"Rejection Makes Me Suspicious": Complex Temporal Network Approach to the Dynamics of Real-Time Paranoid Thoughts and Psychological Vulnerability.

Background and Hypothesis: Theoretical models and empirical evidence suggest that paranoid thoughts stem from a heightened sense of vulnerability, including the perception of the world as dangerous, and fears of rejection and social evaluation. However, the factors contributing to this sense of vulnerability and the complex interplay between these elements remain underexplored. Study Design: A total of 175 individuals recruited from a nonclinical community sample, including 103 participants with low levels of paranoid thoughts (LP) and 72 with high levels (HP), took part in a 7-day ESM study assessing momentary levels of paranoia, social functioning, social rejection, negative affect, body image, and misophonia symptoms. Temporal, contemporaneous, and between-subject network models were estimated for the total sample and its subgroups separately. Study Results: The temporal network identified paranoid thoughts as a predictor of negative affect, feelings of rejection, and negative body image, while in turn being predicted by feelings of rejection and reduced social safety. A bidirectional relationship between paranoia and social rejection emerged. These findings were supported by contemporaneous and between-subject networks, which showed that paranoid thoughts co-occurred with and were, on average, linked to feelings of rejection, negative affect, and reduced social safety. Conclusions: These findings suggest that social rejection plays a central role in paranoia. While group differences in network structure were modest, the HP group exhibited more numerous and stronger connections between variables, suggesting that paranoia may develop through the gradual reinforcement of connections between symptoms rather than structural shifts, highlighting the importance of early intervention.