ArticleBMJ mental health2023
Explaining paranoia: cognitive and social processes in the occurrence of extreme mistrust.
Article in BMJ mental health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
25 citing papers in PubMed, 30 citations in OpenAlex.
- Treatment effect modifiers of virtual reality-based versus standard cognitive behavioral therapy for paranoia in schizophrenia spectrum disorders: an exploratory moderator analysis of clinical and demographic characteristics in the FaceYourFears trial.Psychological medicine · 2026Trial
- Learning How to Improve the Treatment of Persecutory Delusions: Using a Principal Trajectories Analysis to Examine Differential Effects of Two Psychological Interventions (Feeling Safe, Befriending) in Distinct Groups of Patients.Schizophrenia bulletin · 2026Trial
- The dynamic interplay between anxiety-related, psychotic, and suicidal experiences: a qualitative study.BMC psychiatry · 2025Trial
- A randomised controlled test in virtual reality of the effects on paranoid thoughts of virtual humans' facial animation and expression.Scientific reports · 2024Trial
- Paranoia and social anxiety: Structural and temporal relationships across adolescence.JCPP advances · 2026Article
- The Cyber Paranoia and Fear Scale-Updated (CPFS-U): development and implications for digital health engagement.BMJ open · 2026Article
- The Salience of Psychotic Experiences: Neural Correlates in the General Population.Schizophrenia bulletin · 2026Article
- Safety behaviors maintain persecutory ideation in individuals with psychotic disorders: evidence from an ecological momentary assessment study.Psychological medicine · 2026Article
- Severity matters: Using network analysis to explain low and high levels of persecutory beliefs.Schizophrenia research. Cognition · 2026Article
- A review and integration of models on delusion maintenance.Psychological medicine · 2026Review
- Helping Patients With Persecutory Delusions Find Safety.Schizophrenia bulletin · 2026Article
- Potential Mechanisms of Change in Virtual Reality-based Cognitive Behavioural Therapy and Standard Cognitive Behavioural Therapy for Schizophrenia-Related Paranoia: A Mediation Analysis from the FaceYourFears Trial.Schizophrenia bulletin open · 2026Article
- The Lived Experience of Paranoia: Systematic Review of Qualitative Studies.Schizophrenia bulletin open · 2026Review
- Better Safe Than Sorry? Exploratory Associations Between Fear-Learning Processes and Later Paranoia in Threat-Exposed Adolescents in Standardized Virtual Reality Environments.Schizophrenia bulletin open · 2026Article
- An identity-based cognitive model of self-schemata, perceived social support and paranoid ideation: data from lesbian, gay and bisexual individuals.Cogent mental health · 2026Article
- Conspiratorial thinking in a 50-state survey of American adults.Journal of affective disorders · 2025Article
- Twin differences in the Minnesota Trust Game relate to neural mechanisms of suspiciousness.Cognitive, affective & behavioral neuroscience · 2025Article
- A psychometric evaluation of the German Revised-Green et al. Paranoid Thoughts Scale (R-GPTS) in clinical and non-clinical groups.BMC psychiatry · 2025Article
- Computerised adaptive testing across the paranoia continuum.BMJ mental health · 2025Article
- Are people noticing excessive mistrust in others and how do they understand it? A survey of a UK representative adult population.Psychological medicine · 2025Article
Corrections and comments
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Authors and funding
2 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundParanoia-incorrectly thinking that others are deliberating trying to harm you-causes distress, undermines social interactions and leads to withdrawal. It presents across multiple psychiatric diagnoses.
objectiveThe primary aim was to determine the extent that cognitive and social processes may explain paranoia. The secondary aim was to identify explanatory factors that distinguished paranoia and social anxiety.
methods10 382 UK adults, quota sampled to match the population for age, gender, ethnicity, income and region, participated in a non-probability survey. All participants completed a paranoia measure and assessments of cognitive and social processes. Structural equation modelling was conducted.
findings2586 (24.9%) participants described being mistrustful of other people. 1756 (16.9%) participants wanted help to trust more. 66.7% of variance in paranoia was explained by a model comprising (in descending order of importance): within-situation defence behaviours, negative images, negative self-beliefs, discrimination, dissociation, aberrant salience, anxiety sensitivity, agoraphobic distress, worry, less social support, agoraphobic avoidance, less analytical reasoning and alcohol use. All explanatory factors were associated with paranoia and social anxiety. Ten factors were more closely associated with paranoia than social anxiety, including discrimination, hallucinations, negative images, aberrant salience and alcohol use. Nine factors were more closely associated with social anxiety, including less positive self-belief, an external locus of control, worry and less analytical reasoning.
conclusionsMultiple causes are likely to be involved in paranoia. Cognitive and social processes may explain a high degree of paranoia. CLINICAL IMPLICATIONS: Multiple clear targets for intervention to reduce paranoia are identified.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.