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Adolescent Paranoia: Prevalence, Structure, and Causal Mechanisms
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Adolescence can be a challenging time, characterized by self-consciousness, heightened regard for peer acceptance, and fear of rejection. Interpersonal concerns are amplified by unpredictable social interactions, both online and offline. This developmental and social context is potentially conducive to the emergence of paranoia. However, research on paranoia during adolescence is scarce.</jats:p> </jats:sec> <jats:sec> <jats:title>Method</jats:title> <jats:p>Our aim was to examine the prevalence, structure, and probabilistic causal mechanisms of adolescent paranoia. A representative school cohort of 801 adolescents (11–15 y) completed measures of paranoia and a range of affective, cognitive, and social factors. A Bayesian approach with Directed Acyclic Graphs (DAGs) was used to assess the causal interactions with paranoia.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Paranoid thoughts were very common, followed a continuous distribution, and were hierarchically structured. There was an overall paranoia factor, with sub-factors of social fears, physical threat fears, and conspiracy concerns. With all other variables controlled, DAG analysis identified paranoia had dependent relationships with negative affect, peer difficulties, bullying, and cognitive-affective responses to social media. The causal directions could not be fully determined, but it was more likely that negative affect contributed to paranoia and paranoia impacted peer relationships. Problematic social media use did not causally influence paranoia.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>There is a continuum of paranoia in adolescence and occasional suspicions are common at this age. Anxiety and depression are closely connected with paranoia and may causally contribute to its development. Paranoia may negatively impact adolescent peer relationships. The clinical significance of paranoia in adolescents accessing mental health services must now be established.</jats:p> </jats:sec>
The Dunn Worry Questionnaire and the Paranoia Worries Questionnaire: new assessments of worry
<jats:title>Abstract</jats:title><jats:sec id="S0033291719000588_sec_a1" sec-type="other"><jats:title>Background</jats:title><jats:p>The cognitive process of worry, which keeps negative thoughts in mind and elaborates the content, contributes to the occurrence of many mental health disorders. Our principal aim was to develop a straightforward measure of general problematic worry suitable for research and clinical treatment. Our secondary aim was to develop a measure of problematic worry specifically concerning paranoid fears.</jats:p></jats:sec><jats:sec id="S0033291719000588_sec_a2" sec-type="methods"><jats:title>Methods</jats:title><jats:p>An item pool concerning worry in the past month was evaluated in 250 non-clinical individuals and 50 patients with psychosis in a worry treatment trial. Exploratory factor analysis and item response theory (IRT) informed the selection of scale items. IRT analyses were repeated with the scales administered to 273 non-clinical individuals, 79 patients with psychosis and 93 patients with social anxiety disorder. Other clinical measures were administered to assess concurrent validity. Test-retest reliability was assessed with 75 participants. Sensitivity to change was assessed with 43 patients with psychosis.</jats:p></jats:sec><jats:sec id="S0033291719000588_sec_a3" sec-type="results"><jats:title>Results</jats:title><jats:p>A 10-item general worry scale (Dunn Worry Questionnaire; DWQ) and a five-item paranoia worry scale (Paranoia Worries Questionnaire; PWQ) were developed. All items were highly discriminative (DWQ <jats:italic>a</jats:italic> = 1.98–5.03; PWQ <jats:italic>a</jats:italic> = 4.10–10.7), indicating small increases in latent worry lead to a high probability of item endorsement. The DWQ was highly informative across a wide range of the worry distribution, whilst the PWQ had greatest precision at clinical levels of paranoia worry. The scales demonstrated excellent internal reliability, test-retest reliability, concurrent validity and sensitivity to change.</jats:p></jats:sec><jats:sec id="S0033291719000588_sec_a4" sec-type="conclusions"><jats:title>Conclusions</jats:title><jats:p>The new measures of general problematic worry and worry about paranoid fears have excellent psychometric properties.</jats:p></jats:sec>
A Twin Study on the Association Between Psychotic Experiences and Tobacco Use During Adolescence.
OBJECTIVE: Psychotic experiences (PE) are dimensional phenomena in the general population that resemble psychotic symptoms, such as paranoia and hallucinations. This is the first twin study to explore the degree to which tobacco use and PE share genetic or environmental influences. Previous studies on the association between adolescent tobacco use and PE have not considered PE dimensionally, included negative symptoms, or accounted for confounding by sleep disturbance and stressful life events. METHOD: An unselected adolescent twin sample (N = 3,787 pairs; mean age = 16.16 years) reported on PE (paranoia, hallucinations, cognitive disorganization, grandiosity, and anhedonia) and regularity of tobacco use. Parents rated the twins' negative symptoms. Regression analyses were conducted while adjusted for sociodemographic characteristics, prenatal maternal smoking, cannabis use, sleep disturbance, and stressful life events. Bivariate twin modeling was used to estimate the degree of genetic and common and unique environmental influences shared between tobacco use and PE. RESULTS: Regular smokers were significantly more likely to experience paranoia, hallucinations, cognitive disorganization, and negative symptoms (β = 0.17-0.34), but not grandiosity or anhedonia, than nonsmokers, after adjustment for confounders. Paranoia, hallucinations, and cognitive disorganization correlated ≥0.15 with tobacco use (r = 0.15-0.21, all p < .001). Significant genetic correlations (rA=0.37-0.45) were found. Genetic influences accounted for most of the association between tobacco use and paranoia (84%) and cognitive disorganization (81%). Familial influences accounted for 80% of the association between tobacco use and hallucinations. CONCLUSION: Tobacco use and PE during adolescence were associated after adjustment for confounders. They appear to co-occur largely because of shared genetic influences.
Society and psychosis
14 Theories of cognition, emotion and the social world: missing links in psychosis Paul ... Daniel Freeman and Elizabeth Kuipers Introduction Throughout the ...