Department of Psychiatry, University of Oxford, Oxford, UK.
Oxford Health NHS Foundation Trust, Oxford, UK.
Psychol Psychother. 2022 Jun;95(2):508-524. doi: 10.1111/papt.12385. Epub 2022 Feb 12.
Paranoia is most likely to emerge in adolescence. In adolescents with mental health disorders, the disruptive effect of paranoia on social relationships could worsen outcomes. However, little is known about clinical presentations of paranoia at this age. We therefore explored the development, experience, and impact of paranoia in adolescent patients.
A qualitative interview design with interpretative phenomenological analysis was used.
Twelve adolescents (11-17 years) with paranoia attending child and adolescent mental health services were interviewed.
Adolescents described a journey starting with their awareness of paranoia beginning to a paranoid experience of mistrust and fear of others, and, subsequently, their adjustment to paranoia in daily life. Paranoia onset was rooted in the discovery of interpersonal threat and personal vulnerability, shaped by challenging peer interactions, becoming aware of danger in the world, and personal adverse experiences. The paranoia experience included a struggle to trust friends, anticipating threat with intense fear, and using defensive strategies to keep safe. Adolescents described how the paranoia experience was confusing, negatively impacted self-concept, held them back from teenage life, and caused disconnection from friends. Longer-term responses to paranoia reflected a tension between reluctantly resigning to the experience and trying to resist the impact.
The journey of paranoia in adolescence involves navigating multiple tensions, with young people balancing independence with vulnerability, trust with mistrust, and the desire to socialise with a fear of danger and deception. Decisions about how to respond to paranoia are likely to determine the next stage of their journey.
偏执最有可能出现在青春期。在患有精神健康障碍的青少年中，偏执对社交关系的破坏作用可能会使结果恶化。然而，目前对于这一年龄段偏执的临床表现知之甚少。因此，我们探讨了青少年患者偏执的发展、体验和影响。
采用定性访谈设计结合阐释现象学分析。
对 12 名（11-17 岁）出现偏执症状的青少年患者（就诊于儿童和青少年心理健康服务机构）进行访谈。
青少年患者描述了一段旅程，从他们开始意识到偏执，到经历不信任和对他人的恐惧，再到随后在日常生活中适应偏执。偏执的出现源于对人际威胁和个人脆弱性的发现，受到挑战性的同伴互动、对世界危险的认识以及个人不良经历的影响。偏执体验包括难以信任朋友、对威胁感到强烈恐惧以及使用防御策略来保持安全。青少年患者描述了偏执体验是如何令人困惑、对自我概念产生负面影响、阻碍他们享受青少年生活并导致与朋友疏远的。对偏执的长期反应反映了一种无奈接受体验和试图抵抗影响之间的紧张关系。
青少年偏执的发展过程涉及应对多种紧张关系，年轻人在平衡独立性与脆弱性、信任与不信任以及渴望社交与对危险和欺骗的恐惧之间保持平衡。如何应对偏执的决定可能会决定他们下一步的旅程。
