Characterization and Predictors of Paranoid Ideation in Youths

Authors: M. Sousa, C. Barreto Carvalho, C. da Motta, J. Cabral, V. Pereira, S. Nunes Caldeira, E. Peixoto

Abstract:

Paranoid ideation is a common thought process that constitutes a defense against perceived social threats. The current study aimed at the characterization of paranoid ideation in youths and to explore the possible predictors involved in the development of paranoid ideations. Paranoid ideation, shame, submission, early childhood memories and current depressive, anxious and stress symptomatology were assessed in a sample of 1516 Portuguese youths. Higher frequencies of paranoid ideation were observed, particularly in females and youths from lower socioeconomic status. The main predictors identified relates to submissive behaviors and adverse childhood experiences, and especially to shame feelings. The current study emphasizes that the these predictors are similar to findings in adults and clinical populations, and future implications to research and clinical practice aiming at paranoid ideations are discussed, as well as the pertinence of the study of mediating factors that allow a wider understanding of this thought process in younger populations and the prevention of psychopathology in adulthood.

Keywords: Adolescence, early memories, paranoid ideation, parenting styles, shame, submissiveness.

Digital Object Identifier (DOI): doi.org/10.5281/zenodo.1107097

References:

[1] A.K. Dixon “Ethological strategies for defence in animals and humans: their role in some psychiatric disorders,” Br. J. Med. Psychol., vol. 71, pp. 417–445, Dec. 1998.
[2] J. Pinto-Gouveia and M. Matos, “Can shame memories become a key to identity? The centrality of shame memories predicts psychopathology,” Appl. Cogn. Psychol., vol. 25, no. 2, pp. 281–290, Apr. 2011.
[3] A. N. Schore, “The effects of early relational trauma on right brain development, affect regulation, and infant mental health,” Spec. Issue Contrib. from Decad. brain to infant Ment. Heal., vol. 22, no. 1-2, pp. 201-269, Jan. 2011
[4] A. R. Yung, B. Nelson, K. Baker, J. A. Buckby, G. Bakshee, and E. M. Cosgrave, “Psychotic-like experiences in a community sample of adolescents: implications for the continuum model of psychosis and prediction of schizophrenia”, Aust New Zeal J. Psychiat, vol.43, pp.118- 128, Aug. 2009.
[5] R. Baumeister and M. Leary, “The Need to Belong: Desire for Interpersonal Attachments as a Fundamental Human Motivation,” Psychol. Bull., vol. 117, no. 3, pp. 497–529, 1995.
[6] S. Escher, M. Romme, A. Buiks, P. Delespaul, and J. van Os, “Formation of delusional ideation in adolescents hearing voices: a prospective study,” Am. J. Med. Genet., vol. 114, no. 8, pp. 913–20, Dec. 2002.
[7] E. Fonseca-Pedrero, S. Lemos-Giráldez, M. Paino, and S. Sierra-Baigrie, “Psychotic-Like Experiences in Non-Clinical Adolescents,” in Hallucinations: Types, Stages and Treatments, M. Payne, Ed. Spain: Science Publishers, INC, 2011.
[8] J. Spauwen, L. Krabbendam, R. Lieb, H.-U. Wittchen, and J. van Os, “Evidence that the outcome of developmental expression of psychosis is worse for adolescents growing up in an urban environment,” Psychol. Med., vol. 36, no. 3, pp. 407–15, Mar. 2006.
[9] H. Verdoux, S. Maurice-Tison, B. Gay, J. Van Os, R. Salamon, and M. L. Bourgeois, “A survey of delusional ideation in primary-care patients,” Psychol. Med., vol. 28, no. 1, pp. 127–34, Jan. 1998.
[10] P. Trower and P. Chadwick, “Pathways to the defense of the self: a theory of two types of paranoia,” Clin. Psychol. Sci. Pract., vol. 2, no. 3, pp. 263–278, Sep. 1995.
[11] A. T. Beck, D. Freeman, and Associates, Cognitive Therapy of Personality Disorders. New York: Guilford Press, 1990.
[12] L. Ellett, B. Lopes, and P. Chadwick, “Paranoia in a nonclinical population of college students,” J. Nerv. Ment. Dis., vol. 191, no. 7, pp. 425–30, Jul. 2003.
[13] A. Fenigstein and P. Vanable, “Paranoia and self-consciousness,” J. Pers. Soc. Psychol., vol. 62, no. 1, pp. 129–38, Jan. 1992.
[14] D. Freeman and P. a. Garety, “Connecting neurosis and psychosis: The direct influence of emotion on delusions and hallucinations,” Behav. Res. Ther., vol. 41, no. 8, pp. 923–947, Aug. 2003.
[15] D. Freeman, “Psychological investigation of the structure of paranoia in a non-clinical population,” Br. J. Psychiatry, vol. 186, no. 5, pp. 427– 435, May 2005.
[16] P. Gilbert, M. Boxall, M. Cheung, and C. Irons, “The relation of paranoid ideation and social anxiety in a mixed clinical population,” Clin. Psychol. Psychother., vol. 12, no. 2, pp. 124–133, Apr. 2005.
[17] D. M. Buss, Evolutionary psychology: the new science of mind. Boston: Allyn and Bacon, 1999.
[18] P. Gilbert, “Evolutionary approaches to psychopathology: the role of natural defenses,” Aust New Zeal J Psychiat, vol. 35, no. September 2000, pp. 17–27, Feb. 2001.
[19] L. Sloman, P. Gilbert, and G. Hasey, “Evolved mechanisms in depression: The role and interaction of attachment and social rank in depression,” J. Affect. Disord., vol. 74, no. 2, pp. 107–121, Apr. 2003.
[20] J. C. Wakefield, “Evolutionary versus prototype analyses of the concept of disorder,” J. Abnorm. Psychol., vol. 108, no. 3, pp. 374–399, Aug. 1999.
[21] S. Allan and P. Gilbert, “Submissive behaviour and psychopathology,” Br. J. Clin. Psychol., vol. 36, pp. 467–88, Nov. 1997.
[22] P. Gilbert, “Evolution, social roles and the differences in shame and guilt,” Soc. Res., vol. 70, no. 4, pp. 1205–1230, 2003.
[23] D. Freeman, “Suspicious minds: the psychology of persecutory delusions,” Clin. Psychol. Rev., vol. 27, no. 4, pp. 425–57, May 2007.
[24] D. Freeman, P. a Garety, E. Kuipers, D. Fowler, and P. E. Bebbington, “A cognitive model of persecutory delusions,” Br. J. Clin. Psychol., vol. 41, no. Pt 4, pp. 331–347, Nov. 2002.
[25] D. Freeman, P. a. Garety, P. E. Bebbington, B. Smith, R. Rollinson, D. Fowler, E. Kuipers, K. Ray, and G. Dunn, “Psychological investigation of the structure of paranoia in a non-clinical population,” Br. J. Psychiatry, vol. 186, no. MAY, pp. 427–435, Apr. 2005.
[26] G. Salvatore, P. H. Lysaker, R. Popolo, M. Procacci, A. Carcione, and G. Dimaggio, “Vulnerable Self, Poor Understanding of Others’ Minds, Threat Anticipation and Cognitive Biases as Triggers for Delusional Experience in Schizophrenia: A Theoretical Model,” Clin. Psychol. Psychother., vol. 19, no. 3, pp. 247–259, May 2012.
[27] J. Pinto-Gouveia, M. Matos, P. Castilho, and A. Xavier, “Differences between depression and paranoia: the role of emotional memories, shame and subordination,” Clin. Psychol. Psychother., vol. 21, no. 1, pp. 49–61, Sep. 2014.
[28] P. Gilbert and S. Allan, “The role of defeat and entrapment (arrested flight) in depression: an exploration of an evolutionary view,” Psychol. Med., vol. 28, no. 3, pp. 585–598, May 1998.
[29] M. Matos, J. Pinto-Gouveia, and P. Gilbert, “The effect of shame and shame memories on paranoid ideation and social anxiety,” Clin. Psychol. Psychother., vol. 20, no. 4, pp. 334–349, Jul. 2013.
[30] J. Pinto-Gouveia, M. Matos, P. Castilho, and A. Xavier, “Differences between depression and paranoia: the role of emotional memories, shame and subordination,” Clin. Psychol. Psychother., vol. 21, no. 1, pp. 49–61, Jan. 2014.
[31] P. Gilbert, Human Nature and Suffering. London: Erlbaum, 1989.
[32] P. Gilbert, “Defence and safety: their function in social behaviour and psychopathology,” Br. J. Clin. Psychol., vol. 32, pp. 131–153, May 1993.
[33] P. Gilbert, “The evolved basis and adaptive functions of cognitive distortions,” Br. J. Med. Psychol., vol. 71, pp. 447–463, Dec. 1998.
[34] P. Gilbert, The Compassionate Mind. United Kingdom: Constable, 2010.
[35] C. Barreto Carvalho, J. Pinto-Gouveia, E. Peixoto, and C. da Motta, “Emotional, cognitive and behavioral reactions to paranoid symptoms in clinical and nonclinical population,” Clin. Schizophr. Relat. Psychoses, vol. 20, pp. 1–25, 2014.
[36] B. Lopes, “Paranóia e ansiedade social na população não clínica : dois fenómenos diferentes?,” Universidade de Coimbra, 2011.
[37] M. Matos and J. Pinto-Gouveia, “Shame as a traumatic memory,” Clin. Psychol. Psychother., vol. 17, no. 4, pp. 299–312, Jul. 2010.
[38] B. Andrews and E. Hunter, “Shame, Early Abuse, and Course of Depression in a Clinical Sample: A Preliminary Study,” Cogn. Emot., vol. 11, no. 4, pp. 373–381, 1997.
[39] B. Andrews, M. Qian, and J. D. Valentine, “Predicting depressive symptoms with a new measure of shame: The Experience of Shame Scale,” Br. J. Clin. Psychol., vol. 41, pp. 29–42, Mar. 2002.
[40] P. Chadwick and P. Trower, “To Defend or Not To Defend: A Comparison of Paranoia and Depression,” J. Cogn. Psychother., vol. 11, no. 1, pp. 63–71, Jan. 1997.
[41] P. Gilbert, S. Allan, and K. Goss, “Parental Representations, Shame, Interpersonal Problems, and Vulnerability to Psychopathology,” Clin. Psychol. Psychother., vol. 3, no. 1, pp. 23–34, Mar. 1996.
[42] C. B. Carvalho, V. Pereira, M. Sousa, C. Motta, and E. B. Peixoto, “Paranoia in the general population: a revised version of the General Paranoia Scale for adolescents,” vol. 10, no. 23, pp. 128–141, Aug. 2014.
[43] C. Barreto Carvalho, J. Pinto-Gouveia, E. Peixoto, and C. da Motta, “Paranoia as a Continuum in the Population,” Asian J. Humanit. Soc. Stud., vol. 2, no. 3, pp. 382–391, Jun. 2014.
[44] D. Dagnan, P. Trower, and P. Gilbert, “Measuring vulnerability to threats to self-construction: the self and other scale,” Psychol. Psychother., vol. 75, pp. 279–293, Sep. 2002.
[45] J. Spauwen, L. Krabbendam, R. Lieb, H.-U. Wittchen, and J. van Os, “Impact of psychological trauma on the development of psychotic symptoms: relationship with psychosis proneness,” Br. J. Psychiatry, vol. 188, pp. 527–33, Jun. 2006.
[46] J. Van Os, M. Hanssen, R. V. Bijl, and A. Ravelli, “Strauss (1969) revisited: A psychosis continuum in the general population?,” Schizophr. Res., vol. 45, no. 1–2, pp. 11–20, Sep. 2000.
[47] H. Verdoux and J. van Os, “Psychotic symptoms in non-clinical populations and the continuum of psychosis,” Schizophr. Res., vol. 54, no. 1–2, pp. 59–65, Mar. 2002.
[48] A. Aleman, M. R. Nieuwenstein, K. B. E. Böcker, and E. H. F. De Haan, “Multi-dimensionality of hallucinatory predisposition: factor structure of the Launay–Slade Hallucination Scale in a normal sample,” Pers. Individ. Dif., vol. 30, no. 2, pp. 287–292, Jan. 2001.
[49] E. De Loore, N. Gunther, M. Drukker, F. Feron, B. Sabbe, D. Deboutte, J. van Os, and I. Myin-Germeys, “Persistence and outcome of auditory hallucinations in adolescence: A longitudinal general population study of 1800 individuals,” Schizophr. Res., vol. 127, no. 1–3, pp. 252–256, Apr. 2011.
[50] J. Horwood, G. Salvi, K. Thomas, L. Duffy, D. Gunnell, C. Hollis, G. Lewis, P. Menezes, A. Thompson, D. Wolke, S. Zammit, and G. Harrison, “IQ and non-clinical psychotic symptoms in 12-year-olds: Results from the ALSPAC birth cohort,” Br. J. Psychiatry, vol. 193, no. 3, pp. 185–191, Sep. 2008.
[51] I. Kelleher, M. Harley, F. Lynch, L. Arseneault, C. Fitzpatrick, and M. Cannon, “Associations between childhood trauma, bullying and psychotic symptoms among a school-based adolescent sample,” Br. J. Psychiatry, vol. 193, no. 5, pp. 378–382, Nov. 2008.
[52] J. Scott, J. Welham, G. Martin, W. Bor, J. Najman, M. O. Callaghan, G. Williams, and R. Aird, “Demographic correlates of psychotic ‐ like experiences in young Australian adults,” Acta Psychiatr. Scand., vol. 118, no. 3, pp. 230–237, Sep. 2008.
[53] J. Scott, G. Martin, J. Welham, W. Bor, J. Najman, M. O'Callaghan, G. Williams, R. Aird, and J. McGrath, “Psychopathology during childhood and adolescence predicts delusional-like experiences in adults: A 21- year birth cohort study,” Am. J. Psychiatry, vol. 166, no. 5, pp. 567–574, May 2009.
[54] T. Yoshizumi, S. Murase, S. Honjo, H. Kaneko, and T. Murakami, “Hallucinatory Experiences in a Community Sample of Japanese Children,” J. Am. Acad. Child Adolesc. Psychiatry, vol. 43, no. 8, pp. 1030–1036, Aug. 2004.
[55] D. R. Combs, C. O. Michael, and D. L. Penn, “Paranoia and emotion perception across the continuum,” Br. J. Clin. Psychol., vol. 45, pp. 19– 31, Mar. 2006.
[56] J. Spauwen, L. Krabbendam, R. Lieb, H. U. Wittchen, and J. Van Os, “Does urbanicity shift the population expression of psychosis?,” J. Psychiatr. Res., vol. 38, no. 6, pp. 613–618, Nov. 2004.
[57] W. Rössler, A. Riecher-Rössler, J. Angst, R. Murray, A. Gamma, D. Eich, J. van Os, and V. A. Gross, “Psychotic experiences in the general population: a twenty-year prospective community study.,” Schizophr. Res., vol. 92, no. 1–3, pp. 1–14, May 2007.
[58] F. Anderson and D. Freeman, “Socioeconomic status and paranoia: the role of life hassles, self-mastery, and striving to avoid inferiority,” J. Nerv. Ment. Dis., vol. 201, no. 8, pp. 698–702, Aug. 2013.
[59] V. Pereira, “A ideação paranóide na dolescência. Um ênfoque comunitário,” Universidade dos Açores, 2012.
[60] S. Goldberg, E. Fruchter, M. Davidson, A. Reichenberg, R. Yoffe, and M. Weiser, “The relationship between risk of hospitalization for schizophrenia, SES, and cognitive functioning,” Schizophr. Bull., vol. 37, no. 4, pp. 664–670, Jul. 2011.
[61] S. Werner, D. Malaspina, and J. Rabinowitz, “Socioeconomic status at birth is associated with risk of schizophrenia: Population-based multilevel study,” Schizophr. Bull., vol. 33, no. 6, pp. 1373–1378, Apr. 2007.
[62] G. Claridge, C. McCreery, O. Mason, R. Bentall, G. Boyle, P. Slade, and D. Popplewell, “The factor structure of "schizotypal’ traits: a large replication study,” Br. J. Clin. Psychol., vol. 35, pp. 103–115, Feb. 1996.
[63] E. R. Peters, S. Joseph, and P. Garety, “Measurement of delusional ideation in the normal population: introducing the PDI (Peters et al. Delusions Inventory),” Schizophr. Bull., vol. 25, no. 3, pp. 553–576, 1999.
[64] J. van Os, R. J. Linscott, I. Myin-Germeys, P. Delespaul, and L. Krabbendam, “A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder,” Psychol. Med., vol. 39, no. 2, pp. 179– 195, Feb. 2009.
[65] P. Galdos and J. van Os, “Gender, psychopathology, and development: from puberty to early adulthood,” Schizophr. Res., vol. 14, no. 2, pp. 105–112, Jan. 1995.
[66] L. E. DeLisi, “Is schizophrenia a lifetime disorder of brain plasticity, growth and aging?,” Schizophr. Res., vol. 23, no. 2, pp. 119–129, Feb. 1997.
[67] J. A. Martin and D. L. Penn, “Brief report Social cognition and subclinical paranoid ideation,” Br. J. Clin. Psychol., vol. 40, pp. 261– 265, Sep. 2001.
[68] L. J. Chapman, J. P. Chapman, T. R. Kwapil, M. Eckblad, and M. C. Zinser, “Putatively psychosis-prone subjects 10 years later,” J. Abnorm. Psychol., vol. 103, no. 2, pp. 171–183, May 1994.
[69] R. Poulton, A. Caspi, T. Moffitt, M. Cannon, R. Murray, and H. Harrington, “Children’s Self-Reported Psychotic Symptoms and Adult Schizophreniform Disorder,” Arch. Gen. Psychiatry, vol. 57, no. 11, pp. 1053–1058, Nov. 2000.
[70] J. Welham, J. Scott, J. Williams, J. Najman, W. Bor, M. O’Callaghan, and J. McGrath, “Emotional and behavioural antecedents of young adults who screen positive for non-affective psychosis: a 21-year birth cohort study,” Psychol. Med., vol. 39, no. 4, pp. 625–634, Apr 2009.
[71] A. Gracie, D. Freeman, S. Green, P. Garety, E. Kuipers, A. Hardy, K. Ray, G. Dunn, P. Bebbington, and D. Fowler, “The association between traumatic experience, paranoia and hallucinations: A test of the predictions of psychological models,” Acta Psychiatr. Scand., vol. 116, no. 4, pp. 280–289, Oct. 2007.
[72] A. MacBeth, M. Schwannauer, and A. Gumley, “The association between attachment style, social mentalities, and paranoid ideation: an analogue study,” Psychol. Psychother., vol. 81, pp. 79–93, Mar. 2008.
[73] A. Mills, P. Gilbert, R. Bellew, K. McEwan, and C. Gale, “Paranoid Beliefs and Self-Criticism in Students,” Clin. Psychol. Psychother., vol. 14, pp. 358–364, Sep. 2007.
[74] P. Gilbert, “Evolutionary psychopathology: why isn’t the mind designed better than it is?,” Br. J. Med. Psychol., vol. 71, pp. 353–373, Dec. 1998.
[75] J. Maroco, Análise de Equações Estruturais , Fundamentos Teóricos, Software & Aplicações. Lisboa: REportNumber, 2010.
[76]
[76]. K. Goss, P. Gilbert, and S. Allan, “An exploration of shame measures-I: The Other as Shamer Scale,” Pers. Individ. Dif., vol. 17, no. 5, pp. 713–717, Nov. 1994.
[77] B. Lopes, J. Pinto-Gouveia, and P. Castilho, “Portuguese version of the Others as Shamer Scale,” unpublished.
[78] A. Richter, P. Gilbert, and K. McEwan, “Development of an early memories of warmth and safeness scale and its relationship to psychopathology,” Psychol. Psychother., vol. 82, pp. 171–184, Jun. 2009.
[79] M. Cunha, A. Xavier, M. I. Martinho, and M. Matos, “Measuring positive emotional memories in youths: Psychometric properties and confirmatory factor analysis of the Early Memories of Warmth and Safeness Scale,” submitted for publication.
[80] C. Irons and P. Gilbert, “Evolved mechanisms in adolescent anxiety and depression symptoms: The role of the attachment and social rank systems,” J. Adolesc., vol. 28, no. 3, pp. 325–341, Jun. 2005.
[81] A. Bifulco, O. Bernazzani, P. M. Moran, and C. Jacobs, “The childhood experience of care and abuse questionnaire (CECA.Q): validation in a community series.,” Br. J. Clin. Psychol., vol. 44, pp. 563–81, Dec. 2005.
[82] C. Barreto Carvalho, “Psicose Esquizofrénica. Crenças Paranóides: exploração da sua Etiologia na população normal e em doentes com esquizofrenia,” Universidade de Coimbra, 2009.
[83] S. Grabe, J. Hyde, and S. Lindberg, “Body objectification and depression in adolescents: the role of gender, shame and rumination,” Psychol. Women Q., vol. 31, no. 2, pp. 164–175, Jun. 2006.
[84] J. W. Moore, B. Jensen, and W. E. Hauck, “Decision-making processes of youth,” Adolescence, vol. 25, no. 99, pp. 583–592, 1990.
[85] H. R. Riggio, “Parental marital conflict and divorce, parent-child relationships, social support, and relationship anxiety in young adulthood,” Pers. Relatsh., vol. 11, no. 1, pp. 99–114, Mar. 2004.
[86] K. M. C. Landman-Peeters, C. a. Hartman, G. Van Der Pompe, J. a. Den Boer, R. B. Minderaa, and J. Ormel, “Gender differences in the relation between social support, problems in parent-offspring communication, and depression and anxiety,” Soc. Sci. Med., vol. 60, no. 11, pp. 2549– 2559, Jun. 2005.
[87] H. R. Riggio and Y. K. Wing, “Paranoid Thinking, Quality of Relationships With Parents, and Social Outcomes Among Young Adults,” J. Fam. Issues, vol. 32, no. 8, pp. 1030–1049, 2011.