Explaining paranoia: cognitive and social processes in the occurrence of extreme mistrust.
Anxiety disorders
Schizophrenia & psychotic disorders
Journal
BMJ mental health
ISSN: 2755-9734
Titre abrégé: BMJ Ment Health
Pays: England
ID NLM: 9918521385306676
Informations de publication
Date de publication:
Nov 2023
Nov 2023
Historique:
received:
08
09
2023
accepted:
26
10
2023
medline:
13
11
2023
pubmed:
10
11
2023
entrez:
9
11
2023
Statut:
ppublish
Résumé
Paranoia-incorrectly thinking that others are deliberating trying to harm you-causes distress, undermines social interactions and leads to withdrawal. It presents across multiple psychiatric diagnoses. The primary aim was to determine the extent that cognitive and social processes may explain paranoia. The secondary aim was to identify explanatory factors that distinguished paranoia and social anxiety. 10 382 UK adults, quota sampled to match the population for age, gender, ethnicity, income and region, participated in a non-probability survey. All participants completed a paranoia measure and assessments of cognitive and social processes. Structural equation modelling was conducted. 2586 (24.9%) participants described being mistrustful of other people. 1756 (16.9%) participants wanted help to trust more. 66.7% of variance in paranoia was explained by a model comprising (in descending order of importance): within-situation defence behaviours, negative images, negative self-beliefs, discrimination, dissociation, aberrant salience, anxiety sensitivity, agoraphobic distress, worry, less social support, agoraphobic avoidance, less analytical reasoning and alcohol use. All explanatory factors were associated with paranoia and social anxiety. Ten factors were more closely associated with paranoia than social anxiety, including discrimination, hallucinations, negative images, aberrant salience and alcohol use. Nine factors were more closely associated with social anxiety, including less positive self-belief, an external locus of control, worry and less analytical reasoning. Multiple causes are likely to be involved in paranoia. Cognitive and social processes may explain a high degree of paranoia. Multiple clear targets for intervention to reduce paranoia are identified.
Sections du résumé
BACKGROUND
BACKGROUND
Paranoia-incorrectly thinking that others are deliberating trying to harm you-causes distress, undermines social interactions and leads to withdrawal. It presents across multiple psychiatric diagnoses.
OBJECTIVE
OBJECTIVE
The primary aim was to determine the extent that cognitive and social processes may explain paranoia. The secondary aim was to identify explanatory factors that distinguished paranoia and social anxiety.
METHODS
METHODS
10 382 UK adults, quota sampled to match the population for age, gender, ethnicity, income and region, participated in a non-probability survey. All participants completed a paranoia measure and assessments of cognitive and social processes. Structural equation modelling was conducted.
FINDINGS
RESULTS
2586 (24.9%) participants described being mistrustful of other people. 1756 (16.9%) participants wanted help to trust more. 66.7% of variance in paranoia was explained by a model comprising (in descending order of importance): within-situation defence behaviours, negative images, negative self-beliefs, discrimination, dissociation, aberrant salience, anxiety sensitivity, agoraphobic distress, worry, less social support, agoraphobic avoidance, less analytical reasoning and alcohol use. All explanatory factors were associated with paranoia and social anxiety. Ten factors were more closely associated with paranoia than social anxiety, including discrimination, hallucinations, negative images, aberrant salience and alcohol use. Nine factors were more closely associated with social anxiety, including less positive self-belief, an external locus of control, worry and less analytical reasoning.
CONCLUSIONS
CONCLUSIONS
Multiple causes are likely to be involved in paranoia. Cognitive and social processes may explain a high degree of paranoia.
CLINICAL IMPLICATIONS
CONCLUSIONS
Multiple clear targets for intervention to reduce paranoia are identified.
Identifiants
pubmed: 37945313
pii: bmjment-2023-300880
doi: 10.1136/bmjment-2023-300880
pmc: PMC10649488
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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