Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking.
ABSTRACT 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.
- SourceAvailable from: Ken I. Manktelow[Show abstract] [Hide abstract]
ABSTRACT: Although adolescence is a particularly sensitive period for the development of schizotypy (Walker and Bollini [Schizophr Res 54:17-23, 2002]), there has been relatively limited research on the psychological factors that specifically predict delusional beliefs during adolescence. We studied 392 school students aged 11 to 16 years with a battery of behavioral and psychometric measures. Anxiety and negative-other schemas mediated the relationship between hallucinatory experiences and paranoid beliefs; anxiety mediated the relationship between hallucinatory experiences and grandiose beliefs; anxiety and self-negative schemas mediated the relationship between hallucinatory experiences and "other delusions" (Schneiderian/reference/misidentification). Furthermore, a jump-to-conclusions (JTC) bias moderated the relation between anxiety and other delusions: scores in the other delusions category were highest in adolescents who had both high anxiety and a JTC bias. Sex and age had only weak effects upon delusional belief. Our findings provide novel data by highlighting the different factors that underpin three delusional subtypes during the vulnerable period of adolescence.Journal of Nervous & Mental Disease 08/2014; · 1.81 Impact Factor
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ABSTRACT: Delusions are, in part, attempts to explain confusing anomalous experience. Depersonalization, a key subset of anomalous experience, has been little studied in relation to persecutory delusions. The aims of this study were to assess the presence of depersonalization in patients with persecutory delusions and to examine associations with levels of paranoia and worry. Fifty patients with a current persecutory delusion completed measures of depersonalization, psychotic symptoms, and worry. Depersonalization experiences were common: 30 patients (60%) each reported at least 10 different depersonalization symptoms occurring often. A greater number of depersonalization experiences were associated with higher levels of paranoia and worry. The positive association of worry and paranoia became nonsignificant when controlling for depersonalization. Overall, depersonalization may be common in patients with persecutory delusions and is associated with the severity of paranoia. The results are consistent with the view that worry may cause depersonalization experiences that contribute to the occurrence of paranoid thoughts.Journal of Nervous & Mental Disease 09/2014; 202(10). · 1.81 Impact Factor
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ABSTRACT: Recent models of psychosis have implicated specific psychological processes in the aetiology of this disorder, and these factors may form a route to later symptoms-either directly or via a mediating pathway after exposure to adversity. Researchers are beginning to bring together findings that look into specific pathways between early experiences of adversity and different symptoms of psychosis, including thought disorder, hallucinations and persecutory delusions. The adversity-specific pathways include parental communication deviance, source monitoring biases, and insecure attachment. Researchers have also begun to utilise specific psychological factors as targets for treatment, and these include a focus on a worrying thinking style, negative beliefs about the self, interpersonal sensitivity, sleep disturbance, anomalous internal experience, and reasoning biases. Research on the impact of psychological processes is beginning to mount and is likely to improve our understanding of aetiology and lead to significant advances in the treatment of psychotic symptoms and disorders.Social Psychiatry and Psychiatric Epidemiology 09/2014; · 2.58 Impact Factor