Early relationships and paranoia: Qualitative investigation of childhood experiences associated with the development of persecutory delusions

Abstract

Research suggests a link between Persecutory Delusions (PDs) and early interpersonal difficulties. However, little research has explored the first-hand experience of navigating such adversities in those who later developed PDs. The current study reports on a qualitative investigation of the early interpersonal experiences and challenges faced by a sample of individuals who have recovered from PDs, using a semi-structured interview. A sample of seven individuals who have previously experienced PDs were recruited from two National Health Services (NHS) and an Early Intervention Psychosis service in England. Using an Interpretative Phenomenological Analytic (IPA) approach, the analysis identified three main themes (early experiences, impact of early experiences, coping with adversity). Early experiences captured early inconsistent and problematic relationships in childhood, and experiences of victimization. Exploring the impact of these early events revealed important roles for the participants' inconsistent sense of self, their negative perception of others, and their disturbed social functioning and substance use. Coping with adversity revealed distinct forms of avoidant and proactive coping. The findings are consistent with models of PDs that emphasise the impact of early interpersonal experiences, and offer support for attachment and cognitive factors.

How is paranoia experienced in a student population? A qualitative study of students scoring highly on a paranoia measure

“…In contrast, qualitative studies can elicit and emphasize aspects of lived experience and they can also help to address theoretical questions about the nature of paranoid experiences. For example, in addition to the importance of intra‐psychic factors noted in cognitive models (e.g., Freeman, 2007), social factors have increasingly been implicated (e.g., Bentall & Fernyhough, 2008) and qualitative research with both clinical and non‐clinical samples has highlighted the role of a range of social and interpersonal factors: early life adversity (Boyd & Gumley, 2007); experiences of victimization (Dickson, Barsky, Kinderman, King, & Taylor, 2016); and interpersonal relationships (Rhodes & Jakes, 2010). Qualitative studies have identified important aspects of the social context which seem to be salient when evaluating evidence for and against paranoid interpretations of situations (Campbell & Morrison, 2007a; Fornells‐Ambrojo et al ., 2015) and they have also given some indication of how and why paranoid beliefs might change over time (Allen‐Crooks & Ellett, 2014).…”

Theory of mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis – a secondary analysis of a randomized-controlled therapy trial

“…Again, it is important to note that these results were obtained in an exploratory analysis and thus are in need of careful replication. If our findings are replicated in longitudinal preregistered assessments, they suggest that delusional frequency negatively affects social interactions (the therapeutic interactions) and thus may also partly contribute to the association between delusions and lower social functioning [68,69], negative family atmosphere [70], more pronounced loneliness [71,72] and social exclusion [73,74].…”

Theory of Mind, emotion recognition, delusions and the quality of the therapeutic relationship in patients with psychosis – a secondary analysis of a randomized-controlled therapy trial.

“…Again, it is important to note these results were obtained in an exploratory analysis and thus are in need of careful replication. If our findings are replicated in longitudinal assessments, they suggest that delusional frequency negatively affects social interactions (the therapeutic interactions) and thus may also partly contribute to the association between delusions and lower social functioning (67,68), negative family atmosphere (69), more pronounced loneliness (70,71) and social exclusion (72,73).…”