Trait Paranoia Research Articles

Taking the edge off: a feasibility randomized controlled trial of an online mindfulness-based intervention to reduce suspiciousness/paranoia in high positive schizotypy.

Positive schizotypy can uniquely predict the development of psychosis with suspiciousness/paranoia having emerged as a key risk factor, pointing to significant worth in reducing this aspect in individuals with high positive schizotypy. Reduced paranoia in the general population following brief online mindfulness training has been previously reported. This study investigated the feasibility of a 40-day online mindfulness-based intervention (MBI) (n = 12) in the individuals with high positive schizotypy characterized by high suspiciousness/paranoia and to estimate its effect on paranoia as compared with an active control condition using reflective journaling (n = 12). The outcome measures were self-reported trait and VR-induced state paranoia, completed at baseline, after 10 days and post-intervention. The feasibility criteria included retention, adherence, engagement, and acceptability. There was 100% retention, excellent adherence to content and engagement, with an average MBI session completion rate of 91%. Acceptability, indexed by a self-rated motivation to continue practice post-intervention, was also high. No MBI effect on trait paranoia was observed; however, the MBI group showed a reduction in the VR-induced state paranoia with a medium-to-large effect (d = 0.63). The findings support conducting larger-scale randomized controlled trials to evaluate the effects of online MBIs on reducing suspiciousness/paranoia to mitigate psychosis risk in individuals with high positive schizotypy. Clinical Trial Registration:https://www.isrctn.com/, identifier ISRCTN78697391.

The effects of paranoia and dopamine on perception of cohesion and conspiracy: a pre-registered, double-blind, placebo-controlled experiment.

Paranoia is a common symptom of psychotic disorders but is also present on a spectrum of severity in the general population. Although paranoia is associated with an increased tendency to perceive cohesion and conspiracy within groups, the mechanistic basis of this variation remains unclear. One potential avenue involves the brain's dopaminergic system, which is known to be altered in psychosis. In this study, we used large-N online samples to establish the association between trait paranoia and perceptions of cohesion and conspiracy. We further evaluated the role of dopamine on perceptions of cohesion and conspiracy using a double-blind, placebo-controlled laboratory experiment where participants received levodopa or a placebo control. Our results were mixed: group perceptions and perceptions of cohesion were higher among more paranoid individuals but were not altered under dopamine administration. We outline the potential reasons for these discrepancies and the broader implications for understanding paranoia in terms of dopamine dysregulation.

Schizophrenia and Increased Distrust-Based Competitiveness in Interpersonal Interactions: A Serial Process Model.

Game theory paradigms, such as the Prisoner's Dilemma Game (PDG), have been used to study nonclinical paranoia, though research using clinical populations has been scarce. We test our novel theoretical model that schizophrenia leads to competitiveness in interpersonal interactions, and that this link is serially mediated by trait paranoia, state paranoia, and distrust. In this quasi-experimental study, individuals with schizophrenia spectrum diagnoses with current persecutory delusions (n = 46) and a nonclinical control group (n = 43) played the PDG, and completed measures of trait paranoia, state paranoia, and distrust. Individuals with schizophrenia competed more in the PDG than the control group. Supporting our theoretical model, all direct effects were significant: schizophrenia was associated with higher trait paranoia (H1); trait paranoia predicted state paranoia in the PDG (H2); state paranoia in the PDG predicted distrust of the opponent in the PDG (H3); and distrust predicted competition in the PDG (H4). The hypothesized indirect effect of schizophrenia on competition in the PDG via trait paranoia, state paranoia, and distrust was supported in a serial mediation model (H5). The findings make clear theoretical and methodological contributions. We provide the first evidence for a theoretical process model by which schizophrenia leads to competitiveness in interpersonal interactions via trait paranoia, state paranoia, and distrust. Game theory paradigms, and the PDG in particular, are important for advancing theory and research on paranoia as it occurs in both clinical and nonclinical populations.

Do emotion regulation strategies mediate the attachment-paranoia association? An experimental study of repeated attachment imagery priming and stress buffering.

ObjectivesParanoia describes unfounded interpersonal threat beliefs. Secure attachment imagery attenuates paranoia, but limited research examines mechanisms of change and no studies examine how secure imagery may be implemented most effectively in clinical practice. In this study, we tested: (a) the causal impact of secure, anxious, and avoidant attachment imagery on paranoia and anxiety, (b) whether emotion regulation strategies mediate these relationships, and (c) whether secure imagery buffers against social stress.DesignWe utilized a longitudinal, experimental design.MethodA general population sample with high non‐clinical paranoia (N = 265) completed measures of paranoia, anxiety, and emotion regulation strategies. Participants were randomly allocated to secure, anxious, or avoidant conditions and repeated an imagery prime for four days prior to a social stress task.ResultsRelative to anxious and avoidant imagery, secure imagery decreased state paranoia and anxiety. These associations were not mediated by state emotion regulation strategies, and secure imagery did not buffer against stress. Exploratory analyses on trait variables revealed that: (a) hyperactivating strategies mediated the association between attachment anxiety and paranoia, and (b) suppression mediated the association between attachment avoidance and paranoia.ConclusionsSecure attachment imagery reduces state paranoia and anxiety and could be incorporated into psychotherapies to attenuate clinical paranoia. Measurement of state emotion regulation was problematic. Attachment imagery does not buffer stress; further research is required to test whether secure imagery facilitates recovery from stress. Attachment style is likely to account for trait paranoia via attachment‐congruent emotion regulation strategies. Research is now needed to determine if these strategies can be targeted to alleviate paranoia in clinical populations.

Using 360° immersive videos to assess paranoia in a non-clinical population

ABSTRACT Introduction: For the past two decades, virtual reality (VR) has proven to be an innovative approach for the assessment of state paranoia. However, the use of VR remains costly, and avatars are still far from realistic in terms of facial and bodily expressions. The present study aimed to test the validity of three 360° immersive videos (360IVs) as an accessible and realistic alternative for the assessment of non-clinical state paranoia. Method: Three 360IVs were created (a Lift, a Library and a Bar) and included actors behaving naturally. One hundred and fifty healthy students were assessed in terms of their proneness towards trait paranoia, were then exposed to one of the three 360IVs, and finally completed measures of state paranoia, sense of presence and cybersickness. Results : Results revealed the presence of various interpretations about the actor’s attitudes in the three 360IVs. Also, paranoid thoughts were predicted by proneness towards trait paranoia in two out of the three 360IVs. Furthermore, moderate levels of sense of presence and low levels of cybersickness were observed for each 360IV. Conclusion: The present study provides evidence in favour of the use of 360IVs as a new accessible, realistic, and standardised tool to assess state paranoia in non-clinical samples.

Impact of attachment imagery on paranoia and mood: evidence from two single case studies.

Cognitive behavioural therapy (CBT) for psychosis currently yields modest outcomes and must be improved. Attachment imagery may be an effective means of reducing severity of paranoid beliefs and associated affect. Experimental studies have demonstrated these effects in non-clinical groups. The impact in clinical populations remains untested. This study assessed the impact of a brief attachment imagery task on paranoia and mood, in two people with a diagnosis of schizophrenia. Two single case studies are presented. Both participants were working age adults with persecutory delusions. The study utilised an A-B-A design. Participants were recruited for a 6-week period, with a 2- and 3-week baseline respectively, 1-week intervention phase, and follow-up phase matched to duration of baseline. Trait paranoia and attachment were measured at the start of the baseline. State paranoia and affect were measured daily over the 6-week period. For both participants, the baseline phase was characterised by high and variable levels of paranoia, which reduced during the intervention phase, with a return to baseline scores at follow-up. We found a similar pattern for negative affect, and the reverse pattern for positive affect. Attachment imagery may function as an effective emotion regulation strategy for people with psychosis. Continued use is likely to be needed to maintain gains. This brief task could prove valuable to people needing skills to manage paranoia and mood, and give clinicians confidence that people can manage short-term distress in CBT for psychosis, for example when addressing past trauma.

Biased interpretation in paranoia and its modification

Background and objectivesCognitive models of psychosis implicate interpretation biases as one of the mechanisms involved in the formation and maintenance of symptoms. First we measured the strength of association between interpretation biases and psychosis-relevant traits. Next we manipulated these biases and quantified the effects of doing so on psychosis-relevant outcomes. MethodsExperiment 1 used two measures of interpretation bias in a healthy sample (n = 70). Experiment 2 used a novel cognitive bias modification procedure (CMB-pa) in individuals with moderate trait paranoia (n = 60). ResultsExperiment 1 revealed that over a third of the variance in interpretation bias could be explained by the combined effect of trait measures of paranoia/psychosis. In Experiment 2, CBM-pa produced training-congruent changes in the interpretation of new ambiguous information and influenced the interpretation, attribution and distress associated with a real-life social event. LimitationsThe potentially confounding effects of elevated anxiety and depression on interpretation bias and the restricted range of outcome measures to assess the wider effects of CBM-pa. ConclusionsThese studies are consistent with interpretation biases contributing to the maintenance of paranoia. CBM-pa could next be adapted and evaluated to test its efficacy as a therapeutic intervention.

Subjective experience of paranoid ideation in a virtual reality social environment: A mixed methods cross-sectional study.

Virtual reality-assisted cognitive-behavioural therapy (VR-CBT) has potential to support people who experience paranoid ideation in social settings. However, virtual reality (VR) research using overt social environments is limited, and lack of qualitative studies on paranoid ideation in VR restricts understanding. This study aimed to use predominantly qualitative methods to investigate subjective experience of paranoia in VR and identify target domains for VR-CBT. Participants (N = 36) were non-clinical adults with high trait paranoia, who entered an interactive VR bar-room environment. After VR, they participated in brief audiotaped semi-structured interviews designed for measuring persecutory ideation in virtual environments. Researchers scored transcripts on the Comprehensive Assessment of At-Risk Mental States Non-Bizarre Ideas Global Rating Scale to rate the state paranoia represented by interview content. Thematic analysis of interviews employed superordinate themes of Social Evaluative Concerns, Ideas of Reference, and Ideas of Persecution to investigate participants' experience of paranoia. Mean score on the Non-Bizarre Ideas scale was 3.06 (standard deviation 1.24, range 1-6), indicating "moderate" attenuated-paranoid experiences. Nearly all participants reported Social Evaluative Concerns (N = 35) and Ideas of Reference (N = 32); half reported Ideas of Persecution (N = 19). Twelve subthemes were identified. Notably, participants believed they did not belong in the environment (N = 31), that they were the object of discussion (N = 20), and that they felt avatars were unfriendly (N = 27) and intentionally rejected them (N = 13). Subthemes reflect interpersonal and social processes that may constitute target areas for VR-CBT, for example, cognitive appraisals and social skills. Identification of these domains indicates how personalized VR-CBT may be operationalized.

Higher Emotion-Related Distress in Patients with Fibromyalgia versus Chronic Neuropathic Pain and Healthy Controls: Is It a Primary Affective Disorder?

Fibromyalgia is central sensitization pain disorder with various psychological symptoms. Our aim is to compare trait paranoia, self-esteem and impulsivity between fibromyalgia patients (FM), chronic neuropathic pain sufferers (CNP) and healthy control. We administrated the Mini International Neuropsychologic Interview to 30 FM, 27 CNP and 22 HC. All participants completed the Paranoia, Rosenberg Self-Esteem and Short UPPS-P Impulsivity Behavior Scales, Beck Depression and State-Trait Anxiety inventories. Patients provided pain ratings and completed the French version of the McGill Pain Questionnaire and Pain Catastrophizing Scale. An analysis of variance compared the three groups, with adjustment for psychological distress, pain severity and education level. Anxiety-related psychiatric comorbidities were more prevalent in FM. Depression and state anxiety were higher in both CNP and FM, while trait anxiety was higher in FM compared to two other groups. Paranoia scores were significantly higher among FM than among HC, with intermediate scores in CNP. These group differences remained after adjustment for psychological distress, pain severity and education level. Lower self-esteem and higher negative urgency in patients with FM disappeared when results were adjusted for psychological distress. FM described sensory and affective aspects of pain as more severe and displayed higher pain catastrophizing than CNP group. These results suggest that emotion-related distress is higher in FM than in CNP.

The Use of Virtual Reality in the Assessment of Paranoid Thoughts: A Comparison with Desktop-Based Tools

Abstract Although virtual reality systems (VR) are being increasingly used to assess paranoid thoughts, there is a scarcity of data concerning the relative usefulness of VR for investigating these symptoms. The current study aimed to compare the usefulness of VR with that of a less expensive desktop-based tool for assessing paranoia. One hundred and twenty-six participants (mean age = 21.42 years, SD = 4.38, range = 18, 47; 81.8% female) were recruited for this study. After completing measures of trait paranoia and of a number of theoretical predictors of paranoia, participants were randomly assigned to a VR or a desktop-based assessment of paranoid thoughts. An identical neutral social scenario was implemented in both conditions. Results showed that unlike desktop-based assessments (F(1, 64) = 2.01, p = .161, partial ŋ2 = .03), VR assessments indicated higher levels of paranoid thoughts among individuals with high levels of trait paranoia than among those with low levels of trait paranoia (F(1, 64) = 5.49, p = .022, partial ŋ2 = .08), but only for one measure of paranoid thoughts. For the other measure, results followed a similar pattern, but the interaction between trait paranoia and the type of environment was not significant (F (1, 65) = 3.57, p = .052). Moreover, both measures of paranoid thoughts used in VR were significantly related to trait paranoia and a large number of predictors (p < .05), while just one measure of paranoid thoughts used in the desktop environment was significantly associated with trait paranoia and solely one of the tested predictors (p < .05). In addition, individuals assessed in VR reported higher levels of cognitive absorption than those assigned to a desktop-based assessment. Overall, findings of the present study suggest that VR may be better suited for the investigation of paranoid thoughts than desktop-based tools.

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.

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.

The Impact of Irrational Beliefs on Paranoid Thoughts

Although the ABC model proposed by cognitive behavioral theory has strong empirical support for a wide range of psychological problems, little is known about the role of irrational beliefs (IBs), a central concept of the ABC model, in the aetiology of paranoid thoughts, one of the most common psychotic symptoms. The present study aimed to investigate the impact of IBs on paranoid thoughts and people's perceptions of others. Eighty-one non-clinical participants (m age = 21.21 years, SD = 2.72, range 18-33; 83.95% female) recruited for this study were randomly assigned to one of the two conditions: IBs or rational beliefs (RBs). In a role-play paradigm, subjects were asked to imagine holding a list of IBs or RBs, respectively, while being exposed to a neutral social context in a virtual reality environment. In line with the ABC model, results indicate that IBs lead to significantly higher levels of state paranoid thoughts and more negative perceptions of others than RBs, even after controlling for participants' baseline irrationality and trait paranoia [F (5,68) = 11.23, p &lt; .001, Wilk's λ = .54, partial η2 = .45]. The findings of this paper suggest that IBs might play an aetiological role in the occurrence of paranoid thoughts. Practical and theoretical implications of these results are also considered.

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.

Trait paranoia shapes inter-subject synchrony in brain activity during an ambiguous social narrative

Individuals often interpret the same event in different ways. How do personality traits modulate brain activity evoked by a complex stimulus? Here we report results from a naturalistic paradigm designed to draw out both neural and behavioral variation along a specific dimension of interest, namely paranoia. Participants listen to a narrative during functional MRI describing an ambiguous social scenario, written such that some individuals would find it highly suspicious, while others less so. Using inter-subject correlation analysis, we identify several brain areas that are differentially synchronized during listening between participants with high and low trait-level paranoia, including theory-of-mind regions. Follow-up analyses indicate that these regions are more active to mentalizing events in high-paranoia individuals. Analyzing participants’ speech as they freely recall the narrative reveals semantic and syntactic features that also scale with paranoia. Results indicate that a personality trait can act as an intrinsic “prime,” yielding different neural and behavioral responses to the same stimulus across individuals.

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.

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.

The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group.

Previous studies have suggested that cannabidiol has anxiolytic and antipsychotic properties, raising hopes that cannabidiol will translate to the psychiatric clinic. Cannabidiol may be particularly useful for anxiety and paranoia in those at-risk of major mental illness. Immersion in a controlled 3D virtual-reality scenario was used to assay persecutory ideation and anxiety in a sample of non-clinical volunteers ( n=32) pre-selected for high paranoid traits. Participants were randomised to receive oral cannabidiol (600 mg) or placebo 130 min prior to entering virtual-reality. Well-validated rating scales were used to assay persecutory thinking and anxiety. Salivary cortisol concentration, heart rate and blood pressure were measured over the course of the experimental session. Immersion in the virtual-reality session elicited anxiety as indexed by the Beck's anxiety inventory ( p<0.005), and increased cortisol concentration ( p=0.05), heart rate ( p<0.05) and systolic blood pressure ( p<0.05). However, cannabidiol had no impact upon any of these effects, except for a strong trend to increase anxiety ( p=0.09). Cannabidiol had no effect on persecutory ideation as assayed by the Community Assessment of Psychic Experiences questionnaire or the State Social Paranoia Scale. In contrast to previous studies, there was no evidence of any benefits of cannabidiol on anxiety or persecutory ideation in healthy volunteers with high trait paranoia. However, a larger sample will be required for a definitive study.

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.