What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation

Abstract

BackgroundIn recent years a close association between anxiety and persecutory ideation has been established, contrary to the traditional division of neurosis and psychosis. Nonetheless, the two experiences are distinct. The aim of this study was to identify factors that distinguish the occurrence of social anxiety and paranoid thoughts in an experimental situation.MethodTwo hundred non-clinical individuals broadly representative of the UK general population were assessed on a range of psychological factors, experienced a neutral virtual reality social environment, and then completed state measures of paranoia and social anxiety. Clustered bivariate logistic regressions were carried out, testing interactions between potential predictors and the type of reaction in virtual reality.ResultsThe strongest finding was that the presence of perceptual anomalies increased the risk of paranoid reactions but decreased the risk of social anxiety. Anxiety, depression, worry and interpersonal sensitivity all had similar associations with paranoia and social anxiety.ConclusionsThe study shows that social anxiety and persecutory ideation share many of the same predictive factors. Non-clinical paranoia may be a type of anxious fear. However, perceptual anomalies are a distinct predictor of paranoia. In the context of an individual feeling anxious, the occurrence of odd internal feelings in social situations may lead to delusional ideas through a sense of ‘things not seeming right’. The study illustrates the approach of focusing on experiences such as paranoid thinking rather than diagnoses such as schizophrenia.

Associations among perceptual anomalies, social anxiety, and paranoia in a college student sample

“…Our central findings, in a sample of relatively high-functioning college students, are loosely consistent with Freeman and colleagues's findings that the combination of anxiety and the experience of perceptual anomalies increases the risk that an individual will report feeling persecuted (Freeman et al, 2005a;Freeman et al, 2008a;Freeman et al, 2008b). However, the effects of anxiety and perceptual aberrations appear to be independent and additive, with each making distinct, if subtle, contributions to different aspects of paranoid thinking.…”

“…Consistent with prior research that treated paranoia as a unitary construct (Freeman et al, 2008a), the experience of perceptual anomalies emerged as a modest but significant independent predictor of scores on all PSQ factors except the Mistrust/Wariness factor, suggesting that individuals who experience perceptual aberrations are at heightened risk for feeling not only suspicious and resentful of others, but also for feeling angry and generally distressed. Given the common co-occurrence of perceptual anomalies and paranoid patterns of thought in individuals with disorders on the schizophrenia spectrum and those with borderline personality characteristics (APA, 2000), these findings might be driven by a subgroup of participants with undiagnosed or subthreshold mental illness.…”

“…Findings from one study suggest that sub-clinical paranoid ideation may be appropriately categorized as a form of anxiety in some individuals (Freeman et al, 2008a); other research similarly links paranoid thoughts more broadly with different types of PERCEPTUAL ANOMALY, SOCIAL ANXIETY, AND PARANOIA 4 negative affect (NA) (Combs et al, 2007). Why only a subset of individuals with social anxiety specifically, and elevated negative affect more generally, might also demonstrate paranoid patterns of thinking, however, remains unclear.…”

“…Social anxiety, perceptual anomalies, and paranoia Freeman and colleagues have recently conducted several studies examining factors that might lead some individuals, but not others, to develop paranoid patterns of thinking in the context of anxiety or broader negative affective states (Freeman et al, 2005a;Freeman et al, 2005b;Freeman et al, 2008a). Their findings converge to suggest that when individuals experience perceptual anomalies, such as sensory hypersensitivity or bodily discontinuities (i.e., feeling as if body parts are disconnected or mis-shapen), in the context of preexisting negative beliefs about themselves and others, they are more likely to interpret them as signs of persecution than they would in the absence of a negative cognitive framework.…”

Are social phobia and paranoia related, and which comes first?

“…According to Freeman and colleagues an additional condition -also having perceptual aberrations -is necessary for social anxiety to evolve into delusions. In those circumstances the thought that "something seems not to be right" is easily triggered (Freeman et al, 2008).…”