Southern Health NHS Foundation Trust and University of Southampton, UK.
Behav Cogn Psychother. 2013 Jan;41(1):66-88. doi: 10.1017/S1352465812000690. Epub 2012 Sep 28.
There is good reason to consider the role of social anxiety processes in paranoia; both the research and clinical literature indicate significant overlap between the two presentations. The aim of this study was to explore cognition and behaviour that are typically associated with social phobia, in people with paranoia, and then to draw out theoretical and clinical implications.
We used a cross-sectional between-subjects design to compare participants with persecutory delusions (without social phobia), social phobia, a clinical control group with panic disorder, and a non-clinical control group. Ten to 15 people were recruited to each of four groups, with a final total of 48 participants. Each person completed measures of automatic thoughts, underlying assumptions, core beliefs and behaviour, and took part in a semi-structured interview designed to assess process (self-consciousness and attentional focus) and metacognitive beliefs.
Surprisingly, measures of cognition and behaviour yielded no systematic differences between people with persecutory delusions and social phobia.
People with persecutory delusions may experience overt and underlying cognition typically associated with social phobia, and behave in similar ways in response to perceived social threat. These initial results indicate: (i) that larger scale research is now warranted in order to draw firm conclusions about social anxiety processes in paranoia; (ii) more specific hypotheses to be tested; and (iii) a clinical model of paranoia, based on the cognitive model of social phobia, which might now usefully be validated.
有充分的理由认为社交焦虑过程在妄想中起作用；研究和临床文献都表明两者之间存在显著重叠。本研究旨在探索与社交恐惧症相关的认知和行为，在妄想症患者中，并从中得出理论和临床意义。
我们使用了一种跨组设计，比较了有被害妄想但没有社交恐惧症的患者、有社交恐惧症的患者、有惊恐障碍的临床对照组患者和无临床症状的对照组患者。每个组招募了 10 到 15 人，最终共有 48 名参与者。每个人都完成了自动思维、潜在假设、核心信念和行为的测量，并参加了一项半结构化访谈，旨在评估过程（自我意识和注意力焦点）和元认知信念。
令人惊讶的是，认知和行为的测量在有被害妄想的人和有社交恐惧症的人之间没有产生系统差异。
有被害妄想的人可能会经历与社交恐惧症相关的明显和潜在的认知，并以类似的方式对感知到的社交威胁做出反应。这些初步结果表明：（i）现在有必要进行更大规模的研究，以便就妄想中的社交焦虑过程得出明确的结论；（ii）提出更具体的假设进行检验；（iii）基于社交恐惧症的认知模型，提出一种妄想症的临床模型，现在可以对其进行验证。
