Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking

Department of Psychiatry, Warneford Hospital, Oxford University, Oxford, OX3 7JX, UK.
Social Psychiatry (Impact Factor: 2.54). 09/2011; 47(8):1195-203. DOI: 10.1007/s00127-011-0433-1
Source: PubMed


Our theoretical model proposes that insomnia, worry, and negative affect are important determinants of paranoid thinking. Anxiety produces anticipation of threat, depression increases the sense of vulnerability, worry leads to implausible ideas, and insomnia exacerbates negative affect and creates an altered perceptual state. The study objective was to examine for the first time these factors as predictors of the onset of new paranoid thinking and of the persistence of existing paranoid thinking.
A total of 2,382 participants in the 2000 British National Psychiatric Morbidity Survey were followed-up 18 months after their first assessment. Baseline assessments were used to predict the development and persistence of paranoid thinking at follow-up. Data were weighted to be representative of the general household population.
Insomnia, worry, anxiety, depression and depressive ideas were each substantial predictors both of new inceptions of paranoia and of the persistence of existing paranoid thinking. Worry and insomnia were the strongest predictors. For example, insomnia at the first assessment led to a more than threefold increase in later inceptions of paranoid thinking.
The study indicates that insomnia, worry, anxiety and depression are potential risk factors for new inceptions of paranoid thinking. The results also corroborate an emerging literature indicating that anxiety, worry and depression may encourage the persistence of paranoid thinking. The study provides the first longitudinal evidence linking insomnia and paranoia. The important clinical implication is that the use of interventions for common mental health difficulties in people with psychosis may have the additional benefit of reducing paranoia.

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    • "Ainsi, des facteurs individuels de vulnérabilité ont pu être identifiés (niveau d'anxiété important, faible estime de soi, etc.) mais également des facteurs environnementaux comme les facteurs de stress, les traumatismes ou les consommations de toxiques (cannabis notamment [15]), courantes en détention. Le rôle des troubles du sommeil a également pu être évoqué [14], ce qui apparaît intéressant puisque l'insomnie constitue une plainte fréquente en milieu pénitentiaire [9]. "

    Annales Médico-psychologiques revue psychiatrique 08/2015; DOI:10.1016/j.amp.2015.07.033 · 0.22 Impact Factor
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    • "Adding to this hypothesis, our findings suggest that shared causes give rise to sleep disturbances and PLEs. Once both have developed, perhaps they then maintain one another in the manner postulated by Freeman et al. (2012), described above. A test of this would be possible with longitudinal twin data; one can assess the direct influence of a trait on another, as well as estimating genetic and environmental contributions to the causal phenotypic relationship between two traits (Luo, Haworth, & Plomin, 2010). "
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    ABSTRACT: Sleep disturbances regularly co-occur with clinical psychotic disorders and dimensions of psychotic-like experiences (PLEs). One possible explanation for this, which has yet to be tested, is that similar genetic or environmental influences underlie sleep disturbances and vulnerability to PLEs. We conducted a twin study to test this possibility in relation to sleep disturbances and six specific PLEs in adolescence in the general population. Approximately 5,000 16-year-old twin pairs completed the Pittsburgh Sleep Quality Index and Insomnia Severity Index. PLEs were assessed using the Specific PLEs Questionnaire, comprising five self-report subscales (Paranoia, Hallucinations, Cognitive Disorganization, Grandiosity, and Anhedonia) and one parent-report subscale (Negative Symptoms). The associations between these measures were tested using structural equation twin model fitting. Paranoia, Hallucinations, and Cognitive Disorganization displayed moderate and significant correlations with both sleep measures (0.32-.42), while Negative Symptoms, Anhedonia, and Grandiosity showed lower correlations (0.01-0.17). Genetic and environmental influences significantly overlapped across PLEs (Paranoia, Hallucinations, Cognitive Disorganization) and both types of sleep disturbance (mean genetic and nonshared environmental correlations = 0.54 and 0.24, respectively). These estimates reduced, yet remained significant, after controlling for negative affect. The association between PLEs with sleep disturbances in adolescence is partly due to genetic and environmental influences that are common to them both. These findings indicate that the known neurobiology of sleep disturbance may provide clues regarding the causes of PLEs in adolescence. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Abnormal Psychology 05/2015; 124(3). DOI:10.1037/abn0000057 · 4.86 Impact Factor
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    • "AVHs and other anomalous perceptions may also induce delusional interpretations of the environment (Freeman, Garety, Kuipers, Fowler, & Bebbington, 2002), while, conversely, delusional representations of the world may facilitate spurious/anomalous perceptions (Haddock, Slade, & Bentall, 1995). The recent finding from Freeman and his colleagues that insomnia is associated with paranoia is consistent with the hypothesis that paranoid thoughts can be triggered by anomalous experiences (Freeman et al., 2011). This study had a number of limitations. "
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    ABSTRACT: A recent general population study demonstrated specificity of association between particular forms of childhood adversity and particular psychotic experiences. This study sought to test the stability of this specificity in an adverse adult environment context using data from the Survey of Psychiatric Morbidity among Prisoners in England and Wales. Multivariate analysis showed that specific adversities predicted specific psychotic experiences. Bullying produced the highest odds ratio for paranoia (OR = 1.99), which was also predicted by being raised in institutional care (OR = 1.49). Sexual abuse produced the highest odds ratio for hallucinations (OR = 2.37). Sexual abuse and bullying produced the highest increased odds ratios for experiencing co-occurring paranoia and hallucinations (OR = 2.80) and (OR = 2.42), respectively.
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