The Effect of State Anxiety on Paranoid Ideation and Jumping to Conclusions. An Experimental Investigation

Abstract

Theoretical models of persecutory delusions have emphasized the impact of reasoning biases and negative emotion at the early stages of symptom formation. However, the causal mechanisms remain unclear. This study tests the hypothesis that state anxiety will increase paranoid ideation and that this increase will be moderated by the level of individual vulnerability and mediated by the tendency to jump to conclusions. Healthy participants (n = 90) with varying levels of vulnerability (psychosis symptoms assessed by the Community Assessment of Psychic Experiences) were randomly assigned to either an anxiety or a nonanxiety condition. Anxiety was induced by pictures from the International Affective Picture System and by in sensu exposure to individual anxiety-provoking situations. During each condition, symptoms of paranoia were assessed by a state-adapted version of the Paranoia Checklist. Jumping to conclusions (JTC) was assessed using a modified version of the beads task. Overall, participants in the anxiety condition reported significantly more paranoid thoughts and showed more JTC than participants in the neutral condition. Participants with higher baseline vulnerability were more likely to show an increase in paranoia as reaction to the anxiety manipulation. Moreover, the association of anxiety and paranoia was mediated by the increased tendency to jump to conclusions in the beads task. The results are in line with a threat anticipation conceptualization of paranoia and provide evidence for an interaction of anxiety and reasoning biases in the development of paranoid beliefs. A combination of meta-cognitive training directed at reasoning biases and promoting emotion regulation skills might prove beneficial in preventing symptoms.

Healthy people with delusional ideation change their mind with conviction

“…Moreover, as proposed by Freeman (2007), anxiety might have a stronger role in delusion maintenance where the purpose of the delusional belief could be to lower the anxiety levels in patients. Interestingly, induced anxiety states are associated with enhanced JTC bias and with paranoid ideation in healthy people (Lincoln et al, 2010a(Lincoln et al, , 2010b. In healthy participants, this relationship between delusional ideas and anxiety might be dependent of the environmental condition and be triggered in specific situations only.…”

“…However, it appears likely that the increased JTC was observed because of the increased paranoia. In healthy people, some found that inducing anxiety significantly increases the JTC bias and the levels of state paranoia in high scorers on the CAPE, a psychotic experiences questionnaire (Lincoln et al, 2010a(Lincoln et al, , 2010b) whilst others did not find effect of induced anxiety on the JTC bias (Keefe and Warman, 2011). Given the lack of strong rationale behind an association between JTC and depression or anxiety, we hypothesise that delusions are independently related to JTC and emotions.…”

“…The total score of this subscale ranges from 0 to 28. Measures of intelligence were collected as Lincoln et al (2010aLincoln et al ( , 2010b reported that the relationship between a hasty decision making and delusions in patients was cancelled if IQ was controlled for. In addition, in healthy people, Freeman et al (2008) reported a trend to observe lower IQ in those who jump to conclusions relative to those who did not and Colbert and Peters (2002) reported a negative correlation between IQ and change to disconfirmatory evidence.…”

“…However, it remains unclear whether depression or anxiety is the best predictor of delusional ideation. Anxiety has been clearly linked to paranoia Lincoln et al, 2010aLincoln et al, , 2010b, but depressive symptoms as well (Chapman et al, 1994;Kwapil et al, 1997;Warman et al, 2010). Therapy to improve anxiety differs greatly from that to improve depression.…”

Reasoning in Anxiety, OCD and Related Disorders: Can Formal Reasoning Theories Inform Us About Psychopathology?

“…In an attempt to tease out distinctions in reasoning between anxiety, depression and paranoia, Bennett and Corcoran (2010) reported that elevated levels of depression were associated with the tendency to underestimate the likelihood of future positive and neutral events, whereas subclinical paranoia was associated with overestimation of the likelihood of future threatening events (Bennett & Corcoran, 2010). Further, there is also evidence that anxiety states may interact in paranoia to produce even greater jumping to conclusions (Lincoln et al, 2010).…”