Department of Experimental Psychology, University of Oxford, Oxford, UK
Oxford Health NHS Foundation Trust, Oxford, UK.
BMJ Ment Health. 2023 Nov;26(1). doi: 10.1136/bmjment-2023-300880.
Paranoia-incorrectly thinking that others are deliberating trying to harm you-causes distress, undermines social interactions and leads to withdrawal. It presents across multiple psychiatric diagnoses.
The primary aim was to determine the extent that cognitive and social processes may explain paranoia. The secondary aim was to identify explanatory factors that distinguished paranoia and social anxiety.
10 382 UK adults, quota sampled to match the population for age, gender, ethnicity, income and region, participated in a non-probability survey. All participants completed a paranoia measure and assessments of cognitive and social processes. Structural equation modelling was conducted.
2586 (24.9%) participants described being mistrustful of other people. 1756 (16.9%) participants wanted help to trust more. 66.7% of variance in paranoia was explained by a model comprising (in descending order of importance): within-situation defence behaviours, negative images, negative self-beliefs, discrimination, dissociation, aberrant salience, anxiety sensitivity, agoraphobic distress, worry, less social support, agoraphobic avoidance, less analytical reasoning and alcohol use. All explanatory factors were associated with paranoia and social anxiety. Ten factors were more closely associated with paranoia than social anxiety, including discrimination, hallucinations, negative images, aberrant salience and alcohol use. Nine factors were more closely associated with social anxiety, including less positive self-belief, an external locus of control, worry and less analytical reasoning.
Multiple causes are likely to be involved in paranoia. Cognitive and social processes may explain a high degree of paranoia.
Multiple clear targets for intervention to reduce paranoia are identified.
偏执——错误地认为别人在蓄意伤害你——会引起痛苦，破坏社交互动，导致退缩。它存在于多种精神科诊断中。
主要目的是确定认知和社会过程在多大程度上可以解释偏执。次要目的是确定区分偏执和社交焦虑的解释因素。
10382 名英国成年人参与了一项非概率调查，该调查按年龄、性别、种族、收入和地区对人口进行了配额抽样。所有参与者都完成了偏执量表和认知及社会过程评估。进行了结构方程模型分析。
2586 名（24.9%）参与者表示对他人不信任。1756 名（16.9%）参与者希望帮助自己更信任他人。偏执的 66.7%可以由一个包含以下因素的模型来解释（按重要性降序排列）：情境内防御行为、消极意象、消极自我信念、歧视、解离、异常突显、焦虑敏感、广场恐怖症痛苦、担忧、较少的社会支持、广场恐怖症回避、较少的分析推理和酒精使用。所有解释因素都与偏执和社交焦虑有关。有 10 个因素与偏执的关系比与社交焦虑的关系更密切，包括歧视、幻觉、消极意象、异常突显和酒精使用。有 9 个因素与社交焦虑的关系更密切，包括较少的积极自我信念、外部控制、担忧和较少的分析推理。
多种原因可能与偏执有关。认知和社会过程可能可以解释很大程度上的偏执。
确定了减少偏执的多个明确干预目标。
