Hostname: page-component-77c89778f8-sh8wx Total loading time: 0 Render date: 2024-07-17T18:12:20.206Z Has data issue: false hasContentIssue false

Interpersonal processes in paranoia: a systematic review

Published online by Cambridge University Press:  20 March 2018

Susanne F. Meisel
Affiliation:
Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK South London and Maudsley NHS Trust, London, UK
Philippa A. Garety
Affiliation:
Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK South London and Maudsley NHS Trust, London, UK
Daniel Stahl
Affiliation:
Department of Biostatistics and Health Informatics, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
Lucia R. Valmaggia*
Affiliation:
Department of Psychology, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK South London and Maudsley NHS Trust, London, UK
*
Author for correspondence: Dr Lucia R. Valmaggia, E-mail: lucia.valmaggia@kcl.ac.uk

Abstract

Paranoid ideation is a core feature of psychosis, and models of paranoia have long proposed that it arises in the context of disturbances in the perception of the self. However, to develop targeted interventions, there is a benefit in clarifying further, which aspects of self-perception are implicated. Interpersonal sensitivity is a personality trait which has been associated with the risk of paranoid thinking in the general population. However, not all studies have found this link. We aimed to review the empirical literature assessing the association between interpersonal sensitivity and paranoia in both general population and clinical samples; and to explore if associations found differed depending on whether state or trait paranoia was assessed. The review followed PRISMA guidelines. Articles were identified through a literature search in OVID (PsychINFO, MEDLINE) and Web of Science up to December 2016. Fourteen studies with a total of 12 138 participants were included. All studies were of ‘fair’ or ‘good’ quality. A robust association was found between interpersonal sensitivity and paranoia in clinical and general population samples alike, regardless of the method of assessment of both paranoia and interpersonal sensitivity. Although this finding was more pronounced in studies of trait paranoia, it is likely that differences in study purpose, measurement, and power explain these differences. Findings from this review support the hypothesis that feelings of personal vulnerability and exaggerated socially evaluative concerns are central for both onset and maintenance of paranoid symptoms, suggesting avenues for future research in targeted interventions.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anderson, P, Rothbaum, BO and Hodges, LF (2003) Virtual reality exposure in the treatment of social anxiety. Cognitive and Behavioral Practice 10, 240247.Google Scholar
Ascone, L, Sundag, J, Schlier, B and Lincoln, TM (2017) Feasibility and effects of a brief compassion-focused imagery intervention in psychotic patients with paranoid ideation: a randomized experimental pilot study. Clinical Psychology & Psychotherapy 24(2), 348358.Google Scholar
Bak, M, Myin-Germeys, I, Hanssen, M, Bijl, R, Vollebergh, W, Delespaul, P et al. (2003) When does experience of psychosis result in a need for care? A prospective general population study. Schizophrenia Bulletin 29(2), 349358.Google Scholar
Bebbington, PE, McBride, O, Steel, C, Kuipers, E, Radovanovič, M, Brugha, T et al. (2013) The structure of paranoia in the general population. The British Journal of Psychiatry 202(6), 419427.Google Scholar
Bell, V and Freeman, D (2014) A pilot trial of cognitive behavioural therapy for interpersonal sensitivity in individuals with persecutory delusions. Journal of Behavior Therapy and Experimental Psychiatry 45(4), 441446.Google Scholar
Bentall, RP (1994) Cognitive biases and abnormal beliefs: towards a model of persecutory delusions. In David, AS and Cutting, J (eds). The Neuropsychology of Schizophrenia. London: Lawrence Erlbaum, pp. 337360.Google Scholar
Bentall, R (2003) The paranoid self. In Kircher, T and David, A (eds). The Self in Neuroscience and Psychiatry. Cambridge: Cambridge University Press, pp. 293318.Google Scholar
Bentall, RP, Corcoran, R, Howard, R, Blackwood, N and Kinderman, P (2001) Persecutory delusions: a review and theoretical integration. Clinical Psychology Review 21(8), 11431192.Google Scholar
Bentall, RP, Wickham, S, Shevlin, M and Varese, F (2012) Do specific early-life adversities lead to specific symptoms of psychosis? A study from the 2007 the adult psychiatric morbidity survey. Schizophrenia Bulletin 38(4), 734740.Google Scholar
Bouchard, S, Dumoulin, S, Robillard, G, Guitard, T, Klinger, É, Forget, H et al. (2017) Virtual reality compared with in vivo exposure in the treatment of social anxiety disorder: a three-arm randomised controlled trial. The British Journal of Psychiatry 210(4), 276283.Google Scholar
Boyce, P and Parker, G (1989) Development of a scale to measure interpersonal sensitivity. Australian and New Zealand Journal of Psychiatry 23(3), 341351.Google Scholar
Boyce, P, Parker, G, Barnett, B, Cooney, M and Smith, F (1991) Personality as a vulnerability factor to depression. The British Journal of Psychiatry 159(1), 106114.Google Scholar
Butler, JC, Doherty, MS and Potter, RM (2007) Social antecedents and consequences of interpersonal rejection sensitivity. Personality and Individual Differences 43(6), 13761385.Google Scholar
Coid, JW, Ullrich, S, Kallis, C, Keers, R, Barker, D, Cowden, F et al. (2013) The relationship between delusions and violence: findings from the East London first episode psychosis study. JAMA Psychiatry 70(5), 465471.Google Scholar
Derogatis, LR (1993) BSI Brief Symptom Inventory: Administration, Scoring, and Procedure Manual, 4th edn. Minneapolis, MN: National Computer Systems.Google Scholar
Derogatis, LR and Fitzpatrick, M (2004) The SCL-90-R, the brief symptom inventory (BSI), and the BSI-18. In Maruish, MR (ed.). The Use of Psychological Testing for Treatment Planning and Outcome Assessment: Volume 3 Instruments for Adults, 3rd edn. Mahwah, NJ: Lawrence Erlbaum, pp. 142.Google Scholar
Derogatis, L and Melisaratos, N (1983) The brief symptom inventory: an introductory report. Psychological Medicine 13, 595605.Google Scholar
Fenigstein, A and Vanable, PA (1992) Paranoia and self-consciousness. Journal of Personality and Social Psychology 62(1), 129.Google Scholar
Fisher, HL, Appiah-Kusi, E and Grant, C (2012) Anxiety and negative self-schemas mediate the association between childhood maltreatment and paranoia. Psychiatry Research 196(2), 323324.Google Scholar
Fowler, D, Hodgekins, J, Garety, P, Freeman, D, Kuipers, E, Dunn, G et al. (2012) Negative cognition, depressed mood, and paranoia: a longitudinal pathway analysis using structural equation modeling. Schizophrenia Bulletin 38(5), 10631073.Google Scholar
Freeman, D (2007) Suspicious minds: the psychology of persecutory delusions. Psychosis 27(4), 425457.Google Scholar
Freeman, D, Dunn, G, Garety, PA, Bebbington, P, Slater, M, Kuipers, E et al. (2005a) The psychology of persecutory ideation I: a questionnaire survey. The Journal of Nervous and Mental Disease 193(5), 302308.Google Scholar
Freeman, D and Garety, PA (2000) Comments on the content of persecutory delusions: does the definition need clarification? British Journal of Clinical Psychology 39, 407414.Google Scholar
Freeman, D and Garety, P (2014) Advances in understanding and treating persecutory delusions: a review. Social Psychiatry and Psychiatric Epidemiology 49(8), 11791189.Google Scholar
Freeman, D, Garety, PA, Bebbington, P, Slater, M, Kuipers, E, Fowler, D et al. (2005b) The psychology of persecutory ideation II: a virtual reality experimental study. The Journal of Nervous and Mental Disease 193(5), 309315.Google Scholar
Freeman, D, Garety, PA, Bebbington, PE, Smith, B, Rollinson, R, Fowler, D et al. (2005c) Psychological investigation of the structure of paranoia in a non-clinical population. The British Journal of Psychiatry 186(5), 427.Google Scholar
Freeman, D, Gittins, M, Pugh, K, Antley, A, Slater, M and Dunn, G (2008a) What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychological Medicine 38(8), 11211132.Google Scholar
Freeman, D, McManus, S, Brugha, T, Meltzer, H, Jenkins, R and Bebbington, P (2011) Concomitants of paranoia in the general population. Psychological Medicine 41(5), 923.Google Scholar
Freeman, D, Pugh, K, Antley, A, Slater, M, Bebbington, P, Gittins, M et al. (2008b) Virtual reality study of paranoid thinking in the general population. The British Journal of Psychiatry 192(4), 258263.Google Scholar
Freeman, D, Pugh, K, Green, C, Valmaggia, L, Dunn, G and Garety, P (2007) A measure of state persecutory ideation for experimental studies. Journal of Nervous and Mental Disease 195(9), 781784.Google Scholar
Freeman, D, Pugh, K, Vorontsova, N, Antley, A and Slater, M (2010) Testing the continuum of delusional beliefs: an experimental study using virtual reality. Journal of Abnormal Psychology 119(1), 83.Google Scholar
Freeman, D, Slater, M, Bebbington, PE, Garety, PA, Kuipers, E, Fowler, D et al. (2003) Can virtual reality be used to investigate persecutory ideation? The Journal of Nervous and Mental Disease 191(8), 509514.Google Scholar
Freeman, D, Waller, H, Harpur-Lewis, RA, Moore, R, Garety, P, Bebbington, P et al. (2015) Urbanicity, persecutory delusions, and clinical intervention: the development of a brief CBT module for helping patients with persecutory delusions enter social urban environments. Behavioural and Cognitive Psychotherapy 43(1), 4251.Google Scholar
Freud, S (1911) Psychoanalytic notes upon an autobiographical account of a case of paranoia (Dementia Paranoids), Collected Papers, vol. 111, tenth impression, pp. 390472. London. Hogarth Press, 1956.Google Scholar
Fusar-Poli, P, Nelson, B, Valmaggia, L, Yung, AR and McGuire, PK (2014) Comorbid depressive and anxiety disorders in 509 individuals with an at-risk mental state: impact on psychopathology and transition to psychosis. Schizophrenia Bulletin 40(1), 120131.Google Scholar
Garety, P, Kuipers, E, Fowler, D, Freeman, D and Bebbington, P (2001) A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31(2), 189195.Google Scholar
Garety, PA and Freeman, D (2013) The past and future of delusions research: from the inexplicable to the treatable. The British Journal of Psychiatry 203(5), 327.Google Scholar
Gayer-Anderson, C and Morgan, C (2013) Social networks, support and early psychosis: a systematic review. Epidemiology and Psychiatric Sciences 22(2), 131146.Google Scholar
Gilbert, P, Boxall, M, Cheung, M and Irons, C (2005) The relation of paranoid ideation and social anxiety in a mixed clinical population. Clinical Psychology & Psychotherapy 12(2), 124133.Google Scholar
Goldsmith, LP, Lewis, S, Dunn, G and Bentall, R (2015) Psychological treatments for early psychosis can be beneficial or harmful, depending on the therapeutic alliance: an instrumental variable analysis. Psychological Medicine 45(11), 23652373.Google Scholar
Green, CE, Freeman, D, Kuipers, E, Bebbington, P, Fowler, D, Dunn, G (2008) Measuring ideas of persecution and social reference: the Green et al. paranoid thought scales (GPTS). Psychological Medicine 38(1), 101111.Google Scholar
Green, CE, Freeman, D, Kuipers, E, Bebbington, P, Fowler, D, Dunn, G et al. (2011) Paranoid explanations of experience: a novel experimental study. Behavioural and Cognitive Psychotherapy 39(1), 21.Google Scholar
Haddock, G, McCarron, J, Tarrier, N and Faragher, EB (1999) Scales to measure dimensions of hallucinations and delusions: the psychotic symptom rating scales (PSYRATS). Psychological Medicine 29(4), 879889.Google Scholar
Hodges, A, Byrne, M, Grant, E and Johnstone, E (1999) People at risk of schizophrenia. Sample characteristics of the first 100 cases in the Edinburgh high-risk study. The British Journal of Psychiatry 174(6), 547553.Google Scholar
Jaya, E, Ascone, L and Lincoln, T (2017) A longitudinal mediation analysis of the effect of negative-self-schemas on positive symptoms via negative affect. Psychological Medicine, 111. doi: 10.1017/S003329171700277X.Google Scholar
Johns, LC, Cannon, M, Singleton, N, Murray, RM, Farrell, M, Brugha, T et al. (2004) Prevalence and correlates of self-reported psychotic symptoms in the British population. The British Journal of Psychiatry 185(4), 298.Google Scholar
Kendler, KS, Lieberman, JA and Walsh, D (1989) The Structured Interview for Schizotypy (SIS): a preliminary report. Schizophrenia Bulletin 15(4), 559571.Google Scholar
Kesting, ML and Lincoln, TM (2013) The relevance of self-esteem and self-schemas to persecutory delusions: a systematic review. Comprehensive Psychiatry 54(7), 766789.Google Scholar
Lin, A, Wigman, J, Nelson, B, Vollebergh, W, Van Os, J, Baksheev, G et al. (2011) The relationship between coping and subclinical psychotic experiences in adolescents from the general population–a longitudinal study. Psychological Medicine 41(12), 25352546.Google Scholar
Lincoln, TM, Hohenhaus, F and Hartmann, M (2013) Can paranoid thoughts be reduced by targeting negative emotions and self-esteem? An experimental investigation of a brief compassion-focused intervention. Cognitive Therapy and Research 37(2), 390402.Google Scholar
Loewy, RL, Bearden, CE, Johnson, JK, Raine, A and Cannon, TD (2005) The Prodromal Questionnaire (PQ): preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophrenia Research 79(1), 117125.Google Scholar
Maki, P, Veijola, J, Jones, PB, Murray, GK, Koponen, H, Tienari, P et al. (2005) Predictors of schizophrenia-a review. British Medical Bulletin 73(74), 115.Google Scholar
Masillo, A, Day, F, Laing, J, Howes, O, Fusar-Poli, P, Byrne, M et al. (2012) Interpersonal sensitivity in the at-risk mental state for psychosis. Psychological Medicine 42(09), 18351845.Google Scholar
Masillo, A, Valmaggia, L, Saba, R, Brandizzi, M, Lindau, J, Solfanelli, A et al. (2016) Interpersonal sensitivity and functioning impairment in youth at ultra-high risk for psychosis. European Child & Adolescent Psychiatry 25(1), 716.Google Scholar
Masillo, A, Valmaggia, LR, Saba, R, Brandizzi, M, Lo Cascio, N, Telesforo, L et al. (2017) Interpersonal sensitivity, bullying victimization and paranoid ideation among help-seeking adolescents and young adults. Early Intervention in Psychiatry. doi: 10.1111/eip.12447.Google Scholar
McDonnell, J, Stahl, D, Day, F, McGuire, P and Valmaggia, L (2018) Interpersonal sensitivity in those at clinical high risk for psychosis mediates the association between childhood bullying victimisation and paranoid ideation: a virtual reality study. Schizophrenia Research 192, 8995.Google Scholar
Michail, M and Birchwood, M (2009) Social anxiety disorder in first-episode psychosis: incidence, phenomenology and relationship with paranoia. The British Journal of Psychiatry 195(3), 234241.Google Scholar
Moher, D, Stewart, L and Shekelle, P (2016) Implementing PRISMA-P: recommendations for prospective authors. Systematic Reviews 5(1), 15.Google Scholar
Oliver, JE, O'Connor, JA, Jose, PE, McLachlan, K and Peters, E (2012) The impact of negative schemas, mood and psychological flexibility on delusional ideation–mediating and moderating effects. Psychosis 4(1), 618.Google Scholar
Peters, ER, Joseph, SA and Garety, PA (1999) Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. Delusions Inventory). Schizophrenia Bulletin 25(3), 553576.Google Scholar
Pickering, L, Simpson, J and Bentall, RP (2008) Insecure attachment predicts proneness to paranoia but not hallucinations. Personality and Individual Differences 44(5), 12121224.Google Scholar
Reininghaus, U, Kempton, MJ, Valmaggia, L, Craig, TK, Garety, P, Onyejiaka, A et al. (2016) Stress sensitivity, aberrant salience, and threat anticipation in early psychosis: an experience sampling study. Schizophrenia Bulletin 42(3), 712722.Google Scholar
Selbæk, G, Engedal, K and Bergh, S (2013) The prevalence and course of neuropsychiatric symptoms in nursing home patients with dementia: a systematic review. Journal of the American Medical Directors Association 14(3), 161169.Google Scholar
Selten, J-P and Cantor-Graee, E (2005) Social defeat: risk factor for schizophrenia? The British Journal of Psychiatry 187(2), 101.Google Scholar
Sharifi, V, Bakhshaie, J, Hatmi, Z, Faghih-Nasiri, L, Sadeghianmehr, Z, Mirkia, S et al. (2012) Self-Reported psychotic symptoms in the general population: correlates in an Iranian urban area. Psychopathology 45(6), 374380.Google Scholar
Stowkowy, J and Addington, J (2012) Maladaptive schemas as a mediator between social defeat and positive symptoms in young people at clinical high risk for psychosis. Early Intervention in Psychiatry 6(1), 8790.Google Scholar
Tiernan, B, Tracey, R and Shannon, C (2014) Paranoia and self-concepts in psychosis: a systematic review of the literature. Psychiatry Research 216(3), 303313.Google Scholar
Udachina, A, Bentall, R, Varese, F and Rowse, G (2017) Stress sensitivity in paranoia: poor-me paranoia protects against the unpleasant effects of social stress. Psychological Medicine 47(16), 28342843.Google Scholar
Valmaggia, LR, Day, F, Garety, P, Freeman, D, Antley, A, Slater, M et al. (2015a) Social defeat predicts paranoid appraisals in people at high risk for psychosis. Schizophrenia Research 168(1), 1622.Google Scholar
Valmaggia, LR, Day, FL, Kroll, J, Laing, J, Byrne, M, Fusar-Poli, P et al. (2015b) Bullying victimisation and paranoid ideation in people at ultra high risk for psychosis. Schizophrenia Research 168(1), 6873.Google Scholar
Valmaggia, LR, Freeman, D, Green, C, Garety, P, Swapp, D, Antley, A et al. (2007) Virtual reality and paranoid ideations in people with an ‘at-risk mental state'for psychosis. The British Journal of Psychiatry 191(51), s63s68.Google Scholar
Wigman, JT, van Nierop, M, Vollebergh, WA, Lieb, R, Beesdo-Baum, K, Wittchen, H-U et al. (2012) Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity—implications for diagnosis and ultra–high risk research. Schizophrenia Bulletin 38(2), 247257.Google Scholar
Wilhelm, K, Boyce, P and Brownhill, S (2004) The relationship between interpersonal sensitivity, anxiety disorders and major depression. Journal of Affective Disorders 79(1), 3341.Google Scholar