Interpersonal processes in paranoia: a systematic review

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

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

The architecture of paranoia in the general population: A self-report and ecological momentary assessment study

Paranoia is a common delusion type found in clinical and non-clinical populations. A hierarchical, dimensional model of paranoia in the general population has been proposed, with four categories representing increasing levels of paranoia: interpersonal sensitivity (IP), mistrust (M), ideas of reference (IR), persecutory ideas (PI). What is currently lacking and could provide insights into etiology is a comprehensive clinical characterization of the lower end of the paranoia spectrum, psychological domains that are associated with symptom severity, and how paranoia and its structure fluctuate over time. This study conducted both cross-sectional and longitudinal surveys with 802 participants from the German population assessing paranoia and general psychopathology. Data was collected through Ecological Momentary Assessment (EMA). Several statistical approaches were used including confirmatory factor analysis (CFA), latent class analysis (LCA) and mixed modelling analyses (ME). Paranoid experiences appear to be a common phenomenon that occur in people with and without mental illness. Subjects clustered into four paranoia severity subgroups (IP, M, IR, PI) and showed significant associations in various psychological domains like increased psychiatric symptoms and maladaptive coping. Paranoia fluctuates over time in all four severity subgroups, but the hierarchical subgrouping was stable. Both persecutory ideations and interpersonal sensitivity were significant predictors of paranoia. Findings provide important insights into the architecture of paranoia in the German population by characterizing their hierarchical, dimensional, and dynamic structure and its link to psychopathology.

Interpersonal consequences of paranoid ideation, negative symptoms and sleep problems in a transdiagnostic sample of individuals with psychosis

Paranoid ideation is a transdiagnostic construct that is associated with social impairment and often occurs in psychotic spectrum disorders. Little research has examined how paranoid ideation is related to social behaviors that underlie social impairment and may ultimately lead to social rejection. It is important to consider that negative symptoms and sleep problems also contribute to social impairment. No research has assessed the unique and combined influence of paranoid ideation, negative symptoms, and sleep problems on social impairment. Therefore, the current study examined how paranoid ideation, negative symptoms, and sleep problems contribute to poorer social skills and social rejection in a transdiagnostic sample of persons with psychosis and community members (N = 112). Assessments included diagnostic and symptom interviews, questionnaires, behavioral ratings of social skill and facial displays of affect, and naive observer reactions utilizing thin-slice methodology. Greater paranoid ideation, negative symptoms, and sleep problems were each related to poorer social skill and more negative reactions from observers. When considered in path analyses, negative symptoms were associated with observer reports of less willingness to interact with participants through poorer social skill. These findings demonstrate the symptom correlates of social rejection and how interpersonal behavior may contribute to social exclusion.

Information processing style and institutional trust as factors of COVID vaccine hesitancy

This study investigates the factors contributing to COVID vaccine hesitancy. Vaccine hesitancy has commonly been attributed to susceptibility to misinformation and linked to particular socio-demographic factors and personality traits. We present a new perspective, emphasizing the interplay between individual cognitive styles and perceptions of public health institutions. In January 2020, before the COVID-19 pandemic, 318 participants underwent a comprehensive assessment, including self-report measures of personality and clinical characteristics, as well as a behavioral task that assessed information processing styles. During 2021, attitudes towards vaccines, scientists, and the CDC were measured at three time points (February-October). Panel data analysis and structural equation modeling revealed nuanced relationships between these measures and information processing styles over time. Trust in public health institutions, authoritarian submission, and lower information processing capabilities together contribute to vaccine acceptance. Information processing capacities influenced vaccination decisions independently from the trust level, but their impact was partially mediated by authoritarian tendencies. These findings underscore the multifactorial nature of vaccine hesitancy, which emerges as a product of interactions between individual cognitive styles and perceptions of public health institutions. This novel perspective provides valuable insights into the underlying mechanisms that drive this complex phenomenon.

Solitary Cannabis Use and Related Consequences Among College Students During the COVID-19 Pandemic

Solitary cannabis use has been associated with greater cannabis problems than social use and may be increasingly prevalent due to pandemic-related isolation. However, little is known about patterns, correlates, and consequences of solitary cannabis use. This study sought to characterize solitary cannabis use since pandemic onset, examine psychosocial risk factors, and examine interactions between solitary and social cannabis use frequency on cannabis consequences. College students (N = 168) who were lifetime cannabis users at a private, northeastern university in the US completed an online cross-sectional survey in fall of 2020. Past-year solitary cannabis use was common among life-time cannabis users (42% past year, 29% monthly or more), especially among past-year regular cannabis users (85% monthly or more). Solitary use frequency was associated with interpersonal sensitivity and pandemic-related stress. Further, solitary use attenuated associations of social use frequency with cannabis consequences, such that social use frequency was associated with greater consequences only among exclusively social users. In contrast, regardless of social use frequency, solitary users reported greater cannabis consequences than exclusively social users. Findings suggest solitary cannabis use is concurrently associated with greater cannabis consequences, and affective risk factors (interpersonal sensitivity, pandemic stress) should be considered for prevention and intervention strategies.

Alike but not the same: Psychological profiles of COVID-19 vaccine skeptics

One of the challenges of the SARS-CoV-2 pandemic was a widespread skepticism about vaccination. To elucidate the underlying mental and emotional predispositions, we examined a sample of 1428 participants using latent profile analysis (LPA) on selected personality trait variables, mental health status, and measures of irrational beliefs. LPA revealed five distinct profiles: two classes of non-skeptics and three of skeptics. The smaller non-skeptic class reported the highest rates of mental health problems, along with high levels of neuroticism, hostility, interpersonal sensitivity, and external locus of control. The larger non-skeptic class was psychologically well-balanced. Conversely, the skeptic groups shared strong distrust of COVID-19 vaccination but differed in emotional and mental profiles, leading to graded differences in endorsing extreme conspiracy beliefs. This suggests that vaccine skepticism is not solely a result of mental illness or emotional instability; rather extreme skepticism manifests as a nuanced, graded phenomenon contingent on personality traits and conspirational beliefs.

Psychosocial stress, interpersonal sensitivity, and social withdrawal in clinical high risk for psychosis: a systematic review

Stress has repeatedly been implicated in the onset and exacerbation of positive symptoms of psychosis. Increasing interest is growing for the role of psychosocial stress in the development of psychosis symptoms in individuals at Clinical High Risk (CHR) for psychosis. A systematic review was therefore conducted to summarize the existing evidence base regarding psychosocial stress, interpersonal sensitivity, and social withdrawal in individuals at CHR for psychosis. An electronic search of Ovid (PsychINFO, EMBASE, MEDLINE, and GLOBAL HEALTH) was conducted until February 2022. Studies that examined psychosocial stress in CHR were included. Twenty-nine studies were eligible for inclusion. Psychosocial stress, interpersonal sensitivity, and social withdrawal were higher in CHR individuals compared to healthy controls and there was some evidence of their association with positive symptoms of psychosis. Two types of psychosocial stressors were found to occur more frequently with CHR status, namely daily stressors, and early and recent trauma, while significant life events did not appear to be significant. Greater exposure to psychosocial stress, emotional abuse, and perceived discrimination significantly increased risk of transition to psychosis in CHR. No studies examined the role of interpersonal sensitivity on transition to psychosis in CHR. This systematic review provides evidence for the association of trauma, daily stressors, social withdrawal, and interpersonal sensitivity with CHR status. Further studies investigating the impact of psychosocial stress on psychosis symptom expression in individuals at CHR and its effects on transition to psychosis are therefore warranted.

The association between psychosocial stress, interpersonal sensitivity, social withdrawal and psychosis relapse: a systematic review

Psychosis is associated with a high risk of relapse, with 67% of clients relapsing within one year following a first episode. In light of the high personal, social, and healthcare costs of the illness, it is paramount to understand the risk factors associated with psychosis relapse. The current systematic review aims to critically review the role of psychosocial stress in psychosis relapse in individuals with an established psychotic disorder. This review systematically searched Ovid (PsycINFO, EMBASE, MEDLINE) literature databases from inception until 28th February 2022. Sixteen studies were eligible for inclusion. Most studies found that individuals with psychosis demonstrate high levels of psychosocial stress and are more likely to be socially withdrawn compared to healthy controls or other clinical presentations. Most studies reported a statistically significant association between psychosocial stress and psychosis relapse, as well as between social withdrawal and psychosis relapse. However, no studies examined the association between high levels of interpersonal sensitivity and psychosis relapse. Individuals with psychosis tend to experience high levels of psychosocial stress and social withdrawal, and these appear to increase the risk of psychosis relapse. Due to high levels of heterogeneity within the literature, we could only conduct a narrative synthesis of the findings. Future studies would benefit from employing a meta-analytic approach.

The impact of mental disturbance on second language learning psychology among Chinese undergraduate students: a structural equation modelling analysis

Recent developments in the field of second language acquisition have led to a growing interest in exploring the influential power of domain-general psychological properties in the L2 learning context. Several attempts have been made to elucidate the impact of properties such as boredom, resilience and enjoyment, etc. However, the association between psychopathology and second language learning psychology has received scant attention and has not been closely examined. Hence, the current study aims to explore the impact of mental disturbance on second language learning psychology and delineate the influential trajectory, by referring to the network approach as the theoretical foundation. Participants were 173 Chinese speakers of L2 English. By performing correlation analysis and structural equation modelling analysis, this research revealed that mental disturbance had a significant positive impact on L2 anxiety and a significant negative impact on L2 autonomy and L2 self-efficacy. L2 anxiety and L2 autonomy acted as mediating roles in the impact of mental disturbance on L2 self-efficacy, in which a chain mediation trajectory was detected. An expanded network approach was thus advanced. Pedagogical implication and future research were identified and discussed.

Wearing face masks impairs dyadic micro-activities in nonverbal social encounter: A mixed-methods first-person study on the sense of I and Thou

The COVID-19 pandemic has manifold negative consequences for people around the world, of which the psychosocial ones have been rather underrepresented in the public eye. Regarding social distancing measures, there is already some experimental work demonstrating that the use of face masks has detrimental effects on various aspects of social cognition such as emotion reading, face identification, and perceived closeness of persons. However, while these findings provide important clues, they do not shed light on what people experience when interacting in real life in a masked society. Therefore, in critical distance to cognitivist accounts and taking Direct Social Perception (DSP) approaches seriously, we developed a first-person experimental design and conducted a study with thirty-four participants in a dyadic setting with two conditions (without vs. with face mask). Data were analyzed with mixed methods including in-depth qualitative coding at three levels, code relations analyses, and various statistical tests. Results yielded significant differences across conditions at all qualitative levels, comprising, for example, expressive behavior, and, in particular, significant decreases of content-independent, complimentary mental micro-activities. In the context of DSP, we argue in the paper that these activities suggest the constitution of a quasi-sensory modality - conceived as I-Thou sense - that oscillates between strongly and weakly embodied mental activities, as the analyses show. In sum, this study suggests that mask-wearing impairs both functional directions of mental activity in relation to more or less embodied experience and thus intervenes deeply in fundamental processes of social perception and interaction.

Bridging the gap between body image and paranoia-like thoughts

A feeling of vulnerability is believed to be one of the foundations upon which paranoia is built. Factors that may increase vulnerability include negative affective states, low self-esteem and high social rejection sensitivity. Body image, which is one aspect of the overall self-esteem, has recently been shown to be associated with paranoia. However, little is known about factors underlying this association. In this online study conducted on a non-clinical sample (n = 539, 65.5% of female), self-report data assessing paranoia-like thoughts, body image, self-esteem, negative emotions, rejection sensitivity as well as various attitudes and beliefs related to body appearance were collected. The results revealed a significant serial mediation effect of negative emotions, self-esteem and rejection sensitivity in the relationship between body image and paranoia-like thoughts. Parallel mediation analysis showed an effect of social criticism as the only one of four studied groups of beliefs related to body appearance in the relationship between paranoia-like thoughts and body image. Moreover, paranoia-like thoughts were increased in people who were not satisfied with their body, both as a result of feeling too thin and overweight. To conclude, body image is an important factor related to paranoia-like thoughts, through its association with increased vulnerability and negative general self-view. The findings highlight the importance of negative emotions, low self-esteem and high rejection sensitivity, as well as the role of critical comments and lack of perceived acceptance as potential (socially-focused) mechanisms paving the way from negative body image to paranoia-like thoughts.

Birdsongs alleviate anxiety and paranoia in healthy participants

The present study investigated the effect of urban (traffic noise) vs. natural (birdsongs) soundscapes on mood, state paranoia, and cognitive performance, hypothesizing that birdsongs lead to significant improvements in these outcomes. An additional goal was to explore the differential impact of lower vs. higher diversity of the soundscapes by manipulating the number of different typical traffic sounds or songs of different bird species within the respective soundscapes. In a randomized online experiment, N = 295 participants were exposed to one out of four conditions for 6 min: traffic noise low, traffic noise high, birdsong low, and birdsong high diversity soundscapes. Before and after the exposure, participants performed a digit-span and dual n-back task, and filled out depression, anxiety, and paranoia questionnaires. The traffic noise soundscapes were associated with a significant increase in depression (small effect size in low, medium effect size in high diversity condition). Concerning the birdsong conditions, depression exclusively decreased after exposure to the high diversity soundscape (small effect size). Anxiety and paranoia significantly decreased in both birdsong conditions (medium effect sizes). For cognition, no effects were observed. In sum, the present study suggests that listening to birdsongs regardless of diversity improves anxiety, while traffic noise, also regardless of diversity, is related to higher depressiveness. Moreover, for the first time, beneficial, medium-sized effects of birdsong soundscapes were demonstrated, reducing paranoia. Overall, the results bear interesting implications for further research, such as actively manipulating soundscapes in different environments or settings (e.g., psychiatric wards) and testing their effect on subclinical or even clinical manifestations of anxiety and paranoia.

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

BACKGROUND

Mental health problems has become a major public health issue among medical students. Self-esteem and psychological flexibility were important associated factors for mental health, but their relations have not been discussed in medical students. The present study aimed to assess the status of mental health problems among medical students and identified whether psychological flexibility had a mediating role in the effects of self-esteem on the top three most common psychological symptoms.

METHODS

A total of 810 undergraduate students from 18 classes comprised in the sample. Nine dimensions of psychological symptoms was assessed by the Symptom Checklist-90-revised (SCL-90-R). Self-esteem was measured by the Self-esteem Scale (SES) and psychological flexibility was evaluated by the Acceptance and Action Questionnaire 2nd Edition (AAQ-II) and Cognitive Fusion Questionnaire (CFQ-F). Univariate analysis and logistic regression analysis were used to determine the relationship among the top three common psychological symptoms, self-esteem, psychological flexibility, and participants' characteristics. The mediating effect of psychological flexibility between self-esteem and psychological symptoms was detected by bootstrap method.

RESULTS

57.8% of the medical undergraduate students reported positive at least one of the nine psychological symptom dimensions assessed by the SCL-90-R and 13.8% of students had moderate or more severe symptoms. The symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression were the three most common psychological symptoms among the medical students. Meanwhile, self-esteem and psychological flexibility were negatively associated to the symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression. And, almost 50% effects of self-esteem on these three symptoms in medical students exert indirect effects through psychological flexibility.

CONCLUSIONS

Psychological distress was quite common in the Chinese medical students. The three most common psychological symptoms were successively obsessive-compulsiveness, interpersonal sensitivity, and depression. Low self-esteem and psychological inflexibility might be the risk factors for these top three symptoms, and psychological flexibility might play a mediating role in the effects of self-esteem on these psychological symptoms.

Virtual reality-based interventions for patients with paranoia: A systematic review

BACKGROUND AND OBJECTIVE

Paranoia is an important psychiatric symptom with a remarkable effect on daily life. Virtual reality (VR)-based treatments are influential and safe for patients with paranoia. This study aimed to evaluate the effectiveness, and define the clinical and technical characteristics of available VR strategies for the treatment of patients with paranoia.

MATERIALS AND METHODS

Studies published up to 25/11/2021 reporting VR-based interventions for the treatment of patients with paranoia were reviewed in five databases, including PubMed, Embase, Web of Science, PsycINFO, and Scopus.

RESULTS

Out of 302 initial search results, eight were included in the present study based on the inclusion criteria. Six studies were randomized clinical trials with the interventions in the experimental group being based on VR, compared to routine interventions as controls. Two were before-after studies. The most commonly used hardware and software were head-mounted display and Unity3D, respectively. Interventions had a range of 1-16 sessions with follow-up durations of 0-6 months. All investigations showed positive results in the main target, including improved social participation, reduced level of anxiety, as well as diminished suspicious ideas and paranoid symptoms.

CONCLUSIONS

Our findings demonstrated that VR-based interventions are effective treatments. Although the use of VR technology is limited for a variety of reasons, such as cost, it improves symptoms in patients with paranoia.

Understanding the Consequences of Moment-by-Moment Fluctuations in Mood and Social Experience for Paranoid Ideation in Psychotic Disorders

Among individuals with psychotic disorders, paranoid ideation is common and associated with increased impairment, decreased quality of life, and a more pessimistic prognosis. Although accumulating research indicates negative affect is a key precipitant of paranoid ideation, the possible protective role of positive affect has not been examined. Further, despite the interpersonal nature of paranoid ideation, there are limited and inconsistent findings regarding how social context, perceptions, and motivation influence paranoid ideation in real-world contexts. In this pilot study, we used smartphone ecological momentary assessment to understand the relevance of hour-by-hour fluctuations in mood and social experience for paranoid ideation in adults with psychotic disorders. Multilevel modeling results indicated that greater negative affect is associated with higher concurrent levels of paranoid ideation and that it is marginally related to elevated levels of future paranoid ideation. In contrast, positive affect was unrelated to momentary experiences of paranoid ideation. More severe momentary paranoid ideation was also associated with an elevated desire to withdraw from social encounters, irrespective of when with familiar or unfamiliar others. These observations underscore the role of negative affect in promoting paranoid ideation and highlight the contribution of paranoid ideation to the motivation to socially withdraw in psychotic disorders.

Exploring the Relationship Between Trait Mindfulness and Interpersonal Sensitivity for Chinese College Students: The Mediating Role of Negative Emotions and Moderating Role of Effectiveness/Authenticity

Background: Interpersonal sensitivity is a prominent mental health problem facing college students today. Trait mindfulness is a potential positive factor that may influence interpersonal relationships. However, the precise relationship between trait mindfulness and interpersonal sensitivity remains elusive, which limits the optimization and further application of mindfulness-based intervention schemes targeting interpersonal sensitivity. This study aimed to explore (a) whether negative emotions mediate the relationship between trait mindfulness and interpersonal sensitivity and (b) whether the relationship among trait mindfulness, negative emotions, and interpersonal sensitivity is moderated by effectiveness/authenticity. We hypothesize that (a) negative emotions mediate the relationship between trait mindfulness and interpersonal sensitivity, and (b) effectiveness/authenticity moderates the indirect association between trait mindfulness and interpersonal sensitivity through negative emotions.

Methods: One thousand four hundred nineteen Chinese college students (1,023 females, 396 males), aged from 17 to 23 (SD = 0.86, mean = 18.38), participated in this study. Their trait mindfulness, negative emotions, the effectiveness/authenticity, and interpersonal sensitivity were measured using well-validated self-report questionnaires.

Results: Correlational analyses indicated that both trait mindfulness and effectiveness/authenticity were significantly and negatively associated with interpersonal sensitivity. Mediation analyses uncovered a partial mediating role of negative emotions in the relationship between trait mindfulness and interpersonal sensitivity. Moderated mediation analyses showed that in college students with high effectiveness/authenticity, the relationship between trait mindfulness and negative emotions was stronger, whereas the relationship between negative emotions and interpersonal sensitivity was weaker.

Conclusion: Negative emotion is a mediator of the relationship between trait mindfulness and interpersonal sensitivity, which in turn is moderated by effectiveness/authenticity. These findings suggest a potential mechanism through which trait mindfulness influences interpersonal sensitivity. Mindfulness-based interventions have the potential to decrease interpersonal sensitivity and offer a basis for predicting individual differences in response to mindfulness-based interventions among individuals.

A Temporal Network Approach to Paranoia: A Pilot Study

Paranoid beliefs have been conceptualized as a central psychological process linked to schizophrenia and many mental disorders. Research on paranoia has indicated that it is pivotal to consider not only levels but also dynamic aspects of incriminated related mechanisms over time. In the present study, we conceptualized paranoia as a system of interacting elements. To do so, we used temporal network analysis to unfold the temporal dynamics between core psychological paranoia-related mechanisms, such as self-esteem, sadness, feeling close to others, and experiential avoidance. Time-series data of 23 participants with high scores in paranoia and/or interpersonal sensitivity were collected via experience sampling methodology (ESM). We applied a multilevel vector autoregressive (mlVAR) model approach and computed three distinct and complementary network models (i.e., contemporaneous, temporal, and between-subject) to disentangle associations between paranoia-related mechanisms in three different time frames. The contemporaneous model indicated that paranoia and sadness co-occurred within the same time frame, while sadness was associated with both low self-esteem and lack of closeness to others. The temporal model highlighted the importance of feeling close to others in predicting low paranoia levels in the next time frame. Finally, the between-subject model largely replicated an association found in both contemporaneous and temporal models. The current study reveals that the network approach offers a viable data-driven methodology for elucidating how paranoia-related mechanisms fluctuate over time and may determine its severity. Moreover, this novel perspective may open up new directions toward identifying potential targets for prevention and treatment of paranoia-related problems.

Deconstructing the relationships between self-esteem and paranoia in early psychosis: an experience sampling study

Background

No studies have examined the association between self‐esteem and paranoia developmentally across the critical stages of psychosis emergence. The present study fills this gap and extends previous research by examining how different dimensions, measures, and types of self‐esteem relate to daily‐life paranoia across at‐risk mental states for psychosis (ARMS) and first episode of psychosis (FEP) stages. Furthermore, the moderation effects of momentary anxiety and momentary perceived social support on the association between momentary self‐esteem and paranoia were examined.

Design

This study used a multilevel, cross‐sectional design.

Methods

One‐hundred and thirteen participants (74 ARMS and 39 FEP) were assessed repeatedly over seven consecutive days on levels of momentary paranoia, self‐esteem, anxiety and perceived social support using experience sampling methodology. Measures of trait and implicit self‐esteem were also collected.

Results

Global momentary and trait self‐esteem, and their positive and negative dimensions, were related to daily‐life paranoia in both ARMS and FEP groups. Conversely, implicit self‐esteem was not associated with daily‐life paranoia in either group. Anxiety negatively moderated the association between positive self‐esteem and lower paranoia, whereas both feeling close to others and feeling cared for by others strengthened this association. However, only feeling cared for by others moderated the association between negative self‐esteem and higher paranoia.

Conclusions

Different types, measures and dimensions of self‐esteem are differentially related to paranoia in early psychosis and are influenced by contextual factors in daily‐life. This yields a more complex picture of these associations and offers insights that might aid psychological interventions.

Practitioner points

Different measures (trait and momentary) and dimensions (positive and negative) of explicit self‐esteem are distinctly related to paranoia across risk and first‐episode stages of psychosis.

Explicit, but not implicit, self‐esteem is associated with real‐life paranoia in incipient psychosis.

Anxiety boosted the association of poor self‐esteem and paranoia ideation in daily‐life.

Social closeness, but feeling cared for by others in particular, interacts with self‐esteem tempering the expression of paranoia in real life.

Paranoia, sensitization and social inference: findings from two large-scale, multi-round behavioural experiments

The sensitization model suggests that paranoia is explained by over-sensitivity to social threat. However, this has been difficult to test experimentally. We report two preregistered social interaction studies that tested (i) whether paranoia predicted overall attribution and peak attribution of harmful intent and (ii) whether anxiety, interpersonal sensitivity and worry predicted the attribution of harmful intent. In Study 1, we recruited a large general population sample (N = 987) who serially interacted with other participants in multi-round dictator games and matched to fair, partially fair or unfair partners. Participants rated attributions of harmful intent and self-interest after each interaction. In Study 2 (N = 1011), a new sample of participants completed the same procedure and additionally completed measures of anxiety, worry and interpersonal sensitivity. As predicted, prior paranoid ideation was associated with higher and faster overall harmful intent attributions, whereas attributions of self-interest were unaffected, supporting the sensitization model. Contrary to predictions, neither worry, interpersonal sensitivity nor anxiety was associated with harmful intent attributions. In a third exploratory internal meta-analysis, we combined datasets to examine the effect of paranoia on trial-by-trial attributional changes when playing fair and unfair dictators. Paranoia was associated with a greater reduction in harmful intent attributions when playing a fair but not unfair dictator, suggesting that paranoia may also exaggerate the volatility of beliefs about the harmful intent of others.

Self-Awareness of Psychopathology and Brain Volume in Patients With First Episode Psychosis

Memory impairment, excessive rumination, and increased interpersonal sensitivity are major characteristics of high psychosis risk or first episode psychosis (FEP). Herein, we investigated the relationship between brain volume and self-awareness of psychopathology in patients with FEP. All participants (FEP: 34 and HCs: 34) completed clinical assessments and the following self-reported psychopathology evaluations: prospective and retrospective memory questionnaire (PRMQ), ruminative response scale (RRS), and interpersonal sensitivity measure (IPSM). Structural magnetic resonance imaging was then conducted. The PRMQ, RRS, and IPSM scores were significantly higher in the FEP group than in the healthy controls (HCs). The volumes of the amygdala, hippocampus, and superior temporal gyrus (STG) were significantly lower in the FEP group than in the HCs. There was a significant group-dependent moderation effect between self-awareness of psychopathology (PRMQ, RRS, and IPSM scores) and right STG (rSTG) volume. In the FEP group, self-awareness of psychopathology was positively associated with rSTG volume, while in the HCs, this correlation was negative. Our results indicate that self-awareness of psychopathology impacts rSTG volume in the opposite direction between patients with FEP and HCs. In patients with FEP, awareness of impairment may induce increases in rSTG brain volume. However, HCs showed decreased rSTG volume when they were aware of impairment.