Social threat perception and the evolution of paranoia

Revisiting the Structure of the Chinese Version of the Questionnaire of Cognitive and Affective Empathy and Its Relationships with Schizotypy and Paranoia Using Network Approaches

Empathy is predominantly assessed with self-report questionnaires. However, their structural validities were not well-supported. This study aimed to re-explore and refine the factor structure of the Chinese version of the Questionnaire of Cognitive and Affective Empathy (QCAE) and investigate the pathways linked between dimensions of empathy and schizotypy. Data from a valid sample of 1,360 community-dwelling adults (aged 18-35) were subjected to the exploratory graph analysis (EGA) and bootstrap EGA for factor retention. A goodness-of-fit evaluation was conducted using confirmatory factor analysis (CFA). Lastly, a Gaussian graphical model with sum scores of the resultant empathy dimensions, positive, negative, and disorganized schizotypy, and paranoia as nodes was estimated. Results supported a three-factor structure for the revised 20-item QCAE, demonstrating a good model fit. The new Online simulation subscale was associated with reduced disorganized schizotypy, whereas the new Perspective-taking subscale was associated with decreased disorganized schizotypy and increased positive schizotypy. The composite Affective empathy subscale was associated with decreased negative schizotypy and increased positive and disorganized schizotypy and paranoia. Overall, the revised QCAE demonstrated good structural validity, measuring three separable and internally cohesive factors of empathy. Each factor possessed unique and differential relationships with schizotypy dimensions that merit research and clinical attention.

Trustworthiness judgments and pupil-size in individuals with schizophrenia

Individuals with schizophrenia show aberrant processing of social cues. In the current study, we (1) compared trustworthiness ratings of faces between patients with schizophrenia and healthy controls, (2) compared pupillary reactivity between patients and controls (3) examined whether trustworthiness judgments in schizophrenia are related to pupil reactivity, (4) and examined associations between trustworthiness judgements and symptom severity, specifically paranoia. Patients with schizophrenia spectrum disorders (N = 48) and healthy controls (N = 33) completed a Trustworthiness Task, during which their pupil size was measured via an eye-tracking device. The mean baseline-corrected pupil size was calculated from 24 pictures of real neutral faces, each presented for 2500 ms. Self-reported psychotic experiences were measured by Community Assessment of Psychic Functioning (CAPE-42), and symptom severity was rated by Brief Psychiatric Rating Scale (BPRS). No group differences were found in trustworthiness ratings or pupil reactivity parameters during trustworthiness judgments. Separately, among patients, absolute difference in pupil-size change and dilation after reaching minimum size were related to more severe positive symptoms and self-reported paranoia. Our results did not show social cognitive biases in the stable outpatients with schizophrenia, or the role of pupil reactivity in trustworthiness judgments. Future studies should use longer stimuli for pupillary reactivity and control the type and dosage of utilized antipsychotic medication. Further studies are required to explore relationships in larger and more symptomatic groups of patients.

Loneliness and psychotic-like experiences in middle-aged and older adults: the mediating role of selective attention to threat and external attribution biases

OBJECTIVES

Loneliness has been associated with psychotic-like experiences (PLEs) in the general population, but the mechanisms underlying this association are poorly understood. Theoretical models, corroborated by empirical findings, signify the key role of biased cognition in both loneliness and psychosis. This study tested whether two cognitive biases - Selective Attention to Threat (ATB) and External Attribution Bias (EAB) - account for the association between loneliness and PLEs.

METHOD

A convenience sample (n = 357) of middle-aged and older adults (aged 40+) was recruited online from the UK population. The parallel mediation model with two the aforementioned cognitive biases as mediators was tested.

RESULTS

A mediation effect between loneliness and PLEs via ATB (ab1 = 0.441, 95% CI = [0.264, 0.646]) and EAB (ab2 = 0.354, 95% CI [0.124, 0.627] was established. This model remained significant after controlling for the current symptoms of anxiety and depression.

CONCLUSION

Greater loneliness was associated with a higher rate of PLEs in the sample of middle-aged and older adults. This association was fully explained by ATB and EAB, independent of the current symptoms of anxiety and depression.

Emotional anticipation for dynamic emotional faces is not modulated by schizotypal traits: A Representational Momentum study

Schizotypy, a personality structure that resembles schizophrenia symptoms, is often associated with abnormal facial emotion perception. Based on the prevailing sense of threat in psychotic experiences, and the immediate perceptual history of seeing others' facial expressions, individuals with high schizotypal traits may exhibit a heightened tendency to anticipate anger. To test this, we used insights from Representational Momentum (RM), a perceptual phenomenon in which the endpoint of a dynamic event is systematically displaced forward, into the immediate future. Angry-to-ambiguous and happy-to-ambiguous avatar faces were presented, each followed by a probe with the same (ambiguous) expression as the endpoint, or one slightly changed to express greater happiness/anger. Participants judged if the probe was "equal" to the endpoint and rated how confident they were. The sample was divided into high (N = 46) and low (N = 49) schizotypal traits using the Schizotypal Personality Questionnaire (SPQ). First, a forward bias was found in happy-to-ambiguous faces, suggesting emotional anticipation solely for dynamic faces changing towards a potential threat (anger). This may reflect an adaptative mechanism, as it is safer to anticipate any hostility from a conspecific than the opposite. Second, contrary to our hypothesis, high schizotypal traits did not heighten RM for happy-to-ambiguous faces, nor did they lead to overconfidence in biased judgements. This may suggest a typical pattern of emotional anticipation in non-clinical schizotypy, but caution is needed due to the use of self-report questionnaires, university students, and a modest sample size. Future studies should also investigate if the same holds for clinical manifestations of schizophrenia.

Position paper - CFT for psychosis

PURPOSE

This paper outlines the theoretical and empirical basis for compassion focused therapy (CFT) for psychosis, the gaps in the current knowledge and research, as well as some of the challenges for addressing gaps. It will guide the direction of future work and the steps needed to develop and advance this approach.

METHOD

This paper reviews evidence of how evolutionary models such as social rank theory and attachment theory have greatly contributed to our understanding of psychosis and provide a clear rationale and evidence base for the mechanisms of change in CFT for psychosis. It reviews the evidence for outcomes of compassion training more generally, and early feasibility evaluations of CFT for psychosis.

RESULTS

The process evidence shows that people with psychosis have highly active social rank and threat systems, and the benefits of switching into attachment and care systems, which can support emotion regulation and integrative mind states. The outcomes evidence shows that compassion training impacts not only psychological outcomes, but also physiological outcomes such as neural circuits, immune system, and the autonomic nervous system. Within the psychosis field, outcomes research is still in the early days, but there are good indications of feasibility and a clear path forward for the next steps.

CONCLUSIONS

CFT for psychosis is an approach that integrates biopsychosocial processes, an integration that's evidenced across each aspect of the model, from theoretical foundations (evolution-informed) to interventions (e.g., body/breath training and relational techniques), to evaluation. Future RCTs are required to understand the effects on biopsychosocial outcomes for people with psychosis.

Better-than-chance prediction of cooperative behaviour from first and second impressions

Could cooperation among strangers be facilitated by adaptations that use sparse information to accurately predict cooperative behaviour? We hypothesise that predictions are influenced by beliefs, descriptions, appearance and behavioural history available for first and second impressions. We also hypothesise that predictions improve when more information is available. We conducted a two-part study. First, we recorded thin-slice videos of university students just before their choices in a repeated Prisoner's Dilemma with matched partners. Second, a worldwide sample of raters evaluated each player using videos, photos, only gender labels or neither images nor labels. Raters guessed players' first-round Prisoner's Dilemma choices and then their second-round choices after reviewing first-round behavioural histories. Our design allows us to investigate incremental effects of gender, appearance and behavioural history gleaned during first and second impressions. Predictions become more accurate and better-than-chance when gender, appearance or behavioural history is added. However, these effects are not incrementally cumulative. Predictions from treatments showing player appearance were no more accurate than those from treatments revealing gender labels and predictions from videos were no more accurate than those from photos. These results demonstrate how people accurately predict cooperation under sparse information conditions, helping explain why conditional cooperation is common among strangers.

Threat Responses in Schizophrenia: A Negative Valence Systems Framework

PURPOSE OF REVIEW

Emotions are prominent in theories and accounts of schizophrenia but are largely understudied compared to cognition. Utilizing the Research Domain Criteria (RDoC) Negative Valence Systems framework, we review the current knowledge of emotions in schizophrenia. Given the pivotal role of threat responses in theories of schizophrenia and the substantial evidence of altered threat responses, we focus on three components of Negative Valence Systems tied to threat responses: responses to acute threat, responses to potential threat, and sustained threat.

RECENT FINDINGS

Individuals with schizophrenia show altered responses to neutral stimuli during acute threat, bed nucleus of the stria terminalis connectivity in response to potential threat, and threat responses associated with sustained threat. Our review concludes that Negative Valence Systems are altered in schizophrenia; however, the level and evidence of alterations vary across the types of threat responses. We suggest avenues for future research to further understand and intervene on threat responses in schizophrenia.

Emotional interference and attentional control in schizophrenia-spectrum disorders: The special case of neutral faces

BACKGROUND AND OBJECTIVES

Schizophrenia-spectrum disorders (SSD) are characterized by impaired emotion processing and attention. SSD patients are more sensitive to the presence of emotional distractors. But despite growing interest on the emotion-attention interplay, emotional interference in SSD is far from fully understood. Moreover, research to date has not established the link between emotional interference and attentional control in SSD. This study thus aimed to investigate the effects of facial expression and attentional control in SSD, by manipulating perceptual load.

METHODS

Twenty-two SSD patients and 22 healthy controls performed a target-letter discrimination task with task-irrelevant angry, happy, and neutral faces. Target-letter was presented among homogenous (low load) or heterogenous (high load) distractor-letters. Accuracy and RT were analysed using (generalized) linear mixed-effect models.

RESULTS

Accuracy was significantly lower in SSD patients than controls, regardless of perceptual load and facial expression. Concerning RT, SSD patients were significantly slower than controls in the presence of neutral faces, but only at high load. No group differences were observed for angry and happy faces.

LIMITATIONS

Heterogeneity of SSD, small sample size, lack of clinical control group, medication.

CONCLUSIONS

One possible explanation is that neutral faces captured exogenous attention to a greater extent in SSD, thus challenging attentional control in perceptually demanding conditions. This may reflect abnormal processing of neutral faces in SSD. If replicated, these findings will help to understand the interplay between exogenous attention, attentional control, and emotion processing in SSD, which may unravel the mechanism underlying socioemotional dysfunction in SSD.

Dress is a Fundamental Component of Person Perception

ACADEMIC ABSTRACT

Clothing, hairstyle, makeup, and accessories influence first impressions. However, target dress is notably absent from current theories and models of person perception. We discuss three reasons for this minimal attention to dress in person perception: high theoretical complexity, incompatibility with traditional methodology, and underappreciation by the groups who have historically guided research in person perception. We propose a working model of person perception that incorporates target dress alongside target face, target body, context, and perceiver characteristics. Then, we identify four types of inferences for which perceivers rely on target dress: social categories, cognitive states, status, and aesthetics. For each of these, we review relevant work in social cognition, integrate this work with existing dress research, and propose future directions. Finally, we identify and offer solutions to the theoretical and methodological challenges accompanying the psychological study of dress.

PUBLIC ABSTRACT

Why is it that people often agonize over what to wear for a job interview, a first date, or a party? The answer is simple: They understand that others' first impressions of them rely on their clothing, hairstyle, makeup, and accessories. Many people might be surprised, then, to learn that psychologists' theories about how people form first impressions of others have little to say about how people dress. This is true in part because the meaning of clothing is so complex and culturally dependent. We propose a working model of first impressions that identifies four types of information that people infer from dress: people's social identities, mental states, status, and aesthetic tastes. For each of these, we review existing research on clothing, integrate this research with related work from social psychology more broadly, and propose future directions for research.

Knowing me, knowing you: a scoping review assessing the current field of social cognition in schizophrenia

BACKGROUND

Impaired social cognition (SC) occurs frequently in schizophrenia (SCZ), yet compared to autism spectrum disorder (ASD), the research on SC in SCZ is sparse and methodologically heterogeneous. To accurately assess between-group SC differences it is further necessary to establish the relationship between nonsocial cognition (NSC) and SC, particularly as this may not be identical across disorders.

PURPOSE

The present study aimed to map, index and assess the quality of research published between 2014-2021 investigating SC in SCZ, and to summarize existing limitations and recommendations for future research.

METHOD

Following the PRISMA guidelines for scoping reviews (PRISMA-ScR) fifteen (n = 15) case-control studies were identified and included across three electronic databases. Studies additionally utilizing ASD samples were included because of their clinical utility.

RESULTS

Most studies reported significant SC impairments in SCZ relative to healthy controls (HC) with varying effect sizes. Significant differences between SCZ and ASD were not found in most studies including both samples. Weak-to-moderate correlations between SC and NSC were often found, although often only within patient samples. Across studies, SC tests were inconsistently described as measurements of "social cognition", "mentalization" and, most frequently and varyingly, "theory of mind". Most studies lacked methodological transparency. Limitations related to sample sizes and test reliability were most frequently mentioned.

CONCLUSIONS

The current research on SC in SCZ is limited by conceptual and methodological uncertainties. Future research should focus on ensuring clear and valid definitions of key terms, evaluating and clarifying SC outcome measures and further untangling the relationship between SC and NSC.

Neuronal signatures of anger and fear in patients with psychosis

The present study investigated the functional neuroanatomy in response to sentence stimuli related to anger-provoking situations and fear of negative evaluation in patients with psychosis. The tasks consisted of four active conditions, Self-Anger (SA), Self-Fear, Other-Anger (OA), and Other-Fear (OF), and two neutral conditions, Neutral-Anger (NA) and Neutral-Fear (NF). Several relevant clinical measures were obtained. Under all contrasts, significantly higher activation in the left inferior parietal gyrus or superior parietal gyrus and the left middle occipital gyrus or superior occipital gyrus was observed in patients compared to healthy controls (HCs). However, we observed significantly lower activation in the left angular gyrus (AG) and left middle temporal gyrus (MTG) under the OA vs. NA contrast, as well as in the left precuneus and left posterior cingulate gyrus (PCG) under the OF vs. NF contrast in patients. The mean beta values for the significant regions under the SA vs. NA and OF vs. NF contrasts were significantly associated with the total PI and PANSS scores, respectively. These findings indicate that patients with psychosis exhibit hypoactivation in the AG, MTG, precuneus, and PCG compared to HCs. The findings suggest that patients with psychosis are less efficient at recruiting neural responses in those regions for semantic processing and social evaluation.

Afraid of whom?: Threat sensitivity's influence changes with perceived source of threat

Taking insights from the fields of psychology and biology, a growing body of scholarship considers the psychophysiological foundations of political attitudes. Subconscious emotional reactions to threat, for example, have been shown to predict socially conservative attitudes toward out-groups. However, many of these studies fail to consider different sources of perceived threat. Using a combination of survey and physiological data, I distinguish between fear of others and fear of authority, finding that threat sensitivity predicts divergent political attitudes depending on the strength of each. Those who are more sensitive to threat from others tend to hold socially conservative attitudes, while those who fear authority generally take more libertarian positions. As sensitivity to threat is at least partially inherited, these findings highlight the genetic role of political predispositions.

Paranoid thinking and perceived competitive intention

Paranoid thinking, that others are hostile, can be seen even in the general population. Paranoia is considered the expectation that others are competitors who aim to maximize the differences in payoffs rather than maximize their own payoffs. This study examined whether paranoia reflects the irrational belief that others have a competitive intention and is associated with avoiding perceived competition. We recruited 884 US residents via the Internet and conducted a modified Dictator Game, in which monetary allocation was carried out between the Dictator and the Recipient. The Dictator chooses either fair or competitive allocation while selecting the competitive allocation is irrelevant to increasing the Dictator's payoffs. The Recipient decides whether to accept the Dictator's decision or receive sure but low rewards. We found that Recipients with high-level paranoid thinking expected their opponent to select competitive allocation more than those with low levels, even when selecting it was costly for Dictators. Paranoid thinking was not associated with selecting sure rewards or competitive allocations. The results suggest that paranoia reflects the belief that others have a competitive intention but is not related to avoidance behavior against perceived threats and unilateral attacks.

Interconnections between Emotion Recognition, Self-Processes and Psychological Well-Being in Adolescents

Background: Adolescence is a critical developmental period for mentalization and emotion regulation skills. Studies show that during this time, adolescents may experience greater vulnerability to challenges of mental and emotional well-being. Studies also show that self-skills, such as mentalization, self-compassion, and self-control are independently associated with feelings of global self-worth or psychological well-being. To date, no known studies have explored interconnected relations among these self-skills, despite significant overlaps in the social-biological development of these skills. Aims: To investigate interconnected relations among psychological well-being, mentalization, self-compassion and self-control. Gender differences in these relations are explored. Method: As part of a larger, longitudinal study of adolescent well-being, this cross-sectional study drew on a variety of self-report measures, investigating relations among adolescents’ self-reports of psychological well-being, emotion recognition, self-control, and self-compassion. Participants consisted of 88 girls and 57 boys, mean age 13.38. Results: Main results showed associations among emotion recognition, self-control and self-compassion and feelings of global self-worth. Specifically, results showed that understanding negative emotions in others relates to lower levels of self-compassion and feelings of self-worth. Further, adolescents who report low levels of self-control reported uncompassionate self-responding and lower levels of self-worth. Gender differences and implications for further research and adolescent social-emotional interventions are discussed.

The scarring impact of status loss in social anxiety: An evolutionary perspective

Evolutionary models suggest that social anxiety (SA) is associated with sensitivity to status loss. These models make several additional predictions concerning the strength as well as the specificity of the association between post-event distress (PED) following status losses and SA. First, the strength of this association is postulated to be enhanced in men, especially following status losses inflicted by other men (intra-male status losses). Second, given the evolutionary postulated relationship between social status and physical fitness, sensitivity to status loss in SA is expected to extend to physically threatening events. We examined these predictions in four online samples (total N = 1123; 59% females, 27% above the cutoff for clinically elevated SA). In all studies, participants recalled social status-loss events and rated the emotional and distressing impact of these experiences. In two samples, participants also identified and recalled physically threatening events. Our findings were consistent with evolutionary predictions. SA was associated with PED following social status-loss events (β = 0.27). This association was stronger in men than in women (β = 0.40, β = 0.16, respectively). Moreover, the SA-PED association was especially enhanced following intra-male, compared to intra-female and inter-gender, status losses (β = 0.47, β = 0.26, and β = 0.17, respectively). Furthermore, SA was uniquely associated with PED following physically threatening events, over and above PED following social status-loss events (β = 0.21). Our data highlights the significant impact of socially and physically threatening events and delineates the scarring signature of such events in SA.

Error patterns of facial emotion recognition in patients with schizophrenia

Error patterns of facial emotion recognition (FER) indicate how individuals misinterpret others' facial expressions, which helps clinicians to manage related deficits. However, previous investigations are limited and may have been biased due to methodological issues (e.g., no consideration of response bias). This study aimed to propose a detectability index (d') for adjusting response bias and examine the error patterns of FER in patients with schizophrenia. Responses to 168 photos showing seven basic emotions, obtained from 351 patients with schizophrenia and 101 healthy adults, were extracted from a previous study. The differences in the d's between the two groups (Δd') were calculated to examine the error patterns of FER among the seven emotions. The findings were generally overlapped with those identified by the traditional confusion matrix. Four error patterns were found. First, the patients were insensitive to some negative emotions (i.e., sadness [Δd' = 0.83] and fear [Δd' = 0.72]). Second, they misrecognized happy faces as showing negative emotions (e.g., disgust [Δd' = 0.43] and sadness [Δd' = 0.37]). Third, they misinterpreted surprised faces as all the other emotions (Δd' = 0.41-0.87), except neutral. Fourth, they confused some negative emotions (e.g., misrecognizing fear as anger [Δd' = 0.87]). Our findings suggest that patients with schizophrenia show four error patterns of FER compared to healthy adults. Accordingly, interventions could be selected to improve their sensitivity to faces with negative emotions, differentiation of faces among positive and negative emotions, understanding of surprised faces, and discrimination of faces with negative emotions.

Characterizing the effects of 2-phenylethylamine and coyote urine on unconditioned and conditioned defensive behaviors in adolescent male and female Long-Evans hooded rats

Predator odors provide critical information to prey species allowing them to gauge potential threat via the detection of semiochemicals called kairomones. Recent reports indicate that the commercially available predator odor coyote urine (CU), and to a lesser extent 2-phenylethylamine (PEA), induce innate defensive behaviors in adult rats and mice. The aim of the present study was to see if the defense-inducing effects of CU and PEA would extend to adolescents. Specifically, we evaluated the ability of CU and PEA to induce unconditioned and conditioned defensive behavior in predator-odor naïve adolescent male and female Long-Evans hooded rats. An additional group of males were exposed to the non-predatory aversive odor formalin to control for potential general aversive properties of the odorants. The data revealed that in males, both CU and PEA, but not formalin induced measures of risk assessment, whereas CU and formalin produced avoidance of the odor source. In partial contrast, both CU and PEA produced avoidance of the odor source and increased measures of risk assessment in females. Surprisingly males failed to show any measures of defense during the cue+context conditioning test trial. In contrast, in females both odorants produced marginal effects during re-exposure to the conditioning context, with CU inducing conditioned avoidance and PEA inducing conditioned risk assessment. We conclude that commercially available CU and PEA elicit a moderate defensive profile compared to previous reports examining cat fur/skin odor in male and female adolescent rats. Future research needs to examine additional concentrations of the odorants to determine if a more robust unconditioned defensive profile (e.g., freezing) can be induced by these predator odors, and whether the defensive profile responds to standard anxiolytic drugs.

Attentional engagement and inhibitory control according to positive and negative symptoms in schizophrenia: An emotional antisaccade task

Despite schizophrenia (SZ) is characterized by a high psychopathological heterogeneity, the underlying psychological mechanisms that result in different clinical profiles are unclear. This study examined the cognitive processing of emotional faces (angry, happy, neutral, and sad) by means of assessing inhibitory control (antisaccade task) and attentional engagement (prosaccade task) with the eye-tracking paradigm. Firstly, two clinical SZ subgroups classified according to the predominance of positive (PSZ; n = 20) or negative symptoms (NSZ; n = 34) and a control group of 32 individuals were compared. Secondly, the association between prosaccade and antisaccade measurements and the severity of positive and negative symptoms were analyzed. The PSZ group showed slower antisaccades when angry faces were displayed, and higher positive symptoms were associated with slower prosaccade latencies to ones. Conversely, the NSZ group made overall slower prosaccades with an emotional advantage for angry faces, and higher negative symptoms were associated with faster antisaccade latencies to ones. Hence, whereas positive SZ profile is related to a lack of attentional engagement and an impaired inhibitory control to threatening information; negative SZ profile is linked to a lack of attentional engagement to faces, mainly with non-threat ones, and with an advantage to ignore distracting threatening stimuli. These findings support affective information-processing theories suggesting a hypersensitivity to threat for positive SZ profiles, and a desensitization to socio-emotional information for negative ones. Consequently, characterizing psychological mechanisms of SZ may allow improving current treatments to threat management when positive symptoms are predominant, or emotion sensitization when negative symptoms prevail.

Socioemotional mechanisms of loneliness in subclinical psychosis

Loneliness is an important predictor of physical and mental health in the general population and in individuals across the psychosis spectrum, including those experiencing subclinical psychotic-like experiences (PLEs). However, the mechanisms underlying loneliness in the psychosis spectrum are not well understood. Emotion processing deficits are well described across the psychosis spectrum, and socioemotional processing biases are critical for the development and maintenance of loneliness through altered social appraisal, including judgements of rejection. Therefore, we propose that PLEs are associated with increased loneliness, and the relationship is mediated by alterations in socioemotional processing. We also explored how this pathway may be affected by mood and anxiety symptoms, which have been associated with loneliness across the psychosis spectrum. As part of the Human Connectome Project, generally healthy adults (n = 1180) reported symptomatology and social functioning and completed the Penn Emotion Recognition Task to assess efficiency in identifying emotions. We found that higher reported PLEs were associated with elevated levels of loneliness and perceived rejection and that these factors were linked by multiple independent pathways. First, anxiety/depression and emotion processing efficiency independently mediated the PLE-loneliness relationship. Second, we found that the association between PLEs and loneliness was serially mediated through inefficient emotion recognition then higher levels of perceived rejection. These separable mechanisms of increased loneliness in subclinical psychosis have implications for treatment and continued study of social functioning in the psychosis spectrum.

Attentional processing biases to threat in schizophrenia: Evidence from a free-viewing task with emotional scenes

Attentional biases to threatening stimuli have been suggested to play a key role in the onset and course of schizophrenia. However, current research has not completely demonstrated this assumption. The aim of this eye-tracking study was to shed light on the underlying psychological mechanisms of schizophrenia by examining the attentional processing of socio-emotional information. Forty-four individuals with schizophrenia and 47 healthy controls were assessed in a 3-s free-viewing task with a social scene (i.e., happy, threatening, or neutral) in competition with a non-social one to determine the effects of emotional information on the different stages of the attentional processing. The location and latency of initial fixations (i.e., initial orienting), the firs-pass fixations and gaze duration (i.e., attentional engagement), and the percentage of total duration and total fixations (i.e., attentional maintenance) were analyzed. It was found that the schizophrenia group showed longer first-pass gaze duration, as well as higher percentage of total fixations and total duration toward threatening scenes in relation to the non-social ones, compared to controls. Therefore, an attentional bias toward threatening scenes in schizophrenia was found in the attentional maintenance and engagement, but not in the initial orienting of attention. Of note, the threat-related attentional bias was not associated with positive symptoms of schizophrenia. These findings offer empirical support to affective-information processing models stating that threatening information may confer psychological vulnerability to develop schizophrenia. Moreover, the results can improve psychological treatments, such as attentional bias modification paradigms or cognitive-behavior interventions managing maladaptive schemas related to threat.

Performance-based assessment of social skills in a large sample of participants with schizophrenia, bipolar disorder and healthy controls: Correlates of social competence and social appropriateness

INTRODUCTION

Performance-based assessments of social skills have detected impairments in people with severe mental illness and are correlated with functional outcomes in people with schizophrenia and bipolar disorder. The most common of these assessments, the Social Skills Performance Assessment (SSPA), has two communication scenarios and items measuring both social competence and appropriateness. As real-world competence and appropriateness appear to have different correlates, we hypothesized that SSPA Items measuring competence and appropriateness would be distinct and have different correlations with other outcomes.

METHODS

We aggregated data from 557 people with schizophrenia, 106 with bipolar disorder, and 378 well controls from 4 separate research studies. All participants were assessed with both SSPA scenarios and other performance based and clinician-rated measures. A single expert rated the SSPA interactions for competence and appropriateness while blind to participant diagnoses.

RESULTS

Participants with bipolar disorder and schizophrenia performed more poorly on every item of the SSPA than healthy controls. Items measuring social competence and appropriateness in communication were intercorrelated across scenarios, as were elements of socially competent communication, although the items measuring competence did not correlate substantially with appropriateness. Items assessing social competence, but not social appropriateness, correlated with better cognitive and functional performance and residential and financial independence.

DISCUSSION

Social competence and social appropriateness were distinct elements of performance-based social skills with potential differences in their functional correlates. As both social competence and appropriateness impact functional outcomes, improvement in the measurement and treatment of appropriate communication seems to be an important goal.

Conjecturing Harmful Intent and Preemptive Strike in Paranoia

Paranoia depicts a belief of others having harmful intent. Research using economic games has exhibited the correlation between paranoia and the propensity to characterize ambiguous intentions as harmful. Using a non-clinical sample recruited online from the United States (N=290), we examined whether paranoid thoughts influence aggressive behavior against the subjective perception of harmful intent. We conducted a preemptive strike game wherein aggressive behavior was assumed to be guided by the fear of an opponent. The outcomes indicate that (1) individuals with high paranoia assume harmful intent of an opponent more than those with low paranoia (2) conjecturing an opponent's harmful intent predicted an increase in the probability of a preemptive strike, and (3) paranoia did not have a statistically significant effect on encouraging a preemptive strike. Additionally, the exploratory analysis revealed that paranoia was related to participant's aggressiveness and with suppositions of other's self-interests and competitiveness. This study presents empirical evidence that paranoia is related to the perception of social threats in an uncertain situation. We discuss the possibility that paranoid ideation can promote or inhibit a preemptive strike.

BNST and amygdala connectivity are altered during threat anticipation in schizophrenia

In schizophrenia, impairments in affect are prominent and anxiety disorders are prevalent. Neuroimaging studies of fear and anxiety in schizophrenia have focused on the amygdala and show alterations in connectivity. Emerging evidence suggests that the bed nucleus of the stria terminalis (BNST) also plays a critical role in anxiety, especially during anticipation of an unpredictable threat; however, previous studies have not examined the BNST in schizophrenia. In the present study, we examined BNST function and connectivity in people with schizophrenia (n = 31; n = 15 with comorbid anxiety) and controls (n = 15) during anticipation of unpredictable and predictable threat. A secondary analysis tested for differences in activation and connectivity of the central nucleus of the amygdala (CeA), which has also been implicated in threat anticipation. Analyses tested for group differences in both activation and connectivity during anticipation of unpredictable threat and predictable threat (p < .05). Relative to controls, individuals with schizophrenia showed stronger BNST-middle temporal gyrus (MTG) connectivity during unpredictable threat anticipation and stronger BNST-MTG and BNST-dorsolateral prefrontal connectivity during predictable threat anticipation. Comparing subgroups of individuals with schizophrenia and a comorbid anxiety disorder (SZ+ANX) to those without an anxiety disorder (SZ-ANX) revealed broader patterns of altered connectivity. During unpredictable threat anticipation, the SZ+ANX group had stronger BNST connectivity with regions of the salience network (insula, dorsal anterior cingulate cortex). During predictable threat anticipation, the SZ+ANX group had stronger BNST connectivity with regions associated with fear processing (insula, extended amygdala, prefrontal cortex). A secondary CeA analysis revealed a different pattern; the SZ+ANX group had weaker CeA connectivity across multiple brain regions during threat anticipation compared to the SZ-ANX group. These findings provide novel evidence for altered functional connectivity during threat anticipation in schizophrenia, especially in individuals with comorbid anxiety.

Attentional biases to emotional scenes in schizophrenia: An eye-tracking study

Attentional biases to emotional information may play a key role in the onset and course of schizophrenia. The aim of this experiment was to examine the attentional processing of four emotional scenes in competition (happy, neutral, sad, threatening) in 53 patients with schizophrenia and 51 controls. The eye movements were recorded in a 20-seconds free-viewing task. The results were: (i) patients showed increased attention on threatening scenes, compared to controls, in terms of attentional engagement and maintenance; (ii) patients payed less attention to happy scenes than controls, in terms of attentional maintenance; (iii) whereas positive symptoms were associated with a late avoidance of sad scenes, negative symptoms were associated with heightened attention to threat. The findings suggest that a threat-related bias and a lack of sensitivity to positive information may represent an underlying psychological mechanism of schizophrenia. Importantly, schizophrenia symptoms modulated the attentional biases, which has aetiological and therapeutic implications.

The relevance to social interaction modulates bistable biological-motion perception

Social interaction, the process through which individuals act and react toward each other, is arguably the building block of society. As the very first step for successful social interaction, we need to derive the orientation and immediate social relevance of other people: a person facing toward us is much more likely to initiate communications than a person who is back to us. Reversely, however, it remains elusive whether the relevance to social interaction modulates how we perceive the other's orientation. Here, we adopted the bistable point-light walker (PLW) which is ambiguous in its in-depth orientation. Participants were asked to report the orientation (facing the viewer or facing away from the viewer) of the PLWs. Three factors that are task-irrelevant but critically pertinent to social interaction, the distance, the speed, and the size of the PLW, were systematically manipulated. The nearer a person is, the more likely it initiates interactions with us. The larger a person is, the larger influence it may exert. The faster a person is, the shorter time is left for us to respond. Results revealed that participants tended to perceive the PLW as facing them more frequently than facing away when the PLW was nearer, faster, or larger. These same factors produced different patterns of effects on a non-biological rotating cylinder. These findings demonstrate that the relevance to social interaction modulates the visual perception of biological motion and highlight that bistable biological motion perception not only reflects competitions of low-level features but is also strongly linked to high-level social cognition.

Altered brain responses to specific negative emotions in schizophrenia

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Scenic stimuli might offer a better understanding of emotional processing than faces.

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Emotional scenes were presented to schizophrenia patients and healthy controls.

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Schizophrenia patients tend to misclassify emotional images as fear.

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Schizophrenia patients hyperactivated regions involved in fear and disgust processing.

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Patients’ brain response did not differ from controls in response to happy and sad scenes.

Deficits in emotion processing are a core feature of schizophrenia, but their neurobiological bases are poorly understood. Previous research, mainly focused on emotional face processing and emotion recognition deficits, has shown controverted results. Furthermore, the use of faces has been questioned for not entailing an appropriate stimulus to study emotional processing. This highlights the importance of investigating emotional processing abnormalities using evocative stimuli. For the first time, we have studied the brain responses to scenic stimuli in patients with schizophrenia. We selected scenes from the IAPS that elicit fear, disgust, happiness, and sadness. Twenty-six patients with schizophrenia and thirty age-, sex- and premorbid IQ-matched healthy controls were included. Behavioral task results show that patients tended to misclassify disgust and sadness as fear. Brain responses in patients were different from controls in images eliciting disgust and fear. In response to disgust images, patients hyperactivated the right temporal cortex, which was not activated by the controls. With fear images, hyperactivation was observed in brain regions involved in fear processing, including midline regions from the medial frontal cortex to the anterior cingulate cortex, the superior frontal gyrus, inferior and superior temporal cortex, and visual areas. These results suggest that schizophrenia is characterized by hyper-responsivity to stimuli evoking high-arousal, negative emotions, and a bias towards fear in emotion recognition.

Sexual minority status and symptoms of psychosis: The role of bullying, discrimination, social support, and drug use - Findings from the Adult Psychiatric Morbidity Survey 2007

OBJECTIVE

Sexual minorities have an increased risk of psychosis, potentially explained by experiences of social adversity. Sexual minorities may also have a specific risk of paranoid symptoms. The current study aimed to determine whether sexual minorities have increased risk of psychosis, whether they have a specific increased risk of paranoia when compared to auditory verbal hallucinations (AVHs), and whether social adversity such as bullying, recent discrimination, lack of social support, and drug use can explain this risk.

METHODS

The study used data from the Adult Psychiatric Morbidity Survey 2007 (n = 7,403), exploring both sexual identity and past sexual behaviour. Associations between sexual minority status and probable psychosis, paranoia, and AVH were analysed using logistic regression. Mediation analysis was also conducted using the Karlson-Holm-Breen method, with bullying, recent discrimination, social support, and drug use as mediators assessing pathways between sexual minority status and paranoia/AVH. Socio-demographic confounders were included in analyses.

RESULTS

Sexual minority status did not significantly predict probable psychosis. Findings generally indicated a specific association between sexual minority status and paranoia when contrasted with AVH. However, sexual behaviour remained significantly associated with AVH in logistic regression models. Bullying, lack of social support, and drug use partially mediated the association between sexual minority status and paranoia.

CONCLUSIONS

Sexual minority status appears to have a specific association with paranoia symptoms, which may be partially explained by experiences of social adversity. However, the cross-sectional nature of the study limits direct inference about causality of such symptoms.

PRACTITIONER POINTS

Sexual minority groups may be more likely to experience symptoms of paranoia. It may be important to consider experiences of social adversity such as bullying, lack of social support, and also history of drug use in the context of paranoia within these groups.

Risk-taking and fairness among cocaine-dependent patients in dual diagnoses: Schizophrenia and Anti-Social Personality Disorder

This study reports experimental results from a clinical sample of patients with a cocaine-related disorder and dual diagnosis: Schizophrenia and Anti-Social Personality Disorder. Both types of patients as well as a non-clinical group of students performed two incentivized decision-making tasks. In the first part of the experiment, they performed a lottery-choice task in order to elicit their degree of risk aversion. In the second part, they decided in two modified dictator games aimed at eliciting their aversion to advantageous and disadvantageous inequality. It is found that the Anti-Social Personality Disorder group exhibits no significant differences from the non-clinical sample in either task. However, compared with the students' sample, subjects from the group with schizophrenia show more risk aversion and exhibit more aversion towards disadvantageous inequality.

Psychobiology of threat appraisal in the context of psychotic experiences: A selective review

A key factor in the transition to psychosis is the appraisal of anomalous experiences as threatening. Cognitive models of psychosis have identified attentional and interpretative biases underlying threat-based appraisals. While much research has been conducted into these biases within the clinical and cognitive literature, little examination has occurred at the neural level. However, neurobiological research in social cognition employing threatening stimuli mirror cognitive accounts of maladaptive appraisal in psychosis. This review attempted to integrate neuroimaging data regarding social cognition in psychosis with the concepts of attentional and interpretative threat biases. Systematic review methodology was used to identify relevant articles from Medline, PsycINFO and EMBASE, and PubMed databases. The selective review showed that attentional and interpretative threat biases relate to abnormal activation of a range of subcortical and prefrontal structures, including the amygdala, insula, hippocampus, anterior cingulate, and prefrontal cortex, as well as disrupted connectivity between these regions, when processing threatening and neutral or ambiguous stimuli. Notably, neural findings regarding the misattribution of threat to neutral or ambiguous stimuli presented a more consistent picture. Overall, however, the findings for any specific emotion were mixed, both in terms of the specific brain areas involved and the direction of effects (increased/decreased activity), possibly owing to confounds including small sample sizes, varying experimental paradigms, medication, and heterogeneous, in some cases poorly characterised, patient groups. Further neuroimaging research examining these biases by employing experimentally induced anomalous perceptual experiences and well-characterised large samples is needed for greater aetiological specificity.

Mechanisms linking childhood trauma exposure and psychopathology: a transdiagnostic model of risk and resilience

BACKGROUND

Transdiagnostic processes confer risk for multiple types of psychopathology and explain the co-occurrence of different disorders. For this reason, transdiagnostic processes provide ideal targets for early intervention and treatment. Childhood trauma exposure is associated with elevated risk for virtually all commonly occurring forms of psychopathology. We articulate a transdiagnostic model of the developmental mechanisms that explain the strong links between childhood trauma and psychopathology as well as protective factors that promote resilience against multiple forms of psychopathology.

MAIN BODY

We present a model of transdiagnostic mechanisms spanning three broad domains: social information processing, emotional processing, and accelerated biological aging. Changes in social information processing that prioritize threat-related information-such as heightened perceptual sensitivity to threat, misclassification of negative and neutral emotions as anger, and attention biases towards threat-related cues-have been consistently observed in children who have experienced trauma. Patterns of emotional processing common in children exposed to trauma include elevated emotional reactivity to threat-related stimuli, low emotional awareness, and difficulties with emotional learning and emotion regulation. More recently, a pattern of accelerated aging across multiple biological metrics, including pubertal development and cellular aging, has been found in trauma-exposed children. Although these changes in social information processing, emotional responding, and the pace of biological aging reflect developmental adaptations that may promote safety and provide other benefits for children raised in dangerous environments, they have been consistently associated with the emergence of multiple forms of internalizing and externalizing psychopathology and explain the link between childhood trauma exposure and transdiagnostic psychopathology. Children with higher levels of social support, particularly from caregivers, are less likely to develop psychopathology following trauma exposure. Caregiver buffering of threat-related processing may be one mechanism explaining this protective effect.

CONCLUSION

Childhood trauma exposure is a powerful transdiagnostic risk factor associated with elevated risk for multiple forms of psychopathology across development. Changes in threat-related social and emotional processing and accelerated biological aging serve as transdiagnostic mechanisms linking childhood trauma with psychopathology. These transdiagnostic mechanisms represent critical targets for early interventions aimed at preventing the emergence of psychopathology in children who have experienced trauma.

Free viewing exploration in schizophrenia: Review of evidence from laboratory settings to natural environment

Several studies have investigated visual processing impairment in schizophrenia. The literature on visual exploration has described restricted scanning in schizophrenia patients. This gaze behavior is characterized by increased fixation duration, a reduced scan path length and avoidance of salient features of the face with emotional content. The aim of this paper is to give an insight on the latest update on scan path deficit. Abnormal gaze exploration was replicated in various visual stimuli. This review describes gaze patterns with stimuli that imply minimal to high cognitive process: figures, objects, faces, and scenes. Interestingly, schizophrenia patients have shown cognitive flexibility by modulating gaze scanning when they are involved in an active assignment. We will also consider scanning abnormalities in real-life environment and discuss the potential therapeutic use of eye tracking in schizophrenia. The therapeutic application of eye tracking in schizophrenia is a young emerging field in psychiatry research. The recent remediation program is based on the reorientation of visual attention on the salient features of faces. For now, this program has shown encouraging results. Further studies are needed to explore behavior in real-world situations to complement laboratory measurements to move toward a full understanding of the mechanisms underlying atypical scanning in patients with schizophrenia.

Impaired Facial Emotion Recognition in Individuals at Ultra-High Risk for Psychosis and Associations With Schizotypy and Paranoia Level

BACKGROUND

Patients with schizophrenia and individuals at ultra-high risk for psychosis (UHR) have been reported to exhibit impaired recognition of facial emotion expressions. This impairment has involved both inaccuracy and negative bias of facial emotion recognition. The present study aimed to investigate whether UHR individuals display both types of impaired facial emotion recognition and to explore correlations between these impairments and schizotypy, as well as paranoia levels, in these individuals.

METHODS

A total of 43 UHR individuals and 57 healthy controls (HC) completed a facial emotion recognition task consisting of 60 standardized facial photographs. To explore correlations, we assessed schizotypy using the Revised Physical Anhedonia Scale and Magical Ideation Scale and paranoia level using the Paranoia Scale and persecution/suspicious item of the Positive and Negative Syndrome Scale in UHR individuals.

RESULTS

Compared with HC, UHR individuals exhibited less accuracy for facial emotion recognition (70.6% vs. 75.6%, p=0.010) and a higher rate of "fear" responses for neutral faces (14.5% vs. 6.0%, p=0.003). In UHR individuals, inaccuracy was significantly correlated with schizotypy scores, but not with paranoia level. Conversely, "disgust" response for neutral faces was the only fear response correlated with paranoia level, and no threat-related emotion response correlated with schizotypy scores.

DISCUSSION

UHR individuals exhibited inaccuracy and negative bias of facial emotion recognition. Furthermore, schizotypy scores were associated with inaccuracy but not with negative bias of facial emotion recognition. Paranoia level was correlated with "disgust" responses for neutral faces but not with inaccuracy. These findings suggest that inaccuracy and negative bias of facial emotion recognition reflect different underlying processes, and that inaccuracy may be a vulnerability marker for schizophrenia.

Social anxiety changes the way we move-A social approach-avoidance task in a virtual reality CAVE system

Investigating approach-avoidance behavior regarding affective stimuli is important in broadening the understanding of one of the most common psychiatric disorders, social anxiety disorder. Many studies in this field rely on approach-avoidance tasks, which mainly assess hand movements, or interpersonal distance measures, which return inconsistent results and lack ecological validity. Therefore, the present study introduces a virtual reality task, looking at avoidance parameters (movement time and speed, distance to social stimulus, gaze behavior) during whole-body movements. These complex movements represent the most ecologically valid form of approach and avoidance behavior. These are at the core of complex and natural social behavior. With this newly developed task, the present study examined whether high socially anxious individuals differ in avoidance behavior when bypassing another person, here virtual humans with neutral and angry facial expressions. Results showed that virtual bystanders displaying angry facial expressions were generally avoided by all participants. In addition, high socially anxious participants generally displayed enhanced avoidance behavior towards virtual people, but no specifically exaggerated avoidance behavior towards virtual people with a negative facial expression. The newly developed virtual reality task proved to be an ecological valid tool for research on complex approach-avoidance behavior in social situations. The first results revealed that whole body approach-avoidance behavior relative to passive bystanders is modulated by their emotional facial expressions and that social anxiety generally amplifies such avoidance.

Vulnerability to Psychosis, Ideas of Reference and Evaluation with an Implicit Test

BACKGROUND

Ideas of reference (IRs) are observed in the general population on the continuum of the psychotic phenotype (as a type of psychotic-like experiences, PLE). The instruments usually used to evaluate IRs show some problems: They depend on the cooperation of the participant, comprehension of items, social desirability, etc. Aims: The Testal emotional counting Stroop (TECS) was developed for the purpose of improving evaluation of individuals vulnerable to psychosis and its relationship with ideas of reference. The TECS (two versions) was applied as an implicit evaluation instrument for IRs and related processes for early identification of persons vulnerable to psychosis and to test the possible influence of emotional symptomatology.

METHOD

A total of 160 participants (67.5% women) from the general population were selected (Mean (M) = 24.12 years, standard deviation (SD) = 5.28), 48 vulnerable and 112 non-vulnerable.

RESULTS

Vulnerability to psychosis was related to greater latency in response to referential stimuli. Version 4 of the TECS showed a slight advantage in identifying more latency in response to referential stimuli among participants with vulnerability to psychosis (Cohen's d = 1.08). Emotional symptomatology (especially stress), and IQ (premorbid) mediated the relationship between vulnerability and IR response latency.

CONCLUSIONS

The application of the implicit Testal emotional counting Stroop test (TECS) is useful for evaluating processes related to vulnerability to psychosis, as demonstrated by the increased latency of response to referential stimuli.

In Two Minds: Similarity, Threat, and Prejudice Contribute to Worse Mindreading of Outgroups Compared With an Ingroup

We examined Turkish participants’ mindreading accuracy toward ingroup versus outgroup targets. Three hundred and fifty-four Turkish participants were randomly assigned to one of three target groups: Turkish, Syrian, or Norwegian. The mindreading accuracy for these targets was measured along with the perceived cultural similarity of the target to the ingroup, as well as prejudice and threat perception. Participants evidenced higher mindreading accuracy toward Turkish targets compared with Syrian and Norwegian targets. Mindreading accuracy for the Syrian and Norwegian targets did not differ, but lower perceived similarity to the Turkish ingroup significantly predicted lower mentalizing for Syrian and Norwegians. In the Syrian target group, lower perceived similarity interacted with lower education and higher prejudice, resulting in a further reduction in mindreading. For Norwegian targets, lower similarity impaired mindreading through an interaction with higher threat perception. Results indicate that even when mentalizing capacity is mature, intergroup factors are linked with the deployment of mindreading.

Loneliness and the recognition of vocal socioemotional expressions in adolescence

Lonely individuals show increased social monitoring and heightened recognition of negative facial expressions. The current study investigated whether this pattern extends to other nonverbal modalities by examining associations between loneliness and the recognition of vocal emotional expressions. Youth, ages 11-18 years (n = 122), were asked to identify the intended emotion in auditory portrayals of basic emotions (anger, disgust, fear, happiness, sadness) and social expressions (friendliness, meanness). Controlling for social anxiety, age, and gender, links between loneliness and recognition accuracy were emotion-specific: loneliness was associated with poorer recognition of fear, but better recognition of friendliness. Lonely individuals' motivation to avoid threat may interfere with the recognition of fear, but their attunement to affiliative cues may promote the identification of friendliness in affective prosody. Monitoring for social affiliation cues in others' voices might represent an adaptive function of the reconnection system in lonely youth, and be a worthy target for intervention.

Oxytocin increases eye gaze in schizophrenia

Abnormal eye gaze is common in schizophrenia and linked to functional impairment. The hypothalamic neuropeptide oxytocin modulates visual attention to social stimuli, but its effects on eye gaze in schizophrenia are unknown. We examined visual scanning of faces in men with schizophrenia and neurotypical controls to quantify oxytocin effects on eye gaze. In a randomized, double-blind, crossover study, 33 men with schizophrenia and 39 matched controls received one dose of intranasal oxytocin (40 IU) and placebo on separate testing days. Participants viewed 20 color photographs of faces while their gaze patterns were recorded. We tested for differences in fixation time on the eyes between patients and controls as well as oxytocin effects using linear mixed-effects models. We also tested whether attachment style, symptom severity, and anti-dopaminergic medication dosage moderated oxytocin effects. In the placebo condition, patients showed reduced fixation time on the eyes compared to controls. Oxytocin was associated with an increase in fixation time among patients, but a decrease among controls. Higher attachment anxiety and greater symptom severity predicted increased fixation time on the eyes on oxytocin versus placebo. Anti-dopaminergic medication dosage and attachment avoidance did not impact response to oxytocin. Consistent with findings that oxytocin optimizes processing of social stimuli, intranasal oxytocin enhanced eye gaze in men with schizophrenia. Further work is needed to determine whether changes in eye gaze impact social cognition and functional outcomes. Both attachment anxiety and symptom severity predicted oxytocin response, highlighting the importance of examining potential moderators of oxytocin effects in future studies.

Paranoia and conspiracy: group cohesion increases harmful intent attribution in the Trust Game

Current theories argue that hyper-sensitisation of social threat perception is central to paranoia. Affected people often also report misperceptions of group cohesion (conspiracy) but little is known about the cognitive mechanisms underpinning this conspiracy thinking in live interactions. In a pre-registered experimental study, we used a large-scale game theory approach (N > 1,000) to test whether the social cohesion of an opposing group affects paranoid attributions in a mixed online and lab-based sample. Participants spanning the full population distribution of paranoia played as proposers in a modified Trust Game: they were allocated a bonus and chose how much money to send to a pair of responders which was quadrupled before reaching these responders. Responders decided how much to return to the proposers through the same process. Participants played in one of two conditions: against a cohesive group who communicated and arrived at a joint decision, or a non-cohesive group who made independent decisions. After the exchange, proposers rated the extent to which the responders’ decisions were driven by (i) self-interest and (ii) intent to harm. Although the true motives are ambiguous, cohesive responders were reliably rated by participants as being more strongly motivated by intent to harm, indicating that group cohesion affects social threat perception. Highly paranoid participants attributed harmful intent more strongly overall but were equally reactive to social cohesion as other participants. This suggests that paranoia involves a generally lowered threshold for social threat detection but with an intact sensitivity for cohesion-related group characteristics.