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Díaz D, Briñol P, Bajo M, Stavraki M, Beato-Fernández L, Petty RE. The association of the persecutory ideation questionnaire with clinically-relevant and other outcomes: the moderating role of confidence. Sci Rep 2024; 14:15809. [PMID: 38982156 PMCID: PMC11233644 DOI: 10.1038/s41598-024-66846-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 07/04/2024] [Indexed: 07/11/2024] Open
Abstract
One of the most used self-administered instruments to assess persecutory delusions is the Persecutory Ideation Questionnaire (PIQ). Individual differences in PIQ scores are important because they predict the severity of symptoms associated with psychosis-related disorders. The current research demonstrates that PIQ is associated with two new outcomes: Satisfaction with life (Studies 1 and 2) and therapy length needed for hospital discharge (Study 2). Most relevant, we introduce meta-cognitive confidence in one's scale responses as a construct capable of improving the predictive validity of the PIQ. Across two studies, participants from the general population (Study 1) and from a clinical sample (Study 2) completed the PIQ and then reported the confidence in their responses. As expected, the PIQ was associated with satisfaction with life in both cases and duration of therapy required to receive hospital discharge for the clinical sample. Most importantly, confidence further moderated the extent to which the PIQ scores were linked with both outcomes, with greater consistency between the PIQ and the dependent measures obtained for those with higher confidence. Therefore, asking a single item about the confidence associated with responses to the PIQ enhances the association of PIQ scores and relevant consequences across domains.
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Affiliation(s)
- Darío Díaz
- Department of Psychology, Ciudad Real Medical School, Universidad de Castilla la Mancha, Camino de Moledores S/N, 13071, Ciudad Real, Spain.
| | | | - Miriam Bajo
- Department of Psychology, Ciudad Real Medical School, Universidad de Castilla la Mancha, Camino de Moledores S/N, 13071, Ciudad Real, Spain
| | - Maria Stavraki
- Department of Psychology, Ciudad Real Medical School, Universidad de Castilla la Mancha, Camino de Moledores S/N, 13071, Ciudad Real, Spain
| | - Luis Beato-Fernández
- Hospital General Universitario de Ciudad Real, Universidad de Castilla la Mancha, Ciudad Real, Spain
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2
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López-Carrilero R, Lo Monaco M, Frígola-Capell E, Ferrer-Quintero M, Díaz-Cutraro L, Verdaguer-Rodríguez M, García-Mieres H, Vila-Badia R, Punsoda-Puche P, Birulés I, Peláez T, Pousa E, Grasa E, Barajas A, Ruiz-Delgado I, Barrigón ML, Gonzalez-Higueras F, Lorente-Rovira E, Gutiérrez-Zotes A, Cid J, Legido T, Ayesa-Arriola R, Moritz S, Ochoa S. Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:160-167. [PMID: 38219901 DOI: 10.1016/j.sjpmh.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
Social cognition (SC) and executive function (EF) have been described as important variables for social functioning and recovery of patients with psychosis. However, the relationship between SC and EF in first-episode psychosis (FEP) deserves further investigation, especially focusing on gender differences. AIMS To investigate the relationship between EF and different domains of SC in FEP patients and to explore gender differences in the relationship between these domains. METHODS A cross-sectional study of 191 patients with new-onset psychosis recruited from two multicenter clinical trials. A comprehensive cognitive battery was used to assess SC (Hinting Task, Face Test and IPSAQ) and EF (TMT, WSCT, Stroop Test and digit span - WAIS-III). Pearson correlations and linear regression models were performed. RESULTS A correlation between Theory of Mind (ToM), Emotional Recognition (ER) and EF was found using the complete sample. Separating the sample by gender showed different association profiles between these variables in women and men. CONCLUSIONS A relationship between different domains of SC and EF is found. Moreover, women and men presented distinct association profiles between EF and SC. These results should be considered in order to improve the treatment of FEP patients and designing personalized interventions by gender.
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Affiliation(s)
- Raquel López-Carrilero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercedes Lo Monaco
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Eva Frígola-Capell
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Marta Ferrer-Quintero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Helena García-Mieres
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Regina Vila-Badia
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain
| | - Trinidad Peláez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther Pousa
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Salut Mental Parc Taulí, Sabadell, Hospital Universitari, UAB Universitat Autònoma de Barcelona, Sabadell, Spain; Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Barajas
- Serra Húnter Programme, Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Centre d'Higiene Mental Les Corts, Department of Research, Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - María Luisa Barrigón
- Departamento de Psiquiatría, Hospital Universitario Virgen del Rocio, Sevilla, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Teresa Legido
- Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unidad de Investigación en Psiquiatría (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Susana Ochoa
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Colledani D, Boragno P, Fiabane EM, Setti I, Gabanelli P. Further Validation of the Persecutory Ideation Questionnaire in the Italian Context: Results From Classical and Modern Test Theory. Assessment 2024:10731911241257012. [PMID: 38860304 DOI: 10.1177/10731911241257012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
The Persecutory Ideation Questionnaire (PIQ) is a valuable instrument to measure persecutory ideation. The aim of this study is to validate the scale in the Italian context and to extend the study of its psychometric properties using approaches from both classical and modern test theories. The results of the study, involving 700 individuals, confirmed the one-factor structure and the good validity and reliability of the scale. Full metric invariance and partial scalar and strict invariance were also supported across gender, age, and education level groups. Rasch analysis indicated that the 5-point response scale is well-functioning and that the PIQ is most appropriate to measure high levels of persecutory ideation. The results contribute to a better understanding of the measurement properties of the PIQ. The paper discusses the advantages and contributions of each method used to explore the measurement properties of the scale.
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Affiliation(s)
| | - Paola Boragno
- Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy
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Bott A, Steer HC, Faße JL, Lincoln TM. Visualizing threat and trustworthiness prior beliefs in face perception in high versus low paranoia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2024; 10:40. [PMID: 38509135 PMCID: PMC10954723 DOI: 10.1038/s41537-024-00459-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 03/12/2024] [Indexed: 03/22/2024]
Abstract
Predictive processing accounts of psychosis conceptualize delusions as overly strong learned expectations (prior beliefs) that shape cognition and perception. Paranoia, the most prevalent form of delusions, involves threat prior beliefs that are inherently social. Here, we investigated whether paranoia is related to overly strong threat prior beliefs in face perception. Participants with subclinical levels of high (n = 109) versus low (n = 111) paranoia viewed face stimuli paired with written descriptions of threatening versus trustworthy behaviors, thereby activating their threat versus trustworthiness prior beliefs. Subsequently, they completed an established social-psychological reverse correlation image classification (RCIC) paradigm. This paradigm used participants' responses to randomly varying face stimuli to generate individual classification images (ICIs) that intend to visualize either facial prior belief (threat vs. trust). An independent sample (n = 76) rated these ICIs as more threatening in the threat compared to the trust condition, validating the causal effect of prior beliefs on face perception. Contrary to expectations derived from predictive processing accounts, there was no evidence for a main effect of paranoia. This finding suggests that paranoia was not related to stronger threat prior beliefs that directly affected face perception, challenging the assumption that paranoid beliefs operate on a perceptual level.
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Affiliation(s)
- Antonia Bott
- Clinical Psychology and Psychotherapy, Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg, Germany.
| | - Hanna C Steer
- Clinical Psychology and Psychotherapy, Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Julian L Faße
- Clinical Psychology and Psychotherapy, Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg, Germany
| | - Tania M Lincoln
- Clinical Psychology and Psychotherapy, Faculty of Psychology and Human Movement Science, Universität Hamburg, Hamburg, Germany
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Bennert K, Brosnan M, Canning A, Roberts G, Russell A. Paranoia and Data-Gathering Biases in Autism. J Autism Dev Disord 2024:10.1007/s10803-024-06301-w. [PMID: 38421502 DOI: 10.1007/s10803-024-06301-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/02/2024]
Abstract
Previous research has identified contradictory patterns in autism upon probabilistic reasoning tasks, and high levels of self-report paranoia symptoms have also been reported. To explore this relationship, the present study assessed 64 non-autistic and 39 autistic adults on two variants of a probabilistic reasoning task which examined the amount of evidence required before making a decision and 'jumping to conclusions' (a neutral beads task and an emotionally-salient words variant). The autism group was found to require significantly more evidence before making a decision and to have significantly less jumping to conclusions than the non-autistic group. For those with relatively low levels of paranoia, the emotionally-salient variant impacted on the non-autistic group, but not the autism group.
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Affiliation(s)
- Kristina Bennert
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY, UK
| | - Mark Brosnan
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY, UK.
| | - Amy Canning
- Fromeside Secure Services, Avon and Wiltshire Mental Health Partnership Trust, Bristol, UK
| | - Ged Roberts
- Specialist Nurse, Bristol Autism Spectrum Service, Bristol, UK
| | - Ailsa Russell
- Centre for Applied Autism Research, Department of Psychology, University of Bath, Bath, BA2 7AY, UK
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Jacobs KA. Changes of intuition in paranoid personality disorder. Front Psychiatry 2024; 14:1307629. [PMID: 38268566 PMCID: PMC10807694 DOI: 10.3389/fpsyt.2023.1307629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/24/2023] [Indexed: 01/26/2024] Open
Abstract
Wherever psychopathology operates with the concept of (disorders of) the self and personality, it can address the role of the intuitive access we have toward ourselves, others, and the world. This study discusses the concept of oikeiôsis. It examines its role in explaining paranoia as a change in intuitive self-and-world relatedness. In the first step, symptomatic features of paranoid personality disorder are sketched, with a focus on the explanatory role of attentional and interpretative biases, which correlate with significant changes in intuitive processing. In the second step, the prototypical phenomenality of feelings of unfamiliarity and mistrust are discussed against the backdrop of changes of oikeiôsis in paranoid personality disorder. In the third step, the main therapeutic challenge in treating paranoid personality disorder-building a trustful relationship-is explored. It is concluded that the notion of oikeiôsis resonates particularly with introspection-based therapeutic approaches.
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Affiliation(s)
- Kerrin Artemis Jacobs
- Department of Philosophy, Ethics, and Religious Studies, University of Hokkaido, Sapporo, Japan
- Center for Human Nature, Artificial Intelligence, and Neuroscience (CHAIN), University of Hokkaido, Sapporo, Japan
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Ito S, Matsumoto J, Hashimoto R, Ishimaru K. Development of the Delusional Interpretation Scale and examination of related variables. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e156. [PMID: 38868731 PMCID: PMC11114438 DOI: 10.1002/pcn5.156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 10/22/2023] [Accepted: 10/26/2023] [Indexed: 06/14/2024]
Abstract
Aim Delusions are a common symptom in schizophrenia. Some scales have been developed to measure delusional tendencies in healthy people, and nonpathological delusional thinking can occur even among these individuals. The existing scales measure the presence and frequency of delusional thoughts, distress levels, and confidence levels. However, these scales are limited because they do not consider the context of the delusions (i.e., where, with whom, and when). In this study, we developed a new scale that presents detailed scenes using illustrations and sentences and measures the tendency toward delusional interpretations. Methods Factor analysis was conducted to confirm the factor structure of the new scale. To examine the validity of the scale, we analyzed the correlations between delusional tendencies and related variables and verified the consistency between the current scale and previously developed tools. Results Factor analysis confirmed that the new scale has a two-factor structure, including "internal attribution and paranoid tendency" and "external attribution tendency." The new scale was found to have acceptable reliability and validity. The internal attribution and paranoid tendency factor was negatively correlated with self-esteem and decentering. Furthermore, the internal attribution and paranoid tendency factor showed a moderate positive correlation with depressive state and anxiety tendency and a very weak positive correlation with experiences of bullying or harassment. Conclusion The correlations between the new scale and related variables confirmed the construct validity and replicated the results reported in previous studies. This new scale enables the measurement of delusional tendencies in healthy subjects based on the social context.
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Affiliation(s)
- Satsuki Ito
- Department of Developmental and Clinical Psychology, The Division of Human Developmental Sciences, Graduate School of Humanity and SciencesOchanomizu UniversityTokyoJapan
- Department of Pathology of Mental Diseases, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Junya Matsumoto
- Department of Pathology of Mental Diseases, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental HealthNational Center of Neurology and PsychiatryTokyoJapan
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Lüdtke T, Hedelt KS, Westermann S. Predictors of paranoia in the daily lives of people with non-affective psychosis and non-clinical controls: A systematic review of intensive longitudinal studies. J Behav Ther Exp Psychiatry 2023; 81:101885. [PMID: 37354896 DOI: 10.1016/j.jbtep.2023.101885] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 05/08/2023] [Accepted: 05/27/2023] [Indexed: 06/26/2023]
Abstract
BACKGROUND AND OBJECTIVES Worrying, self-esteem, sleep problems, anomalous internal experiences, reasoning biases, and interpersonal sensitivity are associated with paranoia. However, no review has examined whether these variables function as predictors of paranoia in everyday life. The present systematic review of intensive longitudinal studies (e.g., experience sampling) examined contemporaneous and time-lagged associations between paranoia and each candidate mechanism in individuals with non-affective psychosis and controls (pre-registration: https://osf.io/uwr9d). METHODS We searched electronic databases, PsyArXiv, and reference lists for studies published since 1994. RESULTS Of n = 5,918 results, n = 54 fulfilled inclusion criteria (n = 43 datasets). Most studies examined individuals with non-affective psychosis (n = 34). Strong evidence emerged for negative affect (subsumed under 'anomalous internal experiences') and sleep problems. For self-esteem, results suggest contemporaneous and lagged effects on paranoia but associations are likely driven by between-person variance. The low number of studies (n = 2 studies each) allowed no conclusions regarding worrying and reasoning biases. Findings on interpersonal sensitivity, which should be interpreted with caution because of the predictor's conceptual overlap with paranoia, indicate contemporaneous effects whereas time-lagged and within-person associations could not be judged due to insufficient data. LIMITATIONS The present review used a narrative data-synthetization and it did not cover outcomes such as hallucinations. CONCLUSIONS Despite convincing evidence for affect and sleep problems, it remains unclear whether affective states are precursors or also consequences of paranoia (vicious circle), and which of the actigraphy measures (sleep time, -efficiency, -fragmentation, etc.) best predicts paranoia.
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Affiliation(s)
- Thies Lüdtke
- Department of Human Medicine, MSH Medical School Hamburg, Hamburg, Germany.
| | | | - Stefan Westermann
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
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Ellett L, Varese F, Owens J, Rafiq S, Penn G, Berry K. Experimental studies of paranoid thinking in clinical and nonclinical populations: a systematic review and meta-analysis. Psychol Med 2023; 53:5933-5944. [PMID: 37427557 PMCID: PMC10520588 DOI: 10.1017/s0033291723001708] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/10/2023] [Accepted: 05/24/2023] [Indexed: 07/11/2023]
Abstract
Paranoia is common in clinical and nonclinical populations, consistent with continuum models of psychosis. A number of experimental studies have been conducted that attempt to induce, manipulate or measure paranoid thinking in both clinical and nonclinical populations, which is important to understand causal mechanisms and advance psychological interventions. Our aim was to conduct a systematic review and meta-analysis of experimental studies (non-sleep, non-drug paradigms) on psychometrically assessed paranoia in clinical and nonclinical populations. The review was conducted using PRISMA guidelines. Six databases (PsycINFO, PubMed, EMBASE, Web of Science, Medline and AMED) were searched for peer-reviewed experimental studies using within and between-subject designs to investigate paranoia in clinical and nonclinical populations. Effect sizes for each study were calculated using Hedge's g and were integrated using a random effect meta-analysis model. Thirty studies were included in the review (total n = 3898), which used 13 experimental paradigms to induce paranoia; 10 studies set out to explicitly induce paranoia, and 20 studies induced a range of other states. Effect sizes for individual studies ranged from 0.03 to 1.55. Meta-analysis found a significant summary effect of 0.51 [95% confidence interval 0.37-0.66, p < 0.001], indicating a medium effect of experimental paradigms on paranoia. Paranoia can be induced and investigated using a wide range of experimental paradigms, which can inform decision-making about which paradigms to use in future studies, and is consistent with cognitive, continuum and evolutionary models of paranoia.
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Affiliation(s)
- Lyn Ellett
- School of Psychology, University of Southampton, UK
| | - Filippo Varese
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Jane Owens
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK
- NHS Lothian, Edinburgh, UK
| | - Sonya Rafiq
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, UK
| | - Georgia Penn
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK
| | - Katherine Berry
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, UK
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, UK
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10
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Eriksdotter M, Joutsimäki K, Johnsson P. Knowing me, knowing you: a scoping review assessing the current field of social cognition in schizophrenia. Nord J Psychiatry 2023; 77:627-640. [PMID: 37366305 DOI: 10.1080/08039488.2023.2226114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 06/06/2023] [Accepted: 06/11/2023] [Indexed: 06/28/2023]
Abstract
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.
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Affiliation(s)
| | | | - Per Johnsson
- Department of Psychology, Lund University, Lund, Sweden
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11
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Collin S, Rowse G, Martinez AP, Bentall RP. Delusions and the dilemmas of life: A systematic review and meta-analyses of the global literature on the prevalence of delusional themes in clinical groups. Clin Psychol Rev 2023; 104:102303. [PMID: 37390804 DOI: 10.1016/j.cpr.2023.102303] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/31/2023] [Accepted: 06/14/2023] [Indexed: 07/02/2023]
Abstract
We investigated the prevalence of persecutory, grandiose, reference, control, and religious delusions in adult clinical populations worldwide and whether they differed according to country characteristics or age, gender, or year of publication. 123 studies met inclusion criteria, across 30 countries; 102 (115 samples, n = 20,979) were included in the main random-effects meta-analysis of studies measuring multiple delusional themes (21 in a separate analysis of studies in recording a single theme). Persecutory delusions were most common (pooled point estimate: 64.5%, CI = 60.6-68.3, k = 106, followed by reference (39.7%, CI 34.5-45.3, k = 65), grandiose (28.2, CI 24.8-31.9, k = 100), control 21.6%, CI 17.8-26.0, k = 53), and religious delusions 18.3%, CI 15.4-21.6, k = 50). Data from studies recording one theme were broadly consistent with these findings. There were no effects for study quality or publication date. Prevalences were higher in samples exclusively with psychotic patients but did not differ between developed and developing countries, or by country individualism, power distance, or prevalence of atheism. Religious and control delusions were more prevalent in countries with higher income inequality. We hypothesize that these delusional themes reflect universal human dilemmas and existential challenges.
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Affiliation(s)
- Sophie Collin
- Clinical Psychology Unit, Department of Psychology, University of Sheffield
| | - Georgina Rowse
- Clinical Psychology Unit, Department of Psychology, University of Sheffield
| | - Anton P Martinez
- Clinical Psychology Unit, Department of Psychology, University of Sheffield
| | - Richard P Bentall
- Clinical Psychology Unit, Department of Psychology, University of Sheffield.
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12
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Kingston JL, Schlier B, Lincoln T, So SH, Gaudiano BA, Morris EMJ, Phiri P, Ellett L. Paranoid Thinking as a Function of Minority Group Status and Intersectionality: An International Examination of the Role of Negative Beliefs. Schizophr Bull 2023; 49:1078-1087. [PMID: 36940411 PMCID: PMC10318883 DOI: 10.1093/schbul/sbad027] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/22/2023]
Abstract
BACKGROUND Paranoia is higher in minority group individuals, especially those reporting intersecting aspects of difference. High negative and low positive self and other beliefs, and low social rank, are predictive of paranoia overtime; however, data are typically from majority group participants. This study examined whether social defeat or healthy cultural mistrust best characterizes paranoia in minority groups. STUDY DESIGN Using cross-sectional, survey design, with a large (n = 2510) international sample, moderation analyses (PROCESS) examined whether self and other beliefs, and perceived social rank, operate similarly or differently in minority vs majority group participants. Specifically, we tested whether beliefs moderated the influence of minority group, and intersecting aspects of difference, on paranoia. STUDY RESULTS Paranoia was consistently higher in participants from minority vs majority groups and level of paranoid thinking was significantly higher at each level of the intersectionality index. Negative self/other beliefs were associated with elevated paranoia in all participants. However, in support of the notion of healthy cultural mistrust, low social rank, and low positive self/other beliefs were significantly associated with paranoia in majority group participants but unrelated to paranoia in respective minority group members. CONCLUSIONS Although mixed, our findings signal the need to consider healthy cultural mistrust when examining paranoia in minority groups and bring into question whether "paranoia" accurately describes the experiences of marginalized individuals, at least at low levels of severity. Further research on paranoia in minority groups is crucial to developing culturally appropriate ways of understanding people's experiences in the context of victimization, discrimination, and difference.
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Affiliation(s)
- J L Kingston
- Department of Psychology, Royal Holloway, University of London, Bowyer, UK
| | - B Schlier
- University of Hamburg, Institute for Psychology, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146, Hamburg, Germany
| | - T Lincoln
- University of Hamburg, Institute for Psychology, Department of Clinical Psychology and Psychotherapy, Von-Melle-Park 5, 20146, Hamburg, Germany
| | - S H So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - B A Gaudiano
- Department of Psychiatry & Human Behavior, Brown University and Butler Hospital, Providence, RI, USA
| | - E M J Morris
- School of Psychology & Public Health, La Trobe University, Bundoora, Melbourne, Australia
| | - P Phiri
- Southern Health NHS Foundation Trust, Botley Rd, West End, UK
- School of Psychology, University of Southampton, Southampton, UK
| | - L Ellett
- School of Psychology, University of Southampton, Southampton, UK
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13
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Shi JY, Cao YM, Luo HY, Liu S, Yang FM, Wang ZH. Effect of a group-based acceptance and commitment therapy (ACT) intervention on self-esteem and psychological flexibility in patients with schizophrenia in remission. Schizophr Res 2023; 255:213-221. [PMID: 37012184 DOI: 10.1016/j.schres.2023.03.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 02/26/2023] [Accepted: 03/18/2023] [Indexed: 04/05/2023]
Abstract
The present study explored whether acceptance and commitment therapy (ACT), a cognitive behavioral therapy approach, could improve the symptoms of schizophrenia spectrum disorders among patients with schizophrenia in remission. A pre- and post-treatment design with two evaluation time points was employed. Sixty outpatients with schizophrenia in remission were randomly divided into two groups: the ACT plus treatment as usual (ACT+TAU) and treatment as usual (TAU) groups. The ACT+TAU group participated in 10 group-based ACT interventions and TAU in the hospital, and the TAU group only received TAU interventions. General psycho-pathological symptoms, self-esteem, and psychological flexibility were assessed before intervention (baseline; pre-test) and after intervention (five weeks; post-test). Results indicated that, compared to the TAU group, the ACT+TAU group exhibited a more significant improvement in general psychopathological symptoms, self-esteem, cognitive fusion, and acceptance and action at post-test. ACT intervention could effectively decrease the general psycho-pathological symptoms and increase self-esteem level and psychological flexibility in people with schizophrenia in remission.
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Affiliation(s)
- Jun-Yan Shi
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, People's Republic of China; Department of Medical Psychology, Mental Health Hospital affiliated to Shanxi Medical University, Taiyuan 030001, People's Republic of China
| | - Yan-Mei Cao
- School of Humanalities and Social Science, Shanxi Medical University, Taiyuan, People's Republic of China
| | | | - Sha Liu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, People's Republic of China
| | - Fa-Ming Yang
- Shanxi Acupuncture and Moxibustion Hospital, Taiyuan, People's Republic of China
| | - Zhen-Hong Wang
- School of Psychology, Shaanxi Normal University, Shaanxi Provincial Key Research Center of Child Mental and Behavioral Health, Xi'an, People's Republic of China.
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14
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Monsonet M, Amedy A, Kwapil TR, Barrantes-Vidal N. A psychosocial pathway to paranoia: The interplay between social connectedness and self-esteem. Schizophr Res 2023; 254:199-207. [PMID: 36931182 DOI: 10.1016/j.schres.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/11/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023]
Abstract
The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness to perceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Amad Amedy
- Department of Psychology, Vanderbilt University, United States of America
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER de Salud Mental, Instituto de Salud Carlos III, Spain.
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15
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Ellett L, Kingston J, Tarant E, Kouimtsidis C, Vivarelli L, Chadwick P. Self-Structure in Persecutory Delusions. Behav Ther 2023; 54:132-140. [PMID: 36608970 DOI: 10.1016/j.beth.2022.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/15/2022] [Accepted: 07/26/2022] [Indexed: 01/14/2023]
Abstract
There is currently limited research examining self-structure in clinical groups and no current data on the extent to which self-structure is amendable to change following psychological therapy. We address this important gap by examining self-structure in individuals with persecutory delusions using the card sort task, an established paradigm measuring key self-structure indices, including the degree to which self-structure is compartmentalized (characterized by primarily positive or negative attributes, as opposed to a mix of both), and the proportion and importance of negative attributes. In Study 1, individuals with a schizophrenia spectrum diagnosis with current persecutory delusions (clinical group, n = 27) and a healthy control group (n = 47) were compared on self-structure indices. In Study 2 (n = 27), the clinical group also completed the card sort task before and after randomization to either a 12-week mindfulness-based psychological therapy or treatment-as-usual control. In Study 1, self-structure differed significantly between the clinical and control groups. The clinical group had a greater proportion of negative attributes, assigned more importance to negative self-aspects, and had more compartmentalized self-structures compared with controls. In Study 2 there were no associations between delusion severity and self-structure. Large effect sizes for reductions in compartmentalization and proportion of negative attributes across self-aspects were found following mindfulness therapy. The findings highlight key differences in self-structure between individuals with persecutory delusions and healthy controls, and suggest that it might be possible to change self-structure following psychological therapy. These data support the central role of the self in theoretical models of paranoid thinking.
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Affiliation(s)
| | | | - Eryna Tarant
- Surrey and Borders Partnership NHS Foundation Trust
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16
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Perceived ostracism and paranoia: A test of potential moderating effects of psychological flexibility and inflexibility. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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17
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Pena-Garijo J, Palop-Grau A, Masanet MJ, Lacruz M, Plaza R, Hernández-Merino A, Edo-Villamón S, Valllina O. Self-reported cognitive biases in psychosis: Validation of the Davos Assessment of Cognitive Biases Scale (DACOBS) in a Spanish sample of psychotic patients and healthy controls. J Psychiatr Res 2022; 155:526-533. [PMID: 36191521 DOI: 10.1016/j.jpsychires.2022.09.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 09/10/2022] [Accepted: 09/23/2022] [Indexed: 10/31/2022]
Abstract
Cognitive biases have been demonstrated to be important in developing and maintaining psychosis. However, self-report measures for everyday clinical practice have been developed only recently. We aimed to study one of these instruments for assessing cognitive biases: the Davos Assessment of Cognitive Biases Scale (DACOBS). In a Spanish sample of 84 patients diagnosed with schizophrenia-spectrum disorders and 152 healthy controls, we examined a) the factor structure using Confirmatory Factor Analysis (CFA) to test the original one-, three- and seven-factor solutions, b) the reliability (Cronbach's alpha), c) the discriminative power (Multivariate Analysis of Covariance - MANCOVA) and d) the relationships of cognitive biases with positive psychotic-like experiences (PPLEs) in healthy individuals and with psychotic symptoms in schizophrenia-spectrum patients. The CFA revealed that the seven-factor solution achieved the best fit. The DACOBS overall scale (Cronbach's alpha = .92) and subscales obtained good internal consistencies. MANCOVA, controlling for age and education, demonstrated that all subscales differentiated between healthy controls and psychotic patients (Wilks' Lambda = 0.87; F7, 226 = 4.70; p < .000; partial eta squared = 0.13). In addition, the DACOBS showed high correlations with PPLEs (controls) and moderate correlations with positive and general symptoms (patients), demonstrating its predictive validity. Concluding, the DACOBS proved to be a psychometrically suitable instrument for assessing cognitive biases in psychosis and adequately differentiated between patients and healthy individuals within the Spanish population. Norm scores are provided.
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Affiliation(s)
| | | | | | - María Lacruz
- University Hospital Doctor Peset, Valencia, Spain
| | - Rut Plaza
- University Hospital Doctor Peset, Valencia, Spain
| | | | - Silvia Edo-Villamón
- Consorcio Hospitalario Provincial of Castellon, Castellon de La Plana, Spain
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18
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Martinez AP, Shevlin M, Valiente C, Hyland P, Bentall RP. Paranoid beliefs and conspiracy mentality are associated with different forms of mistrust: A three-nation study. Front Psychol 2022; 13:1023366. [PMID: 36329737 PMCID: PMC9623260 DOI: 10.3389/fpsyg.2022.1023366] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 09/13/2022] [Indexed: 01/05/2024] Open
Abstract
Paranoia and conspiracy are terms typically used interchangeably. However, although the underlying content of these types of beliefs might be similar (e.g., seeing others as powerful and threatening), recent research suggests that these constructs differ in important ways. One important feature shared by both constructs is excessive mistrust but this aspect might play different roles in each belief system. In this study we explored the strength of associations of different trust predictors (i.e., trust in institutions, trust in sources of information, perceptual trust, and interpersonal trust) between conspiracy mentality and paranoid beliefs. We tested this association in a large representative multinational sample (United Kingdom n = 2025; Spain n = 1951; and Ireland n = 1041). Confirmatory factor analysis supported a two-factor model of conspiracy and paranoid beliefs in each nation sample. Path and equality of constraints analysis revealed that paranoia was more strongly associated with perceptual mistrust (bias towards mistrusting unfamiliar faces) whereas conspiracy was more strongly associated with mistrust in political institutions. Although interpersonal mistrust and trust in social sources of information were associated significantly with conspiracy their association with paranoid beliefs was stronger. These findings clarify the role of different trust processes in both belief systems. Limitations of this study are discussed.
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Affiliation(s)
- Anton P. Martinez
- Department of Psychology, The University of Sheffield, Sheffield, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, United Kingdom
| | - Carmen Valiente
- Department of Personality Assessment and Clinical Psychology, Complutense University of Madrid, Madrid, Spain
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Richard P. Bentall
- Department of Psychology, The University of Sheffield, Sheffield, United Kingdom
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19
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Herms EN, Bolbecker AR, Wisner KM. Emotion regulation and delusion-proneness relate to empathetic tendencies in a transdiagnostic sample. Front Psychiatry 2022; 13:992757. [PMID: 36226099 PMCID: PMC9548608 DOI: 10.3389/fpsyt.2022.992757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 09/08/2022] [Indexed: 11/24/2022] Open
Abstract
Empathetic tendencies (i.e., perspective taking and empathic concern) are a key factor in interpersonal relationships, which may be impacted by emotion regulation (i.e., reappraisal and suppression) and mental health symptoms, such as psychotic-like experiences. However, it is unclear if certain psychotic-like experiences, such as delusion-proneness, are still associated with reduced empathetic tendencies after accounting for emotion regulation style and dimensions of psychopathology that are often comorbid. In the current study, linear models tested these associations in a transdiagnostic community sample (N = 128), using the Interpersonal Reactivity Index (IRI), Emotion Regulation Questionnaire, and the Peter's Delusion Inventory. Results indicated that perspective taking was positively associated with reappraisal and negatively associated with delusion-proneness, after controlling for age, sex, race, intelligence, and symptoms of anxiety and depression. A significant change in R 2 supported the addition of delusion-proneness in this model. Specificity analyses demonstrated perspective taking was also negatively associated with suppression, but this relationship did not remain after accounting for the effects of reappraisal and delusion-proneness. Additional specificity analyses found no association between empathic concern and reappraisal or delusion-proneness but replicated previous findings that empathic concern was negatively associated with suppression. Taken together, delusion-proneness accounts for unique variance in perspective taking, which can inform future experimental research and may have important implications for psychosocial interventions.
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Affiliation(s)
- Emma N. Herms
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Amanda R. Bolbecker
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
| | - Krista M. Wisner
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, United States
- Program of Neuroscience, Indiana University, Bloomington, IN, United States
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20
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Zamfir E, Dayan P. Interactions between attributions and beliefs at trial-by-trial level: Evidence from a novel computer game task. PLoS Comput Biol 2022; 18:e1009920. [PMID: 36155635 PMCID: PMC9536582 DOI: 10.1371/journal.pcbi.1009920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 10/06/2022] [Accepted: 08/28/2022] [Indexed: 11/19/2022] Open
Abstract
Inferring causes of the good and bad events that we experience is part of the process of building models of our own capabilities and of the world around us. Making such inferences can be difficult because of complex reciprocal relationships between attributions of the causes of particular events, and beliefs about the capabilities and skills that influence our role in bringing them about. Abnormal causal attributions have long been studied in connection with psychiatric disorders, notably depression and paranoia; however, the mechanisms behind attributional inferences and the way they can go awry are not fully understood. We administered a novel, challenging, game of skill to a substantial population of healthy online participants, and collected trial-by-trial time series of both their beliefs about skill and attributions about the causes of the success and failure of real experienced outcomes. We found reciprocal relationships that provide empirical confirmation of the attribution-self representation cycle theory. This highlights the dynamic nature of the processes involved in attribution, and validates a framework for developing and testing computational accounts of attribution-belief interactions. As part of interpreting our experiences, we spontaneously make causal attributions and use them to update our beliefs about the world, ourselves and others. This has long been a topic of interest, particularly within psychiatry. Some theories assume that people have stable “attributional styles”, others focus on the changing nature of attribution-making and on the relationships between attributions and one’s beliefs about the self, suggesting that the two are mutually connected. In this area of research, people have traditionally been asked to imagine themselves experiencing various significant life events and report on how they would interpret those, or have been exposed to artificial and highly simplified situations in the lab. In this work, we introduce a new task to study relationships between causal attributions and beliefs: repeatedly playing an engaging and relatively complex game of skill. We show that we can detect mutual influences between attributions and beliefs at the level of individual wins and losses. This has implications for how everyday successes and failures impact our beliefs about ourselves and our well-being. It also could help understand how our interpretations of negative experiences can spiral out of control, affecting our mental health.
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Affiliation(s)
- Elena Zamfir
- Department of Education, University of Oxford, Oxford, United Kingdom
- * E-mail:
| | - Peter Dayan
- Max Plack Institute for Biological Cybernetics, Tuebingen, Germany
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21
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Fan L, Bass E, Klein H, Springfield C, Pinkham A. A preliminary investigation of paranoia variability and its association with social functioning. Schizophr Res Cogn 2022; 29:100258. [PMID: 35620385 PMCID: PMC9126935 DOI: 10.1016/j.scog.2022.100258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/12/2022] [Accepted: 05/13/2022] [Indexed: 12/21/2022]
Abstract
Background Paranoid ideation is a core feature of psychosis and is associated with impaired social functioning. Severity of paranoia can fluctuate across time as symptoms wax and wane; however, no study has systematically investigated how this intra-individual variability in paranoia may relate to social impairments and social functioning. Methods Fifty-five patients with DSM-5 diagnoses and recent paranoia were followed for up to one year and completed the suspiciousness/persecution section (P6) of the Positive and Negative Symptom Scale (PANSS) on a monthly basis to monitor fluctuations in paranoia. Categorical changes between paranoid and non-paranoid status were monitored and tallied. Participants self-reported current paranoia and anxiety levels as well as social functioning when demonstrating paranoia changes. Results Most patients showed changes between paranoid categories (60%). Individuals with no paranoia change showed higher current paranoia and lower independence-competence subscores of the Birchwood Social Functioning Scale (SFS) compared with those with one change. Current paranoia and state anxiety explained significant variance in the prosocial activities subscore of SFS, and importantly, paranoia changes accounted for variance above and beyond these effects. Individuals with higher current paranoia participated less in prosocial activities, however those with higher paranoia variability were more involved in social activities. Similarly, individuals with more paranoia variability demonstrated better overall social functioning as measured by the averaged SFS total score. Conclusion Paranoia fluctuation is prevalent across time, and both paranoia severity and variability impact social functioning, in that lower levels of paranoia severity and higher levels of paranoia variability are associated with better interpersonal functioning.
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Affiliation(s)
- Linlin Fan
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Emily Bass
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Hans Klein
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Cassi Springfield
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | - Amy Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, United States
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22
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Adams RA, Vincent P, Benrimoh D, Friston KJ, Parr T. Everything is connected: Inference and attractors in delusions. Schizophr Res 2022; 245:5-22. [PMID: 34384664 PMCID: PMC9241990 DOI: 10.1016/j.schres.2021.07.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 02/06/2023]
Abstract
Delusions are, by popular definition, false beliefs that are held with certainty and resistant to contradictory evidence. They seem at odds with the notion that the brain at least approximates Bayesian inference. This is especially the case in schizophrenia, a disorder thought to relate to decreased - rather than increased - certainty in the brain's model of the world. We use an active inference Markov decision process model (a Bayes-optimal decision-making agent) to perform a simple task involving social and non-social inferences. We show that even moderate changes in some model parameters - decreasing confidence in sensory input and increasing confidence in states implied by its own (especially habitual) actions - can lead to delusions as defined above. Incorporating affect in the model increases delusions, specifically in the social domain. The model also reproduces some classic psychological effects, including choice-induced preference change, and an optimism bias in inferences about oneself. A key observation is that no change in a single parameter is both necessary and sufficient for delusions; rather, delusions arise due to conditional dependencies that create 'basins of attraction' which trap Bayesian beliefs. Simulating the effects of antidopaminergic antipsychotics - by reducing the model's confidence in its actions - demonstrates that the model can escape from these attractors, through this synthetic pharmacotherapy.
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Affiliation(s)
- Rick A Adams
- Centre for Medical Image Computing, Dept of Computer Science, University College London, 90 High Holborn, London WC1V 6LJ, UK; Max Planck Centre for Computational Psychiatry and Ageing Research, University College London, Russell Square House, 10-12 Russell Square, London WC1B 5EH, UK.
| | - Peter Vincent
- Sainsbury Wellcome Centre, University College London, 25 Howland St, London W1T 4JG, UK
| | - David Benrimoh
- Department of Psychiatry, McGill University, H3G 1A4 QC, Canada
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
| | - Thomas Parr
- Wellcome Centre for Human Neuroimaging, University College London, 12 Queen Square, London WC1N 3AR, UK
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23
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Barnby JM, Mehta MA, Moutoussis M. The computational relationship between reinforcement learning, social inference, and paranoia. PLoS Comput Biol 2022; 18:e1010326. [PMID: 35877675 PMCID: PMC9352206 DOI: 10.1371/journal.pcbi.1010326] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 08/04/2022] [Accepted: 06/23/2022] [Indexed: 11/18/2022] Open
Abstract
Theoretical accounts suggest heightened uncertainty about the state of the world underpin aberrant belief updates, which in turn increase the risk of developing a persecutory delusion. However, this raises the question as to how an agent's uncertainty may relate to the precise phenomenology of paranoia, as opposed to other qualitatively different forms of belief. We tested whether the same population (n = 693) responded similarly to non-social and social contingency changes in a probabilistic reversal learning task and a modified repeated reversal Dictator game, and the impact of paranoia on both. We fitted computational models that included closely related parameters that quantified the rigidity across contingency reversals and the uncertainty about the environment/partner. Consistent with prior work we show that paranoia was associated with uncertainty around a partner's behavioural policy and rigidity in harmful intent attributions in the social task. In the non-social task we found that pre-existing paranoia was associated with larger decision temperatures and commitment to suboptimal cards. We show relationships between decision temperature in the non-social task and priors over harmful intent attributions and uncertainty over beliefs about partners in the social task. Our results converge across both classes of model, suggesting paranoia is associated with a general uncertainty over the state of the world (and agents within it) that takes longer to resolve, although we demonstrate that this uncertainty is expressed asymmetrically in social contexts. Our model and data allow the representation of sociocognitive mechanisms that explain persecutory delusions and provide testable, phenomenologically relevant predictions for causal experiments.
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Affiliation(s)
- Joseph M. Barnby
- Department of Psychology, Royal Holloway, University of London, London, United Kingdom
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Mitul A. Mehta
- Cultural and Social Neuroscience Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
- Neuropharmacology Group, Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, University of London, London, United Kingdom
| | - Michael Moutoussis
- Wellcome Centre for Human Neuroimaging, University College London, London, United Kingdom
- Max-Planck–UCL Centre for Computational Psychiatry and Ageing, University College London, London, United Kingdom
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24
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Faith LA, Lecomte T, Corbière M, Lysaker PH. Metacognitive mastery moderates the relationship between positive symptoms and distress in adults with serious mental illness. J Ment Health 2022:1-8. [PMID: 35766302 DOI: 10.1080/09638237.2022.2091758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Research supports the possibility that a person's metacognitive ability may influence the impact of positive symptoms. This connection is important because understanding how metacognitive capacity relates to positive symptoms and distress can guide treatment and bolster recovery. AIMS To explore this, we assessed the moderating role of Metacognitive Mastery on the relationship of positive symptoms to affective symptoms, or markers of distress, measured both concurrently and at a later time point (to assess durability of metacognition) with persons with serious mental illness. To rule out the possibility that any findings were the result of cognitive impairments or general psychopathology we included measures of neurocognition and symptoms as potential covariates. METHODS Participants were 67 individuals with the majority diagnosed with either schizophrenia spectrum disorder, major depressive disorder, or bipolar disorder. Metacognition was measured with the Metacognitive Assessment Scale-Abbreviated, symptoms were measured using the Brief Psychiatric Rating Scale and verbal memory was measured using the California Verbal Learning Test. RESULTS Metacognitive Mastery moderated the relationship between positive symptoms and affective symptoms at both time points with differential patterns at each point. CONCLUSIONS Metacognitive Mastery may exert a complex influence upon the effects of positive symptoms on distress.
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Affiliation(s)
- Laura A Faith
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychology, University of Missouri, Kansas City, MO, USA
| | - Tania Lecomte
- Department of Psychology, University of Montreal, Montreal, QC, USA
| | - Marc Corbière
- Department of Psychology, University of Montreal, Montreal, QC, USA
| | - Paul H Lysaker
- Richard L Roudebush VA Medical Center, Indianapolis, IN, USA.,Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
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25
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Monsonet M, Rockwood NJ, Kwapil TR, Barrantes-Vidal N. Psychological Pathways to Paranoia and Psychotic-Like Experiences in Daily-Life: The Mediating Role of Distinct Affective Disturbances. Schizophr Bull 2022; 48:1053-1065. [PMID: 35759215 PMCID: PMC9434429 DOI: 10.1093/schbul/sbac071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND HYPOTHESIS Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype. STUDY DESIGN Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions. STUDY RESULTS Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found. CONCLUSIONS This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- To whom correspondence should be addressed; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain; tel: 34-93-581-38-64, fax: 34-93-581-21-25, e-mail:
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26
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Trucharte A, Valiente C, Espinosa R, Chaves C. The role of insecure attachment and psychological mechanisms in paranoid and depressive symptoms: An exploratory model. Schizophr Res 2022; 243:9-16. [PMID: 35220038 DOI: 10.1016/j.schres.2022.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 12/01/2022]
Abstract
Attachment theory is considered an important theoretical framework for understanding the ontogenesis of psychopathology. In this regard, insecure attachment styles have been associated with the development and maintenance of paranoid and depressive symptoms. Furthermore, different psychological processes (i.e., self-esteem and experiential avoidance) have been identified as mediating mechanisms between the relationship of insecure attachment and these symptoms. Nowadays, there is a more positive view in psychology focusing on factors that contribute to well-being, although little is known about the role of these psychological well-being variables as mediators between insecure attachment and psychopathology. For thus, the aim of this study was to test one explorative structural equation model of insecure attachment on paranoid and depressive symptoms through psychological mediating mechanisms to elucidate the processes involved in each of them. To evaluate the model, 141 individuals with severe psychiatric conditions participated in the study. The results revealed good model fit, highlighting that avoidant attachment has a direct and indirect effect on the symptoms, while anxious attachment has only an indirect effect through mediating mechanisms. On the other hand, lower levels of self-acceptance and environmental mastery have been identified as important processes associated with paranoid and depressive symptoms. However, less positive relationships were a significant mediating mechanism only for paranoid ideation symptoms. These results have important clinical implications by shedding light on the relationship between insecure attachment, paranoid and depressive symptoms, and the psychological mediating mechanisms involved in this relationship, which may be considered key variables in clinical treatments.
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Affiliation(s)
- Almudena Trucharte
- Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain.
| | - Carmen Valiente
- Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
| | - Regina Espinosa
- Department of Psychology, Faculty of Health, Camilo Jose Cela University, Madrid, Spain
| | - Covadonga Chaves
- Personality, Evaluation and Clinical Psychology, Faculty of Psychology, Complutense University of Madrid, Madrid, Spain
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27
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Alsuhibani A, Shevlin M, Freeman D, Sheaves B, Bentall RP. Why conspiracy theorists are not always paranoid: Conspiracy theories and paranoia form separate factors with distinct psychological predictors. PLoS One 2022; 17:e0259053. [PMID: 35389988 PMCID: PMC8989304 DOI: 10.1371/journal.pone.0259053] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 10/11/2021] [Indexed: 01/12/2023] Open
Abstract
Paranoia and belief in conspiracy theories both involve suspiciousness about the intentions of others but have rarely been studied together. In three studies, one with a mainly student sample (N = 496) and two with more representative UK population samples (N = 1,519, N = 638) we compared single and two-factor models of paranoia and conspiracy theories as well as associations between both belief systems and other psychological constructs. A model with two correlated factors was the best fit in all studies. Both belief systems were associated with poor locus of control (belief in powerful others and chance) and loneliness. Paranoid beliefs were specifically associated with negative self-esteem and, in two studies, insecure attachment; conspiracy theories were associated with positive self-esteem in the two larger studies and narcissistic personality traits in the final study. Conspiracist thinking but not paranoia was associated with poor performance on the Cognitive Reflection Task (poor analytical thinking). The findings suggest that paranoia and belief in conspiracy theories are distinct but correlated belief systems with both common and specific psychological components.
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Affiliation(s)
- Azzam Alsuhibani
- Department of Psychology, King Saud University, Riyadh, Saudi Arabia
| | - Mark Shevlin
- Department of Psychology, University of Ulster, Ulster, United Kingdom
| | - Daniel Freeman
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Bryony Sheaves
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Richard P. Bentall
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, United Kingdom
- * E-mail:
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28
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Cavieres A, Acuña V, Wachtendorff C, Maldonado R. People with schizophrenia use less information to interpret ambiguous social situations. J Behav Ther Exp Psychiatry 2022; 74:101690. [PMID: 34753052 DOI: 10.1016/j.jbtep.2021.101690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/11/2021] [Accepted: 08/28/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND AND OBJECTIVES The tendency of people with schizophrenia to gather insufficient information before making decisions or jumping to conclusions has been repeatedly reported. However, criticism has also been expressed regarding the ecological validity of this finding. Here we present the results obtained by a group of people with schizophrenia and a control group in a non-probabilistic task that requires obtaining items of information before interpreting an ambiguous social situation. METHODS Patients with schizophrenia (n = 48) and controls (n = 44) aged 18-50 years participated in the study. All subjects completed the Beads Task and the modified Social Information Preference Task. RESULTS Patients with schizophrenia showed a statistically significant tendency to jump to conclusions, including in the proposed novel social task. Unlike other studies, we were unable to find a relationship between this bias and greater severity of psychotic symptoms. LIMITATIONS We did not include patients with high levels of psychotic symptoms or a clinical control group. CONCLUSIONS The tendency to jump to conclusions in schizophrenia could be present in everyday interpersonal situations.
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Affiliation(s)
- Alvaro Cavieres
- Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile.
| | - Vanessa Acuña
- Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile
| | | | - Rocío Maldonado
- Departamento de Psiquiatría, Universidad de Valparaíso, Valparaíso, Chile
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29
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So SHW, Zhu C, Lincoln TM, Gaudiano BA, Kingston JL, Ellett L, Morris EMJ. Pandemic paranoia, general paranoia, and their relationships with worry and beliefs about self/others - A multi-site latent class analysis. Schizophr Res 2022; 241:122-129. [PMID: 35121437 DOI: 10.1016/j.schres.2022.01.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/18/2022] [Accepted: 01/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, an increase in paranoid thinking has been reported internationally. The development of the Pandemic Paranoia Scale (PPS) has provided a reliable assessment of various facets of pandemic paranoia. This study aimed to (i) identify classes of individuals with varying levels of general paranoia and pandemic paranoia, and (ii) examine associations between classification and worry, core beliefs, and pro-health behaviours. METHODS An international sample of adults (N = 2510) across five sites completed the Revised-Green Paranoid Thoughts Scale and the PPS. Latent class analysis (LCA) was conducted using these two paranoia variables. Classes were compared on trait worry (Penn State Worry Questionnaire), beliefs about self/others (Brief Core Schema Scales), and pro-health behaviour. RESULTS Three latent classes emerged: Class 1 with low R-GPTS and PPS scores, Class 2 with a high R-GPTS score and a moderate PPS score, and Class 3 with high R-GPTS and PPS scores. Compared to Class 1, Classes 2-3 were associated with more worry and negative self- and other-beliefs. Class 3 was further characterised by greater positive-self beliefs and less engagement in pro-health behaviours. Engagement in pro-health behaviours was positively correlated with interpersonal mistrust and negatively correlated with paranoid conspiracy and persecutory threat. CONCLUSIONS Individuals with a general paranoia tendency were more likely to respond to the global health threats in a suspicious and distrusting way. Our findings suggested that worry and negative self/other beliefs may contribute to not just general paranoia but also pandemic paranoia. The preliminary finding of a link between pro-health behaviours and interpersonal mistrust warrants further examination.
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Affiliation(s)
| | - Chen Zhu
- The Chinese University of Hong Kong, Hong Kong, China
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30
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Fett AKJ, Hanssen E, Eemers M, Peters E, Shergill SS. Social isolation and psychosis: an investigation of social interactions and paranoia in daily life. Eur Arch Psychiatry Clin Neurosci 2022; 272:119-127. [PMID: 34129115 PMCID: PMC8803722 DOI: 10.1007/s00406-021-01278-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 06/01/2021] [Indexed: 01/01/2023]
Abstract
Social isolation has been suggested to foster paranoia. Here we investigate whether social company (i.e., being alone vs. not) and its nature (i.e., stranger/distant vs. familiar other) affects paranoia differently depending on psychosis risk. Social interactions and paranoid thinking in daily life were investigated in 29 patients with clinically stable non-affective psychotic disorders, 20 first-degree relatives, and 26 controls (n = 75), using the experience sampling method (ESM). ESM was completed up to ten times daily for 1 week. Patients experienced marginally greater paranoia than relatives [b = 0.47, p = 0.08, 95% CI (- 0.06, 1.0)] and significantly greater paranoia than controls [b = 0.55, p = 0.03, 95% CI (0.5, 1.0)], but controls and relatives did not differ [b = 0.07, p = 0.78, 95% CI (- 0.47, 0.61)]. Patients were more often alone [68.5% vs. 44.8% and 56.2%, respectively, p = 0.057] and experienced greater paranoia when alone than when in company [b = 0.11, p = 0.016, 95% CI (0.02, 0.19)]. In relatives this was reversed [b = - 0.17, p < 0.001, 95% CI (- 0.28, - 0.07)] and in controls non-significant [b = - 0.02, p = 0.67, 95% CI (- 0.09, 0.06)]. The time-lagged association between being in social company and subsequent paranoia was non-significant and paranoia did not predict the likelihood of being in social company over time (both p's = 0.68). All groups experienced greater paranoia in company of strangers/distant others than familiar others [X2(2) = 4.56, p = 0.03] and being with familiar others was associated with lower paranoia over time [X2(2) = 4.9, p = 0.03]. Patients are frequently alone. Importantly, social company appears to limit their paranoia, particularly when being with familiar people. The findings stress the importance of interventions that foster social engagement and ties with family and friends.
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Affiliation(s)
- Anne-Kathrin J Fett
- Department of Psychology, City, University of London, London, ECIV 0HB, UK.
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK.
- Department of Developmental and Clinical Psychology, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Van der Boechorststraat 1s, 1081 BT, Amsterdam, The Netherlands.
| | - Esther Hanssen
- Department of Developmental and Clinical Psychology, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Van der Boechorststraat 1s, 1081 BT, Amsterdam, The Netherlands
| | - Marlie Eemers
- Department of Developmental and Clinical Psychology, Faculty of Behavioural and Movement Sciences, VU Amsterdam, Van der Boechorststraat 1s, 1081 BT, Amsterdam, The Netherlands
| | - Emmanuelle Peters
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Sukhi S Shergill
- Department of Psychosis Studies, King's College London, Institute of Psychiatry, Psychology and Neuroscience, De Crespigny Park, London, SE5 8AF, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
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31
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Xenaki LA, Stefanatou P, Ralli E, Hatzimanolis A, Dimitrakopoulos S, Soldatos RF, Vlachos II, Selakovic M, Foteli S, Kosteletos I, Nianiakas N, Ntigridaki A, Triantafyllou TF, Voulgaraki M, Mantonakis L, Tsapas A, Bozikas VP, Kollias K, Stefanis NC. The relationship between early symptom severity, improvement and remission in first episode psychosis with jumping to conclusions. Schizophr Res 2022; 240:24-30. [PMID: 34915248 DOI: 10.1016/j.schres.2021.11.039] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 09/22/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022]
Abstract
It is suggested that Jumping To Conclusions (JTC) reasoning bias might contribute to the distortion of external reality. However, the association between psychotic manifestations and JTC is obscure, especially if general intelligence is considered as a mediator. The aim of this study is to investigate the relation between severity, early clinical improvement and remission of symptoms in First Episode Psychosis (FEP) with JTC as an explanatory factor. One hundred seventy-one FEP individuals were evaluated with the Positive and Negative Syndrome Scale (PANSS) at baseline and one month after treatment initiation. Clinical improvement was ascribed as symptom change one-month post-baseline measurements. Symptomatic remission was assessed with the Andreasen severity criteria and JTC with the Beads Task, operationalized through Draws To Decision (DTD) (the lower the number of DTD, the higher the JTC bias). Regarding symptoms severity, total psychotic, total positive psychotic, and hallucinations-item PANSS scores showed a negative association with JTC after controlling for IQ. Regarding early clinical improvement, the association with JTC was non-significant. No significant association was detected between one month remission status of FEP and JTC. Our findings indicate that severity of positive symptoms is not associated with hastiness in decision-making, but rather with a heightened conservatism in terms of increased data gathering. Further research is required to replicate the results and clarify the cognitive processes involved.
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Affiliation(s)
- Lida Alkisti Xenaki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.
| | - Pentagiotissa Stefanatou
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Eirini Ralli
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Alex Hatzimanolis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Stefanos Dimitrakopoulos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece; Psychiatric Clinic, 414 Military Hospital of Athens, Palea Penteli, Greece
| | - Rigas Filippos Soldatos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Ilias I Vlachos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Mirjana Selakovic
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Stefania Foteli
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Ioannis Kosteletos
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikos Nianiakas
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Aggeliki Ntigridaki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | | | - Marina Voulgaraki
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Leonidas Mantonakis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Apostolos Tsapas
- 2nd Medical Clinic, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Vasilios P Bozikas
- 2nd Department of Psychiatry, School of Medicine, Aristotle University of Thessaloniki, Greece
| | - Konstantinos Kollias
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
| | - Nikos C Stefanis
- 1st Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
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Pindikura R, Javangula S, Kumar KU. The association between body image, self-esteem, and body mass index in patients with schizophrenia at a tertiary care unit: A case–control study. ARCHIVES OF MENTAL HEALTH 2022. [DOI: 10.4103/amh.amh_194_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Wei Q, Pan Y, Zhang S, Yin W, Lin Q, Pan S, Dai C, Zhou L, Wu J. Epidemiology of childhood trauma and its association with insomnia and psychotic-like experiences in Chinese Zhuang adolescents. Front Psychiatry 2022; 13:974674. [PMID: 36072448 PMCID: PMC9441791 DOI: 10.3389/fpsyt.2022.974674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents who have experienced childhood trauma are more likely to have insomnia and psychotic-like experiences (PLEs) than adolescents from other ethnic groups. However, little is known about the youth of ethnic minorities. This study aimed to investigate the epidemiology of childhood trauma and its relationship with insomnia and PLEs in Chinese Zhuang adolescents, focusing on the role of a specific type of trauma and accumulation. METHODS A questionnaire of Childhood Trauma Questionnaire-Short Form (CTQ-SF), Athens Insomnia Scale (AIS), and Chinese Version Community assessment psychic experiences-8 (CCAPE- 8) were all completed by 1,493 Chinese Zhuang adolescents. Chi-square and multivariate logistic regression analyses examined the association between childhood trauma and insomnia/PLEs. RESULTS The incidences of emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN) occurred at rates of 5.63, 5.02, 6.56, 23.98, and 33.15%, respectively. EA, SA, EN, and PN were all positively related to insomnia (OR: 1.314-7.720, all p < 0.05). EA and SA were positively associated with PLEs (OR: 2.131-3.202, all p < 0.001). Adolescents who had experienced three or more types of traumas were more likely to have insomnia (OR = 6.961, p < 0.001) and PLEs (OR = 3.558, p < 0.001). CONCLUSION The most common type of childhood trauma is PN. Childhood trauma has the primary effect on insomnia/PLE. A significant dose-response relationship was found between Childhood trauma and insomnia/ PLEs. This association varied depending on the type and accumulation of exposure.
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Affiliation(s)
- Qiaoyue Wei
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yuli Pan
- Department of Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, China
| | - Shengjie Zhang
- Department of Graduate Management, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Wenwen Yin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Qinghong Lin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Shuibo Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Chenyangzi Dai
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Linhua Zhou
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China.,Department of Psychology, School of Medicine, Guangxi Medical College, Nanning, China
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34
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Decombe L, Henry A, Decombe R, Tir M, Doé de Maindreville A, Galland Hairabedian L, Kaladjian A, Raucher-Chéné D. "Accidental, really?" Attributional bias in patients with Parkinson's disease. Parkinsonism Relat Disord 2021; 95:18-22. [PMID: 34959046 DOI: 10.1016/j.parkreldis.2021.12.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/03/2021] [Accepted: 12/20/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Among the cognitive domains impaired in Parkinson's disease (PD), social cognition has received particular attention in recent years. Nevertheless, attributional bias, a social-cognitive subdomain, has not yet been studied in this population, despite its potential relationship with neuropsychiatric symptoms, and despite the possibility that deep-brain stimulation of the subthalamic nucleus, an effective treatment for disabling motor symptoms, worsens cognitive impairment. The present study therefore compared the attributional bias of patients with PD (stimulated and nonstimulated subgroups) with that of controls. It also explored the potential correlations between patients' attributional bias and their clinical scores. METHODS Thirty-two patients with PD (12 stimulated and 20 nonstimulated) were recruited and matched with 32 healthy controls. Attributional bias was assessed using the Ambiguous Intentions Hostility Questionnaire, which yields three subscores: Hostility Bias, Aggression Bias, and Blame. Depressive symptoms (Hamilton Rating Scale for Depression), paranoid thoughts (Paranoia Scale), global cognition (Montreal Cognitive Assessment), and social functioning (Social Functioning Questionnaire) were also assessed. RESULTS Patients exhibited more hostile and aggressive biases than controls, especially in ambiguous situations. Stimulated patients had greater hostility and aggression biases and a higher blame score than controls in accidental situations. No significant differences were observed between stimulated and nonstimulated patients. CONCLUSION To our knowledge, this is the first study to have assessed attributional bias in patients with PD and explored the impact of deep-brain stimulation on this particular subdomain of social cognition. Results suggest that patients exhibit attributional bias, and this impairment may be exacerbated in stimulated patients.
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Affiliation(s)
- Léa Decombe
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France.
| | - Audrey Henry
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France; Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
| | - René Decombe
- Service de Neurologie, Centre Hospitalier « Simone Veil », Troyes, France
| | - Mélissa Tir
- Service de Neurologie, CHU Amiens Site Sud, Amiens, France
| | | | - Lou Galland Hairabedian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
| | - Arthur Kaladjian
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France; Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
| | - Delphine Raucher-Chéné
- Pôle de Psychiatrie Universitaire, CHU de Reims, EPSMM, Reims, France; Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571, Reims Cedex, France
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Hepper EG, Ellett L, Kerley D, Kingston JL. Are they out to get me? Individual differences in nonclinical paranoia as a function of narcissism and defensive self-protection. J Pers 2021; 90:727-747. [PMID: 34888884 DOI: 10.1111/jopy.12693] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 11/04/2021] [Accepted: 12/01/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Three studies tested a novel model of the narcissism-paranoia link, whereby narcissism (primarily its socially maladaptive facets) is associated with paranoia via over-use of defensive self-protection and/or under-use of self-affirmation. METHODS In Study 1, 245 online volunteers (87% female; MAGE = 20.92; 44% White-British) completed trait measures of narcissism, self-enhancement/protection strategies and paranoia. In Study 2, 116 students (82% female; MAGE = 20.23; 70% White-British) completed baseline measures, then reported state reactions and paranoia following two difficult and two pleasant interpersonal events after 3-10 days. In Study 3, 517 online volunteers (64% female; MAGE = 22.76; 77% White/Caucasian) completed baseline measures, experienced a standardized social exclusion (vs. neutral) manipulation (Cyberball), then reported state reactions and paranoia. RESULTS In Study 1, narcissism was associated with higher paranoia via defensiveness. In Study 2, this was replicated in difficult but not pleasant events, and was driven by the Entitlement/Exploitativeness facet of narcissism. In Study 3, narcissistic rivalry and vulnerable narcissism, but not admiration, were associated with Cyberball-related paranoia via general defensiveness and denigration of others. CONCLUSIONS Individuals high in narcissism-especially its socially maladaptive facets-who over-rely on defensive self-protection strategies in response to threat, are particularly vulnerable to paranoia. Findings help to understand individual differences in paranoia.
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Affiliation(s)
- Erica G Hepper
- School of Psychology, University of Surrey, Guildford, UK
| | - Lyn Ellett
- School of Psychology, Royal Holloway, University of London, Egham, UK
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Postma MR, van Amelsvoort T, Myin-Germeys I, Gayer-Anderson C, Kempton MJ, Valmaggia L, McGuire P, Murray RM, Garety P, Wykes T, Morgan C, Reininghaus U. Across the continuum: Associations between (fluctuations in) momentary self-esteem and psychotic experiences. Schizophr Res 2021; 238:188-198. [PMID: 34785480 DOI: 10.1016/j.schres.2021.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 07/29/2021] [Accepted: 09/07/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Low self-esteem has been suggested as a putative mechanism in the development and maintenance of psychosis. Uncertainty still exists about how unstable self-esteem relates to psychotic experiences. The present study examines the potential (temporal) associations between momentary self-esteem, fluctuations in self-esteem, and psychotic experiences in daily life. METHODS Experience sampling data were collected from 46 individuals presenting with an at-risk mental state (ARMS), 51 individuals with first-episode psychosis (FEP), and 53 controls, to investigate associations between (fluctuations in) self-esteem and psychotic experiences within and across FEP, ARMS, and controls, using linear mixed models. RESULTS In all three groups we found that lower momentary self-esteem was associated with a greater intensity of psychotic experiences (adj. βFEP = -0.15, 95% CI -0.20 to -0.10, p = 0.000; adj. βARMS = -0.20, 95% CI -0.26 to -0.15, p = 0.000; adj. βcontrols = -0.12, 95% CI -0.17 to -0.07, p = 0.000). Variability in momentary self-esteem was associated with a greater intensity of psychotic experiences only in ARMS (adj. βARMS = 0.08, 95% CI 0.04 to 0.11, p = 0.000) and controls (adj. βcontrols = 0.04, 95% CI 0.01 to 0.08, p = 0.023). For instability this association held only in controls (adj. βcontrols = 0.03, 95% CI 0.00 to 0.05, p = 0.020). Furthermore, findings may suggest a reciprocal temporal association between self-esteem and psychotic experiences. CONCLUSIONS Our findings suggest that self-esteem may be an important mechanism targetable by ecological momentary interventions to reduce the intensity of psychotic experiences and potentially prevent illness progression at an early stage.
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Affiliation(s)
- Mary Rose Postma
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany.
| | - Therese van Amelsvoort
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neuroscience, Catholic University of Leuven, Leuven, Belgium
| | - Charlotte Gayer-Anderson
- ESRC Centre for Society and Mental Health, King's College London, UK; Social Epidemiology Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Lucia Valmaggia
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Philippa Garety
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Til Wykes
- Psychology Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Craig Morgan
- ESRC Centre for Society and Mental Health, King's College London, UK; Social Epidemiology Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | - Ulrich Reininghaus
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, the Netherlands; Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany; ESRC Centre for Society and Mental Health, King's College London, UK; Social Epidemiology Research Group, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Parker A, Kingston J. Evaluating a Values-Based Intervention for Adolescence with High Nonclinical Paranoia: A Schools-Based Randomised Control Trial. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10278-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Background
Paranoia in adolescents is common, but research on attenuating it is scarce. Focusing on values and enhancing value-based acts is a low intensity method for attenuating paranoia in adults. This randomised trial compared a brief (30-min, self-directed) values-plus-goals intervention to an active control for adolescents with high nonclinical paranoia (Paranoia Scale ≥ 53), delivered in schools. The study also investigated the role of self-esteem.
Methods
Ninety adolescents were randomly assigned to condition. Paranoia (primary outcome) and self-esteem (potential mediator) were assessed at baseline (T1), and two- (T2) and six-weeks (T3) after baseline.
Results
Results were analysed using intention to treat (ITT) and per protocol (PP) analysis. Using ITT analysis, the Condition*Time interaction was significant (F(2, 168) = 3.98, p = .02), paranoia was significantly lower at T3 following values-plus-goals as compared to control (d = 0.64). Differences were not significant using per protocol analysis (F(2, 106) = 1.61, p = .21). The between group effect size at T3 was (d = 0.61). The Condition*Time interaction for self-esteem was not significant (F(2, 112) = 2.86, p = .06).
Conclusions
Tentatively, findings suggest that a brief values-plus-goals intervention can reduce paranoia in adolescents relative to an active control.
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Underwood R, Mason L, O'Daly O, Dalton J, Simmons A, Barker GJ, Peters E, Kumari V. You read my mind: fMRI markers of threatening appraisals in people with persistent psychotic experiences. NPJ SCHIZOPHRENIA 2021; 7:49. [PMID: 34635671 PMCID: PMC8505497 DOI: 10.1038/s41537-021-00173-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 08/06/2021] [Indexed: 11/09/2022]
Abstract
Anomalous perceptual experiences are relatively common in the general population. Evidence indicates that the key to distinguishing individuals with persistent psychotic experiences (PEs) with a need for care from those without is how they appraise their anomalous experiences. Here, we aimed to characterise the neural circuits underlying threatening and non-threatening appraisals in people with and without a need for care for PEs, respectively. A total of 48 participants, consisting of patients with psychosis spectrum disorder (clinical group, n = 16), non-need-for-care participants with PEs (non-clinical group, n = 16), and no-PE healthy control participants (n = 16), underwent functional magnetic resonance imaging while completing the Telepath task, designed to induce an anomalous perceptual experience. Appraisals of the anomalous perceptual experiences were examined, as well as functional brain responses during this window, for significant group differences. We also examined whether activation co-varied with the subjective threat appraisals reported in-task by participants. The clinical group reported elevated subjective threat appraisals compared to both the non-clinical and no-PE control groups, with no differences between the two non-clinical groups. This pattern of results was accompanied by reduced activation in the superior and inferior frontal gyri in the clinical group as compared to the non-clinical and control groups. Precuneus activation scaled with threat appraisals reported in-task. Resilience in the context of persistent anomalous experiences may be explained by intact functioning of fronto-parietal regions, and may correspond to the ability to contextualise and flexibly evaluate psychotic experiences.
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Affiliation(s)
- Raphael Underwood
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, London, UK. .,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, UK.
| | - Liam Mason
- University College London, Max Planck Centre for Computational Psychiatry and Ageing Research, London, UK.,University College London, Research Department of Clinical, Educational and Health Psychology, London, UK
| | - Owen O'Daly
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Neuroimaging, London, UK
| | - Jeffrey Dalton
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Neuroimaging, London, UK
| | - Andrew Simmons
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Neuroimaging, London, UK
| | - Gareth J Barker
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Neuroimaging, London, UK
| | - Emmanuelle Peters
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, London, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Kent, UK
| | - Veena Kumari
- King's College London, Institute of Psychiatry, Psychology & Neuroscience, Department of Psychology, London, UK.,Brunel University London, College of Health, Medicine and Life Sciences, Centre for Cognitive Neuroscience, Uxbridge, UK
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Martinez AP, Agostini M, Al‐Suhibani A, Bentall RP. Mistrust and negative self-esteem: Two paths from attachment styles to paranoia. Psychol Psychother 2021; 94:391-406. [PMID: 33314565 PMCID: PMC8451824 DOI: 10.1111/papt.12314] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 09/02/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Paranoia is known to be associated with insecure attachment, with negative self-esteem as a mediator, but this pathway is insufficient to explain the paranoid individual's beliefs about malevolent others. Mistrust is a likely additional factor as it is a core feature of paranoid thinking also associated with insecure attachment styles. In this study, we tested whether mistrust - operationalized as judgements about the trustworthiness of unfamiliar faces - constitutes a second pathway from insecure attachment to paranoia. DESIGN The design of the study was cross-sectional. METHODS A nationally representative British sample of 1,508 participants aged 18-86, 50.8% female, recruited through the survey company Qualtrics, completed measurements of attachment style, negative self-esteem, and paranoid beliefs. Usable data were obtained from 1,121 participants. Participants were asked to make trustworthiness judgements about computer-generated faces, and their outcomes were analysed by conducting signal detection analysis, which provided measures of bias (the tendency to assume untrustworthiness in conditions of uncertainty) and sensitivity (accuracy in distinguish between trustworthy and untrustworthy faces). RESULTS Results using structural equation modelling revealed a good model fit (RMSEA = .071, 95% CI: 0.067-0.075, SRMR = .045, CFI = .93, TLI = .92). We observed indirect effects through bias towards mistrust both for the relationship between attachment anxiety and avoidance (β = .003, 95% CI: 0.001-0.005,p < .001) and attachment anxiety and paranoia (β = .003, 95% CI 0.002-0.006, p < .001). We observed an indirect effect through negative self-esteem only for the relationship between attachment anxiety and paranoia (β = .064, 95% CI: 0.053-0.077, p < .001). Trust judgements and negative self-esteem were not associated with each other. CONCLUSIONS We find that a bias towards mistrust is associated with greater paranoia. We also find indirect effects through bias towards mistrust between attachment styles and paranoia. Finally, we reaffirm the strong indirect effect through negative self-esteem between attachment anxiety and paranoia. Limitations of the study are discussed. PRACTITIONER POINTS When working with individuals suffering from paranoia, clinicians should consider not only explicit, deliberative cognitive processes of the kind addressed in cognitive behaviour therapy (e.g. cognitive restructuring) but also the way in which their patients make perceptual judgements (e.g., their immediate reactions on encountering new people) and consider interventions targeted at these judgements, for example, bias modification training. Assessment and clinical interventions for people should consider the role of trust judgements and the way in which they combine with low self-esteem to provoke paranoid beliefs. Psychological interventions targeting paranoid beliefs should focus on both attachment anxiety and attachment avoidance.
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Affiliation(s)
| | - Maximilian Agostini
- Department of Social and Organizational PsychologyUniversity of GroningenThe Netherlands
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LoPilato AM, Zhang Y, Pike M, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Seidman L, Perkins DO, Tsuang MT, Woods SW, Walker EF. Associations between childhood adversity, cognitive schemas and attenuated psychotic symptoms. Early Interv Psychiatry 2021; 15:818-827. [PMID: 32770658 DOI: 10.1111/eip.13017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/29/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022]
Abstract
AIM Childhood Adversity (CA) is strongly linked to psychotic-like symptoms across the clinical spectrum, though the mechanisms underlying these associations remain poorly understood. Negative cognitive schemas are associated with both CA exposure and psychotic symptoms, highlighting the possibility that cognitive schemas may be a key risk pathway. The purpose of this study was to determine whether negative cognitive schemas mediate the association between CA and specific attenuated psychotic symptoms in a large sample of clinical-high risk youth. Given the variability in experiences that encompass CA (eg, abuse, neglect and poverty) and attenuated psychotic symptoms (eg, suspiciousness and perceptual abnormalities), we also tested whether these associations differ by CA type (threat vs deprivation) and attenuated positive psychotic symptom domain. METHODS Data were collected from 531 clinical-high risk youth between 12 and 35 years of age (mean = 18.80, SD = 4.21) who completed a clinical assessment that included the Structured Interview of Prodromal Syndromes (SIPS), Childhood Trauma and Abuse scale and questionnaires on cognitive schemas and depressive symptoms. RESULTS No direct effects of threat or deprivation exposure on any of the psychotic symptom domains were found. However, there was a unique indirect effect of threat, but not deprivation, on delusional thinking and suspiciousness through negative cognitive schemas about others. CONCLUSION Cognitive vulnerability in the form of negative schemas about others may be one mechanism linking childhood threat experiences and attenuated psychotic symptoms. The results underscore the importance of targeting negative schemas in interventions to mitigate psychosis risk.
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Affiliation(s)
- Allison M LoPilato
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Yinghao Zhang
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Madeline Pike
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychology, Semel Institute for Neuroscience and Human Behaviour, UCLA, Los Angeles, California, USA
| | | | - Tyrone D Cannon
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA.,Department of Psychology, Yale University, New Haven, Connecticut, USA
| | | | | | | | - Larry Seidman
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Diana O Perkins
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, La Jolla, California, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut, USA
| | - Elaine F Walker
- Department of Psychiatry and Behavioral Sciences, Emory School of Medicine, Atlanta, Georgia, USA.,Department of Psychology, Emory University, Atlanta, Georgia, USA
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Ibanez-Casas I, Carmen Maura CDAC, Gutiérrez B, Cervilla JA. A population-based cross-sectional study of cognitive deficits in paranoia. Psychiatry Res 2021; 299:113820. [PMID: 33706196 DOI: 10.1016/j.psychres.2021.113820] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 02/19/2021] [Indexed: 12/17/2022]
Abstract
This study sought to investigate the association between paranoia and performance in a range of neurocognitive domains using a large community sample. We conducted a cross-sectional survey of 4507 individuals within the PISMA-ep Study. We used a large community sample selected after multistage sampling using standard stratification techniques. Socio-demographic variables such as age, gender, educational level, urbanicity, and geographical region were recorded. The Spanish version of the Green Paranoid Thought Scale (S-GPTS) was used to assess paranoid thoughts. The Screening for Cognitive Impairment in Psychiatry (SCIP) was used to assess neurocognitive performance both globally and by domains (i.e., immediate and delayed verbal learning, working memory, verbal fluency and processing speed). Individuals with high S-GPTS paranoia scores showed significantly lower performance on global cognitive function and also on immediate (but not delayed) verbal learning, working memory, verbal fluency and processing speed. These results held statistical significance even after controlling for the effects of education and estimated IQ. We propose that cognitive deficits may be mediators of paranoid thinking formation and need to be considered when assessing patients with high levels of paranoia.
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Affiliation(s)
| | | | - Blanca Gutiérrez
- Department of Psychiatry, University of Granada, Avda de la investigación, 11 - School of Medicine. Tower A, 9th Floor, 18016 Granada Spain.
| | - Jorge A Cervilla
- Department of Psychiatry, University of Granada, Avda de la investigación, 11 - School of Medicine. Tower A, 9th Floor, 18016 Granada Spain; Mental Health Unit, "Clínico San Cecilio" University Hospital, Granada, Spain.
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Wolf RC, Hildebrandt V, Schmitgen MM, Pycha R, Kirchler E, Macina C, Karner M, Hirjak D, Kubera KM, Romanov D, Freudenmann RW, Huber M. Aberrant Gray Matter Volume and Cortical Surface in Paranoid-Type Delusional Disorder. Neuropsychobiology 2021; 79:335-344. [PMID: 32160619 DOI: 10.1159/000505601] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Delusions are core symptoms of schizophrenia-spectrum and related disorders. Despite their clinical relevance, the neural correlates underlying such phenomena are unclear. Recent research suggests that specific delusional content may be associated with distinct neural substrates. OBJECTIVE Here, we used structural magnetic resonance imaging to investigate multiple parameters of brain morphology in patients presenting with paranoid type delusional disorder (pt-DD, n = 14) compared to those of healthy controls (HC, n = 25). METHODS Voxel- and surface-based morphometry for structural data was used to investigate gray matter volume (GMV), cortical thickness (CT) and gyrification. RESULTS Compared to HC, patients with pt-DD showed reduced GMV in bilateral amygdala and right inferior frontal gyrus. Higher GMV in patients was found in bilateral orbitofrontal and in left superior frontal cortices. Patients also had lower CT in frontal and temporal regions. Abnormal gyrification in patients was evident in frontal and temporal areas, as well as in bilateral insula. CONCLUSIONS The data suggest the presence of aberrant GMV in a right prefrontal region associated with belief evaluation, as well as distinct structural abnormalities in areas that essentially subserve processing of fear, anxiety and threat in patients with pt-DD. It is possible that cortical features of distinct evolutionary and genetic origin, i.e. CT and gyrification, contribute differently to the pathogenesis of pt-DD.
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Affiliation(s)
- Robert Christian Wolf
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany,
| | - Viviane Hildebrandt
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Mike M Schmitgen
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Roger Pycha
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| | - Erwin Kirchler
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| | - Christian Macina
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
| | - Martin Karner
- Department of Radiology, General Hospital Bruneck, Bruneck, Italy
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Katharina M Kubera
- Center for Psychosocial Medicine, Department of General Psychiatry, Heidelberg University, Heidelberg, Germany
| | - Dmitry Romanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | | | - Markus Huber
- Department of Psychiatry, General Hospital Bruneck, Bruneck, Italy
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Hinojosa-Marqués L, Monsonet M, Kwapil TR, Barrantes-Vidal N. The impact of family environment on self-esteem and symptoms in early psychosis. PLoS One 2021; 16:e0249721. [PMID: 33819314 PMCID: PMC8021173 DOI: 10.1371/journal.pone.0249721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022] Open
Abstract
Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients’ SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients’ SE mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia; (2) patients’ perceived EE mediated the effect of relatives’ EE on patients’ SE; (3) patients’ SE mediated between patients’ perceived EE and patients’ symptomatology; and (4) patients’ perceived EE and patients’ SE serially mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients’ perceived EE mediated the link between relatives’ EE and patients’ negative, but not positive, SE; (2) patients’ negative SE mediated the effect of patients’ perceived EE on positive symptoms and paranoia; (3) the association of relatives’ EE with positive symptoms and paranoia was serially mediated by an increased level of patients’ perceived EE leading to increases in negative SE; (4) high levels of patients’ distress moderated the effect of relatives’ EE on symptoms through patients’ perceived EE and negative SE. Findings emphasize that patients’ SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients’ negative SE and symptoms.
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Affiliation(s)
- Lídia Hinojosa-Marqués
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Sant Pere Claver- Fundació Sanitària, Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
- * E-mail:
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McIntyre JC, Elahi A, Barlow FK, White RG, Bentall RP. The relationship between ingroup identity and Paranoid ideation among people from African and African Caribbean backgrounds. Psychol Psychother 2021; 94:16-32. [PMID: 31742832 DOI: 10.1111/papt.12261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 10/31/2019] [Indexed: 12/22/2022]
Abstract
OBJECTIVES People from ethnic minority groups experience higher rates of paranoid delusions compared with people from ethnic majority groups. Identifying with social groups has been shown to protect against mental health symptoms; however, no studies have investigated the relationship between social identification and paranoia in ethnic minority populations. Here, we investigated the association between British identification and paranoia in a sample of people from African and African Caribbean backgrounds living in the United Kingdom. We also assessed the role of potential mediating (self-esteem and locus of control) and moderating (contact with White British people) factors. DESIGN Cross-sectional quantitative survey design. METHODS We recruited 335 people from African and African Caribbean backgrounds who completed online self-report measures of identification with Great Britain, self-esteem, locus of control, positive and negative contact with White British people, and paranoia. RESULTS A parallel moderated mediation model indicated that British identification was associated with lower paranoia when participants experienced primarily positive contact with White British people. British identification was associated with higher paranoia when participants had primarily negative contact with White British people. Both effects were mediated by changes in locus of control, but self-esteem was not implicated in either pathway. CONCLUSIONS Identification with the majority culture is associated both positively and negatively with paranoid beliefs depending on the types of social interactions people experience. The findings have implications for preventative social prescribing initiatives and for understanding the causes of the high rates of psychosis in ethnic minority populations. PRACTITIONER POINTS People from African and African Caribbean backgrounds experience high rates of paranoia, which may stem from social causes such as lack of belonging and negative social experiences. Among people from African backgrounds living in the UK, British identification is associated with lower paranoia when people's social experiences with White British people are positive and higher paranoia when their social experiences with White British people are negative. It is recommended that social interventions designed to reduce paranoia in vulnerable groups foster positive social contact and community belonging, which should enhance feelings of personal control. Understanding the complex interplay between social identity and social contact in the development of paranoia may help therapists and researchers better understand the phenomenology and risk factors of paranoid symptomology.
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Affiliation(s)
- Jason C McIntyre
- School of Psychology, Liverpool John Moores University, UK.,Department of Health Services Research, University of Liverpool, UK
| | - Anam Elahi
- Division of Psychology and Mental Health, University of Manchester, UK
| | - Fiona Kate Barlow
- School of Psychology, The University of Queensland, St Lucia, Queensland, Australia
| | - Ross G White
- Institute of Life and Human Sciences, University of Liverpool, UK
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Corral L, Labad J, Ochoa S, Cabezas A, Muntané G, Valero J, Sanchez-Gistau V, Ahuir M, Gallardo-Pujol D, Crosas JM, Palao D, Vilella E, Gutierrez-Zotes A. Cognitive Biases Questionnaire for Psychosis (CBQp): Spanish Validation and Relationship With Cognitive Insight in Psychotic Patients. Front Psychiatry 2021; 11:596625. [PMID: 33679460 PMCID: PMC7935547 DOI: 10.3389/fpsyt.2020.596625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/28/2020] [Indexed: 11/21/2022] Open
Abstract
Introduction: Cognitive biases are key factors in the development and persistence of delusions in psychosis. The Cognitive Biases Questionnaire for Psychosis (CBQp) is a new self-reported questionnaire of 30 relevant situations to evaluate five types of cognitive biases in psychosis. In the context of the validation of the Spanish version of the CBQp, our objectives were to (1) analyze the factorial structure of the questionnaire with a confirmatory factor analysis (CFA), (2) relate cognitive biases with a widely used scale in the field of delusion cognitive therapies for assessing metacognition, specifically, Beck's Cognitive Insight Scale (BCIS) (1), and, finally, (3) associate cognitive biases with delusional experiences, evaluated with the Peters Delusions Inventory (PDI) (2). Materials and Methods: An authorized Spanish version of the CBQp, by a translation and back-translation procedure, was obtained. A sample of 171 patients with different diagnoses of psychoses was included. A CFA was used to test three different construct models. Associations between CBQp biases, the BCIS, and the PDI were made by correlation and mean differences. Comparisons of the CBQp scores between a control group and patients with psychosis were analyzed. Results: The CFA showed comparative fit index (CFI) values of 0.94 and 0.95 for the models with one, two, and five factors, with root mean square error of approximation values of 0.031 and 0.029. The CBQp reliability was 0.87. Associations between cognitive biases, self-certainty, and cognitive insight subscales of the BCIS were found. Similarly, associations between total punctuation, conviction, distress, and concern subscales of the PDI were also found. When compared with the group of healthy subjects, patients with psychoses scored significantly higher in several cognitive biases. Conclusion: Given the correlation between biases, a one-factor model might be more appropriate to explain the scale's underlying construct. Biases were associated with a greater frequency of delusions, distress, conviction, and concern as well as worse cognitive insight in patients with psychosis.
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Affiliation(s)
- Lia Corral
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Javier Labad
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - Susana Ochoa
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Sant Joan de Déu Research Institute (IRSJD), Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Angel Cabezas
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Gerard Muntané
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Joaquín Valero
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Vanessa Sanchez-Gistau
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Maribel Ahuir
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - David Gallardo-Pujol
- Faculty of Psychology, University of Barcelona, Barcelona, Spain
- Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Josep María Crosas
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - Diego Palao
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Autonomous University of Barcelona, Barcelona, Spain
- Instituto de Investigación e Innovación Parc Taulí (I3PT), Barcelona, Spain
| | - Elisabet Vilella
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
| | - Alfonso Gutierrez-Zotes
- Institut Pere Mata, Hospital Universitari Institut Pere Mata of Reus, Reus, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Tarragona, Spain
- University of Rovira i Virgili, Tarragona, Spain
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46
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Navalón P, Serrano E, Almansa B, Perea M, Benavent P, Domínguez A, Sierra P, Cañada Y, García-Blanco A. Attentional biases to emotional scenes in schizophrenia: An eye-tracking study. Biol Psychol 2021; 160:108045. [PMID: 33581230 DOI: 10.1016/j.biopsycho.2021.108045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 12/31/2022]
Abstract
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.
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Affiliation(s)
- Pablo Navalón
- Neonatal Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Elena Serrano
- Department of Psychology, University of Valencia, Valencia, Spain
| | - Belén Almansa
- Neonatal Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Psychology, University of Valencia, Valencia, Spain
| | - Manuel Perea
- Department of Psychology, University of Valencia, Valencia, Spain; Nebrija University, Madrid, Spain
| | - Pilar Benavent
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Alberto Domínguez
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - Pilar Sierra
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Department of Medicine, University of Valencia, Valencia, Spain; Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Yolanda Cañada
- Department of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain; Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain
| | - Ana García-Blanco
- Neonatal Research Group, La Fe Health Research Institute, Valencia, Spain; Department of Psychology, University of Valencia, Valencia, Spain.
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47
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Monfort-Escrig C, Pena-Garijo J. Attributional Styles and Social Functioning in Schizophrenia. Is the Learned Helplessness Model Suitable? CLÍNICA Y SALUD 2021. [DOI: 10.5093/clysa2020a21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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48
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Externalizing the threat from within: A new direction for researching associations between suicide and psychotic experiences. Dev Psychopathol 2021; 34:1034-1044. [PMID: 33402232 DOI: 10.1017/s0954579420001728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A recent suicidal drive hypothesis posits that psychotic experiences (PEs) may serve to externalize internally generated and self-directed threat (i.e., self-injurious/suicidal behavior [SIB]) in order to optimize survival; however, it must first be demonstrated that such internal threat can both precede and inform PEs. The current study conducted the first known bidirectional analysis of SIB and PEs to test whether SIB could be considered as a plausible antecedent for PEs. Prospective data were utilized from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of 2232 twins, that captured SIB (any self-harm or suicidal attempt) and PEs at ages 12 and 18 years. Cross-lagged panel models demonstrated that the association between SIB at age 12 and PEs at age 18 was as strong as the association between PEs at age 12 and SIB at age 18. Indeed, the best representation of the data was a model where these paths were constrained to be equal (OR = 2.48, 95% CI = 1.63-3.79). Clinical interview case notes for those who reported both SIB and PEs at age 18, revealed that PEs were explicitly characterized by SIB/threat/death-related content for 39% of cases. These findings justify further investigation of the suicidal drive hypothesis.
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49
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Zhao Y, Wang Z, Zhang Y, Zhang Y, Zhang J, Li D, Xiao C, Tan S, Zhang D. Impaired Emotional Self-Referential Processing in First-Episode Schizophrenia. Front Psychiatry 2021; 12:591401. [PMID: 33897479 PMCID: PMC8058190 DOI: 10.3389/fpsyt.2021.591401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/01/2021] [Indexed: 11/17/2022] Open
Abstract
Impairments in self-representation are relevant to the expression of psychosis. To date, the characteristics and neural mechanisms of self-impairment in schizophrenia remain unclear. To this end, we used event-related potentials (ERPs) to measure brain activity in 56 first-episode patients with schizophrenia and 56 healthy controls. Participants judged personal trait adjectives regarding themselves, their mothers, or a public person, followed by an unexpected old/new recognition test. The recognition score for mother-reference adjectives was lower than that for self-reference adjectives in patients, while the control group showed comparatively high recognition scores for both self- and mother-referential adjectives. In addition, control subjects recognized more negative words, while patients remembered more positive words. ERP data revealed that controls exhibited typical task effects (self-reference = mother-reference > other-reference) during both automatic attention and effortful encoding periods [indexed by P2 and the late positive potential (LPP), respectively]. In contrast, patients only exhibited the task effect in the P2 amplitude. Moreover, controls exhibited larger P2 amplitudes during encoding negative than positive words, whereas patients had enhanced LPP amplitudes during memory retrieval of positive compared to negative words. These findings demonstrated self-representation dysfunction in first-episode schizophrenic patients in mother (the intimate other) referential processing and the absence of a negative memory bias.
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Affiliation(s)
- Yanli Zhao
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Zhiren Wang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Yueyao Zhang
- College of Psychology, Shenzhen University, Shenzhen, China
| | - Yuanyuan Zhang
- School of Psychology, North China University of Science and Technology, Tangshan, China
| | - Jinguo Zhang
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Dong Li
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Chunling Xiao
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Shuping Tan
- Psychiatry Research Center, Beijing Huilongguan Hospital, Peking University Huilonguan Clinical Medical School, Beijing, China
| | - Dandan Zhang
- College of Psychology, Shenzhen University, Shenzhen, China
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50
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Monsonet M, Ballespí S, Sheinbaum T, Valiente C, Espinosa R, Kwapil TR, Barrantes-Vidal N. Self-Schemas and Self-Esteem Discrepancies in Subclinical Paranoia: The Essential Role of Depressive Symptoms. Front Psychiatry 2021; 12:623755. [PMID: 33790815 PMCID: PMC8005540 DOI: 10.3389/fpsyt.2021.623755] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background : Self-concepts are being intensively investigated in relation to paranoia, but research has shown some contradictory findings. Studying subclinical phenomena in a non-clinical population should allow for a clearer understanding given that clinical confounding factors are avoided. We explored self-esteem, self-schemas, and implicit/explicit self-esteem discrepancies in three non-clinical groups with different psychopathological traits and a control group. Methods: Participants with elevated trait-paranoia (n = 41), depressive symptoms (n = 34), a combination of both traits (n = 32), and a control group (n = 71) were assessed on implicit and explicit self-esteem, self-schemas, depression, and paranoia. A dimensional approach with the total sample (n = 208) was also used to complement the information provided by the group approach. Results: All groups presented similar and positive levels of implicit self-esteem. Trait-paranoia participants had similar levels of explicit self-esteem and self-schemas compared with the control group. However, the group with a combination of trait-paranoia and depressive symptoms showed the lowest levels of positive self-schemas and self-esteem. Furthermore, this group and the control group displayed implicit/explicit self-esteem discrepancies, although in opposite directions and with different implications. The dimensional approach revealed associations of trait-paranoia and depressive symptoms with poor explicit self-esteem and self-schemas but not with implicit self-esteem. Conclusions: Trait-paranoia participants showed different self-representations depending on whether depressive symptoms were present or not. The interaction between subclinical neurotic and psychotic traits entailed a detrimental self-representation that might increase the risk for psychopathology.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Sergi Ballespí
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Tamara Sheinbaum
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Carmen Valiente
- School of Psychology, Complutense University of Madrid, Pozuelo de Alarcón, Spain
| | - Regina Espinosa
- Department of Psychology, University of Camilo José Cela, Villanueva de la Cañada, Spain
| | - Thomas Richard Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain.,Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.,Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
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