Paranoia as a Continuum in the Population
Keywords:paranoia, schizophrenia, cognitive-behavioral therapy
Paranoid beliefs, though key to the diagnosis of paranoid schizophrenia, are not exclusively seen in patients suffering from this psychopathology and exist in less severe forms across different populations. Evaluating these symptoms as a continuum may be more interesting for the understanding of paranoia rather than the dichotomous approach to this kind of ideation. The main goal of the current research is to assess how paranoid beliefs are present across different populations. Using the Portuguese versions of the General Paranoia Scale and the Paranoia checklist, we compared the endorsement of paranoid beliefs in 187 subjects (64 healthy controls from the general population, 32 relatives from schizophrenia patients, 30 patients in remission and 61 patients with acute schizophrenia symptoms).Â The results show that paranoia is present throughout the population, from non-clinical forms to more severe clinical samples, demonstrating a continuum of increased frequency and intensity until it reaches a delusional level. Environmental factors in the endorsement of such beliefs are also discussed.
American Psychiatric Association. â€œDiagnostic and statistical manual of mental disordersâ€ (4th ed.) (American Psychiatric Association), Washington, DC, 1994.
C. L. Bowden, L. S. Schoenfeld, & R. L. Adams. â€œMental health attitudes and treatment expectations as treatment variablesâ€, Journal of Clinical Psychology, vol. 36, no. 3, pp. 653-657, 1980. DOI: 10.1037/0735-7028.22.2.149.
P. W. Corrigan. â€œMental health stigma as social attribution: Implications for research methods and attitude changeâ€, Clinical Psychology: Science and Practice, vol. 71, pp. 48-67, 2000. DOI:10.1093/clipsy/7.1.48.
A. Mestdagh, & B. Hansen. â€œStigma in patients with schizophrenia receiving community mental health care: a review of qualitative studiesâ€, Social psychiatry and psychiatric epidemiology, Vol. 49, no. 1, pp. 79-87, 2014.
G. Thornicroft, E. Brohan, D. Rose, N. Sartorius, & M. Leese. â€œGlobal pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional surveyâ€, The Lancet, Vol. 373, no. 9661, pp. 408-415, 2009. DOI:10.1016/S0140-67360861817-6.
W.W. Eaton, A. Romanoski, J. C. Anthony, & G. Nestadt. â€œScreening for psychosis in the general population with a self-report interviewâ€, Journal of Nervous and Mental Disease, vol. 179, no. 11, pp. 689-93, 1991. DOI: 10.1097/00005053-199111000-00007.
H. Verdoux, J. van Os, S. Maurice-Tison, B. Gay, R. Salamon, & M. Bourgeois. â€œIs early adulthood a critical developmental stage for psychosis proneness? A survey of delusional ideation in normal subjectsâ€, Schizophrenia Research, Vol. 29, no. 3, pp. 247-254, 1998. DOI: 10.1016/S0920-99649700095-9.
J. van Os, M. Hanssen, R. Bijl, & A. Raveli. â€œStrauss 1969 revisited: a psychosis continuum in the general population?â€, Schizophrenia Research, Vol. 45, no. 1-2, pp. 11-20, 2000; DOI: 10.1016/S0920-99640090323-2.
D. Combs, C. Michael, & D. Penn. â€œParanoia and emotion perception across the continuumâ€, The British Journal of Clinical Psychology, Vol. 45, no. 1, 19-31, 2006. DOI: 10.1348/014466505X29099.
M. Campbell, & A. Morrison. â€œThe Subjective Experience of Paranoia: Comparing the Experiences of Patients with Psychosis and Individuals with No Psychiatric Historyâ€, Clinical Psychology and Psychotherapy, Vol 14, no. 1, pp. 63-77, 2007. DOI: 10.1002/cpp.510.
S. Melo, & R. Bentall. â€œCoping in subclinical paranoia: A two nations studyâ€, Psychology and Psychotherapy: Theory, Research and Practice, Vol. 83, no. 4, pp. 407-420, 2010. DOI: 10.1348/147608310X487542.
B.G. Schimmelmann, C. Michel, N. Schaffner, & F. Schultze-Lutter. â€œWhat percentage of people in the general population satisfies the current clinical at-risk criteria of psychosis?â€, Schizophrenia Research, Vol. 125, pp. 99-100, 2011. DOI:10.1016/j.schres.2010.09.018.
J.van Os, R.J. Linscott, I. Myin-Germeys, P. Delespaul, & L. Krabbendam. â€œA systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorderâ€, Psychological Medicine, Vol. 39, no. 2, pp. 179-95, 2009. DOI: 10.1017/S0033291708003814.
H. Verdoux, & J. van Os. â€œPsychotic symptoms in non-clinical populations and the continuum of psychosisâ€, Schizophrenia Research, Vol. 54, no. 1-2, pp. 59-65, 2002.
A. Fenigstein, & P. Vanable. â€œParanoia and self-consciousnessâ€, Journal of Personality and Social Psychology, Vol. 62, no. 1, pp. 129-138, 1992. DOI: 10.1037/0022-35188.8.131.52.
B. A. Alford & A.T. Beck. â€œThe Integrative Power of Cognitive Therapyâ€, pp. 137-164, (Guilford Press), New York, 1997.
D. Freeman, P. Garety, E. Kuipers, D. Fowler, & E. Bebbington. â€œA Cognitive model of persecutory delusionsâ€, British Journal of Clinical Psychology, vol. 41, no. 4, pp. 331-347, 2002. DOI: 10.1348/014466502760387461.
T. Binbay, M. Drukker, H. Elbi, F. Aksu Tanik, F. Ozkinay, H. Onay, N. Zagli, J van Os, & -K. Alptekin. â€œTesting the Psychosis Continuum: Differential Impact of Genetic and Nongenetic Risk Factors and Comorbid Psychopathology across the Entire Spectrum of Psychosisâ€, Schizophrenia Bulletin, vol. 38, no. 5, pp. 992-1002, 2011. DOI: 10.1093/schbul/sbr003.
I. Kelleher, & M. Cannon. â€œPsychotic-like experiences in the general population: characterizing a high-risk group for psychosisâ€, Psychological Medicine, Vol. 41, no. 1, pp. 1-6, 2011. DOI: 10.1017/S0033291710001005.
D. Freeman, K. Pugh, & P. Garety. â€œJumping to conclusions and paranoid ideation in the general populationâ€, Schizophrenia research, Vol. 102, no. 1, pp. 254-260, 2008.
E. Peters, S. A. Joseph, & P. Garety. â€œMeasurement of delusional ideation in the normal population: Introducing the PDIâ€, Schizophrenia Bulletin, Vol. 25, no. 3, pp. 553â€“563, 1999.
D. Freeman, P. Garety, E. Kuipers, S. Colbert, S. Jolley, D. Fowler, G. Dunn, & P. Bebbington. â€œDelusions and Decision-making style: Use of Need for Closure Scaleâ€, Behaviour Research and Therapy, vol. 44, no. 8, pp. 263-283, 2005. DOI: 10.1016/j.brat.2005.09.00.
D. Freeman, K. Pugh, N. Vorontsova, A. Antley, & M. Slater. â€œTesting the Continuum of Delusional Beliefs: An Experimental Study Using Virtual Realityâ€, Journal of Abnormal Psychology, Vol. 119, no. 1, pp. 83-92, 2010. DOI: 10.1037/a0017514.
B. Lopes Paranoia e Ansiedade Social na PopulaÃ§Ã£o NÃ£o-ClÃnica [Dissertation]. Coimbra: University of Coimbra; 2010. 285p.
D. Freeman, P. Garety, P. Bebbington, B. Smith, R. Rollinson, D. Fowler, E. Kuipers, K. Ray, & G. Dunn. â€œPsychological investigation of the structure of paranoia in a non-clinical populationâ€, The British Journal of Psychiatry, vol. 186, pp. 427-435, 2005. DOI: 10.1192/bjp.186.5.427.
J. Maroco. â€œAnÃ¡lise estatÃstica com utilizaÃ§Ã£o do SPSS [Statistical analysis using SPSS]â€, (EdiÃ§Ãµes SÃlabo), Lisboa, 2010.
P. Garety, & D. Hemsley. â€œDelusions: Investigations into the psychology of delusional reasoningâ€, (Oxford University Press), Oxford, 1994.
P. Garety, & D. Freeman. â€œCognitive approaches to delusions: a critical review of theories and evidenceâ€, British Journal of Clinical Psychology, Vol. 38, no. 2, pp. 113-154, 1999. DOI: 10.1348/014466599162700.
E. Georgaca. â€œTalk and the Nature of Delusions: Defending Sociocultural Perspectives on Mental Illnessâ€, Philosophy, Psychiatry & Psychology: PPP, Vol. 11, no. 1, pp. 87-94, 2004. DOI: 10.1353/ppp.2004.0038.
M. L. Esterberg, & M.T. Compton. â€œThe psychosis continuum and categorical versus dimensional diagnostic approachesâ€, Current Psychiatry Reports, Vol. 11, no. 3, pp. 179-84, 2009. DOI: 10.1007/s11920-009-0028-7.
A.R. Yung, B. Nelson, K. Baker, J.A. Buckby, G. Baksheev, & E. M. Cosgrave. â€œPsychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophreniaâ€, The Australian and New Zealand Journal of Psychiatry, Vol. 43, no. 2, pp. 118-28, 2009. DOI: 10.1080/00048670802607188.
L. Ellett, B. Lopes, & P. Chadwick. â€œParanoia in a Nonclinical Population of College Studentsâ€, Journal of Nervous and Mental Disease, vol. 191, no. 7, pp. 425â€“430, 2003. DOI: 10.1097/01.NMD.0000081646.33030.EF.
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