Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.
Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom; Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom.
J Behav Ther Exp Psychiatry. 2019 Mar;62:30-37. doi: 10.1016/j.jbtep.2018.08.008. Epub 2018 Aug 29.
Interpersonal stress is key to the development and maintenance of paranoia. Much attention has been given to the impact of interpersonal stressors, such as criticism, on outcomes in psychosis. Less attention has been given to the potentially protective effects of positive interpersonal factors. This study tested experimentally whether criticism and warm comments elicited changes in state paranoia. Whether warm comments provided protective effects when participants faced subsequent social exclusion was also examined.
A nonclinical sample (N = 97) was randomised to criticism, warm comments, or neutral comments conditions. Participants then played a virtual ball game (Cyberball), during which they were systematically excluded from the game. State paranoia was measured before and after the affective stimuli and after social exclusion. Self-esteem and trait paranoia were also measured.
Paranoia levels increased following exposure to criticism (p = .011). Paranoia was not significantly lower following exposure to warm comments (p = .203). Warm comments did not provide protection against the effects of subsequent social exclusion. The warm comments condition was the only condition in which significant increases in paranoia were seen following social exclusion (p = .004).
Use of a non-clinical sample limits generalisation to clinical populations.
Criticism is sufficient to elicit increases in paranoia in non-clinical participants. Warm comments are insufficient to significantly reduce paranoia or provide protective effects against subsequent negative interpersonal experiences, highlighting the need to balance therapeutic warmth with amelioration of social stressors in paranoia.
人际压力是偏执发展和维持的关键。人们已经关注到人际压力源(如批评)对精神病结局的影响。但对积极人际因素的潜在保护作用关注较少。本研究通过实验测试了批评和温暖的评论是否会引起状态偏执的变化。当参与者面临随后的社会排斥时,温暖的评论是否提供保护作用也进行了检验。
非临床样本(N=97)被随机分配到批评、温暖评论或中性评论条件。然后,参与者玩了一个虚拟的球类游戏(Cyberball),在这个游戏中,他们被系统地排除在游戏之外。在情感刺激前后以及社会排斥后测量状态偏执。自尊和特质偏执也进行了测量。
在暴露于批评后,偏执水平升高(p=0.011)。在暴露于温暖的评论后,偏执水平没有明显降低(p=0.203)。温暖的评论并不能防止随后的社会排斥的影响。只有在社会排斥后,温暖的评论条件才会出现偏执明显增加的情况(p=0.004)。
使用非临床样本限制了对临床人群的推广。
批评足以引起非临床参与者的偏执增加。温暖的评论不足以显著降低偏执或对随后的负面人际经历提供保护作用,这突出表明需要在偏执症的治疗中平衡治疗的温暖和减轻社会压力源。