipulation (high self-awareness plus failure feedback). Paranoid cognitions were measured before (T1) and after (T2) the value-affirmation task and after the paranoia-induction task (T3). Depressive cognitions were also measured at T3. ResultsAffirming a valued domain had a direct and significant effect on reducing state paranoia prior to the paranoia-induction task (T2), such that the overall impact of the paranoia-induction on state paranoia was not significantly different from baseline. This effect was not attributable to differential changes in depression across groups. LimitationsUse of a nonclinical sample limits generalisation to clinical groups. Repeat testing of key variables is a limitation, although this was necessary to assess change over time, and use of randomisation increased the internal validity of the study. ConclusionsThese findings suggest that self-affirmation is effective in reducing state paranoia in a nonclinical sample.

Cognitive mechanisms of change in delusions: an experimental investigation targeting reasoning to effect change in paranoia.

Background: Given the evidence that reasoning biases contribute to delusional persistence and change, several research groups have made systematic efforts to modify them. The current experiment tested the hypothesis that targeting reasoning biases would result in change in delusions. Methods: One hundred and one participants with current delusions and schizophrenia spectrum psychosis were randomly allocated to a brief computerized reasoning training intervention or to a control condition involving computer-based activities of similar duration. The primary hypotheses tested were that the reasoning training intervention, would improve (1) data gathering and belief flexibility and (2) delusional thinking, specifically paranoia. We then tested whether the changes in paranoia were mediated by changes in data gathering and flexibility, and whether working memory and negative symptoms moderated any intervention effects. Results: On an intention-to-treat analysis, there were significant improvements in state paranoia and reasoning in the experimental compared with the control condition. There was evidence that changes in reasoning mediated changes in paranoia, although this effect fell just outside the conventional level of significance after adjustment for baseline confounders. Working memory and negative symptoms significantly moderated the effects of the intervention on reasoning. Conclusion: The study demonstrated the effectiveness of a brief reasoning intervention in improving both reasoning processes and paranoia. It thereby provides proof-of-concept evidence that reasoning is a promising intermediary target in interventions to ameliorate delusions, and thus supports the value of developing this approach as a longer therapeutic intervention.

Abusive Supervision Through the Lens of Employee State Paranoia

We use insights into the social dynamics of state paranoia to better understand and explain the evolution and effects of perceived abusive supervision. Within our framework, abusive supervision and employee state paranoia are reciprocally related. We explain how perceived abusive supervision can influence paranoid arousal (characterized by extreme distrust, a sense of threat, anxiety, and fear of one's supervisor) and paranoid cognition (characterized by hypervigilance, rumination, and sinister attribution tendencies) and how it has attendant implications for employee behavior. We also identify an intrapersonal mechanism of cognitive bias (e.g., sinister attribution tendencies, interpretive bias), and an interpersonal process of victim precipitation whereby employee state paranoia can influence both experienced and subjective evaluations of abusive supervision. In addition, we identify personal, relational, and contextual factors that moderate the relationship between abusive supervision and employee state paranoia. Our analysis brings into focus the psychological and emergent nature of abusive supervision, as well as the mechanisms by which abusive supervision influences employee psychological well-being and behavior.

Current Paranoid Thinking in Patients With Delusions: The Presence of Cognitive-Affective Biases

Background: There has been renewed interest in the influence of affect on psychosis. Psychological research on persecutory delusions ascribes a prominent role to cognitive processes related to negative affect: anxiety leads to the anticipation of threat within paranoia; depressive negative ideas about the self create a sense of vulnerability in which paranoid thoughts flourish; and self-consciousness enhances feelings of the self as a target. The objective of this study was to examine such affective processes in relation to state paranoia in patients with delusions. Methods: 130 patients with delusions in the context of a nonaffective psychosis diagnosis (predominately schizophrenia) were assessed for contemporaneous levels of persecutory ideation on 5 visual analog scales. Measures were taken of anxiety, depression, threat anticipation, interpretation of ambiguity, self-focus, and negative ideas about the self. Results: Of the patients, 85% report paranoid thinking at testing. Symptoms of anxiety and depression were highly prevalent. Current paranoid thinking was associated with anxiety, depression, greater anticipation of threat events, negative interpretations of ambiguous events, a self-focused cognitive style, and negative ideas about the self. Conclusions: The study provides a clear demonstration that a range of emotion-related cognitive biases, each of which could plausibly maintain delusions, are associated with current paranoid thinking in patients with psychosis. We identified biases both in the contents of cognition and in the processing of information. Links between affect and psychosis are central to the understanding of schizophrenia. We conclude that treatment of emotional dysfunction should lead to reductions in current psychotic experiences.