Bidirectional pathways between psychosocial risk factors and paranoid ideation in a general nonclinical population

Psychological problems and work ability in unemployed people diagnosed with a mental illness

BACKGROUND

Research shows that unemployed individuals are more often affected by mental illness, and that mental illness can impede an individual's work ability, creating a significant obstacle to (re)entering the workforce.

AIMS

The objective of this study is to examine the relationships between psychological symptoms and work ability in unemployed individuals with mental illnesses (UMIs). This will enable us to identify the symptoms that are most relevant for future research and application.

METHOD

Our study is based on a sample from the project LIPSY, which aims to maintain and/or restore the employability of UMIs. We conducted regression analyses with the outcome variable work ability in a sample of unemployed individuals with a mental illness (ICD-10: F-diagnosis). In the initial analysis, age, gender, education, and cohabitation status were used as predictors; in the final model, all nine symptom dimensions (SCL-90) were added, that is, (1) Somatization, (2) Obsessive-Compulsive, (3) Interpersonal Sensitivity, (4) Depression, (5) Anxiety, (6) Anger-Hostility, (7) Phobic Anxiety, (8) Paranoid Ideation, and (9) Psychoticism.

RESULTS

Our sample comprised 402 participants, with a mean age of 35.7 years, 52.5% were female. In the final analysis, we found significant positive associations between education, Paranoid Ideation, and work ability, and a significant negative one between Depression and work ability, but no other significant associations.

CONCLUSIONS

The elevated scores on all SCL-90 dimensions, along with the associations between two dimensions and work ability, underscore the need for psychological screening, diagnosis, prevention, and therapy (Depression) as well as additional public health attention and research (Paranoid Ideation) in this high-risk population.

Immersive virtual reality as a novel approach to investigate the association between adverse events and adolescent paranoid ideation

PURPOSE

Paranoid ideation is common among adolescents, yet little is known about the precursors. Using a novel immersive virtual reality (VR) paradigm, we tested whether experiences of bullying, and other interpersonal/threatening events, are associated with paranoid ideation to a greater degree than other types of (i) non-interpersonal events or (ii) adverse childhood experiences.

METHODS

Self-reported exposure to adverse life events and bullying was collected on 481 adolescents, aged 11-15. We used mixed effects (multilevel) linear regression to estimate the magnitude of associations between risk factors and paranoid ideation, assessed by means of adolescents' reactions to ambiguously behaving avatars in a VR school canteen, adjusting for putative confounders (gender, year group, ethnicity, free school meal status, place of birth, family mental health problems).

RESULTS

Lifetime exposure to interpersonal/threatening events, but not non-interpersonal events or adverse circumstances, was associated with higher levels of state paranoid ideation, with further evidence that the effect was cumulative (1 type: ϐadj 0.07, 95% CI -0.01-0.14; 2 types: ϐadj 0.14, 95% CI 0.05-0.24; 3 + types: ϐadj 0.24, 95% CI 0.12-0.36). More tentatively, for girls, but not boys, recent bullying was associated with heightened paranoid ideation with effect estimates ranging from ϐadj 0.06 (95% CI -0.02-0.15) for physical bullying to ϐadj 0.21 (95% CI 0.10-0.32) for cyber bullying.

CONCLUSIONS

Our data suggest a degree of specificity for adversities involving interpersonal threat or hostility, i.e. those that involve unwanted interference and/or attempted control of an individual's personal boundaries being associated with heightened levels of state paranoid ideation among adolescents.

Conspiratorial thinking in a 50-state survey of American adults

Background

While the NIMH Research Domain Criteria framework stresses understanding how neuropsychiatric phenotypes vary across populations, little is known outside of small clinical cohorts about conspiratorial thoughts as an aspect of cognition.

Methods

We conducted a 50-state non-probability internet survey conducted in 6 waves between October 6, 2022 and January 29, 2024, with respondents age 18 and older. Respondents completed the American Conspiratorial Thinking Scale (ACTS) and the 9-item Patient Health Questionnaire (PHQ-9). Survey-weighted regression models were used to examine sociodemographic and clinical associations with ACTS score, and associations with vaccination status.

Results

Across the 6 survey waves, there were 123,781 unique individuals. After reweighting, a total of 78.6% of respondents somewhat or strongly agreed with at least one conspiratorial idea; 19.0% agreed with all four of them. More conspiratorial thoughts were reported among those age 25 - 54, males, individuals who finished high school but did not start or complete college, those with household income between $25,000 and $50,000 per year, and those who reside in rural areas, as well as those with greater levels of depressive symptoms. Endorsing more conspiratorial thoughts was associated with a significantly lower likelihood of being vaccinated against COVID-19.

Discussion

A substantial proportion of US adults endorsed at least some conspiratorial thinking, which varied widely across population subgroups. The extent of correlation with non-vaccination suggests the importance of considering such thinking in designing public health strategies.

The Pandemic Paranoia Scale (PPS): factor structure and measurement invariance across languages

BACKGROUND

Globally, the corona virus disease 2019 (COVID-19) pandemic has created an interpersonally threatening context within which other people have become a source of possible threat. This study reports on the development and validation of a self-report measure of pandemic paranoia; that is, heightened levels of suspicion and mistrust towards others due to the COVID-19 pandemic.

METHODS

An international consortium developed an initial set of 28 items for the Pandemic Paranoia Scale (PPS), which were completed by participants from the UK (n = 512), USA (n = 535), Germany (n = 516), Hong Kong (n = 454) and Australia (n = 502) using stratified quota sampling (for age, sex and educational attainment) through Qualtrics and translated for Germany and Hong Kong.

RESULTS

Exploratory factor analysis in the UK sample suggested a 25-item, three-factor solution (persecutory threat; paranoid conspiracy and interpersonal mistrust). Confirmatory factor analysis (CFA) on the remaining combined sample showed sufficient model fit in this independent set of data. Measurement invariance analyses suggested configural and metric invariance, but no scalar invariance across cultures/languages. A second-order factor CFA on the whole sample indicated that the three factors showed large loadings on a common second-order pandemic paranoia factor. Analyses also supported the test-retest reliability and internal and convergent validity.

CONCLUSION

The PPS offers an internationally validated and reliable method for assessing paranoia in the context of a pandemic. The PPS has the potential to enhance our understanding of the impact of the pandemic, the nature of paranoia and to assist in identifying and supporting people affected by pandemic-specific paranoia.