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Bidirectional pathways between psychosocial risk factors and paranoid ideation in a general nonclinical population

Published online by Cambridge University Press:  21 October 2020

Aino Saarinen Open the ORCID record for Aino Saarinen [Opens in a new window] ,
Niklas Granö ,
Mirka Hintsanen ,
Terho Lehtimäki ,
C. Robert Cloninger Open the ORCID record for C. Robert Cloninger [Opens in a new window]  and
Liisa Keltikangas-Järvinen
Aino Saarinen*
Affiliation:
Research Unit of Psychology, University of Oulu, Oulu, Finland Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
Niklas Granö
Affiliation:
Department of Adolescent Psychiatry, Helsinki University Hospital, Helsinki, Finland
Mirka Hintsanen
Affiliation:
Research Unit of Psychology, University of Oulu, Oulu, Finland
Terho Lehtimäki
Affiliation:
Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
C. Robert Cloninger
Affiliation:
Department of Psychiatry, School of Medicine, Washington University, St. Louis, MO, USA Anthropedia Foundation, St. Louis, MO, USA
Liisa Keltikangas-Järvinen
Affiliation:
Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
*
Author for Correspondence: Aino Saarinen, Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, PO Box 21, 00014Helsinki, Finland; E-mail: aino.i.saarinen@helsinki.fi.
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Abstract

We investigated (a) whether psychosocial factors (experienced stress, anticipatory worry, social detachment, sleeping disturbances, alcohol use) predict the course of paranoid ideation between the ages of 24 to 50 years and (b) whether the predictive relationships are more likely to proceed from the psychosocial factors to paranoid ideation, or vice versa. The participants (N = 1534–1553) came from the population-based Young Finns study. Paranoid ideation and psychosocial factors were assessed by reliable self-report questionnaires in 2001, 2007, and 2011/2012. The data were analyzed using growth curve and structural equation models. High experienced stress, anticipatory worry, social detachment, frequent sleeping disturbances, and frequent alcohol use predicted more paranoid ideation. More risk factors predicted increasing paranoid ideation. There were bidirectional predictive relationships of paranoid ideation with experienced stress, anticipatory worry, social detachment, and sleeping disturbances. The link between alcohol use and paranoid ideation was only correlative. In conclusion, paranoid ideation increases by reciprocal interactions with stress, worry, social detachment, and sleeping disturbances. The findings support the threat–anticipation model of paranoid ideation, providing important implications for treatment of paranoia.

Keywords

alcohol useparanoidsleepsocial isolationstress
Type
Regular Article
Information
Development and Psychopathology , Volume 34 , Issue 1 , February 2022 , pp. 421 - 430
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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References

Alsawy, S., Wood, L., Taylor, P. J., & Morrison, A. P. (2015). Psychotic experiences and PTSD: Exploring associations in a population survey. Psychological Medicine, 45, 2849–2859.CrossRefGoogle Scholar
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). Washington DC, US: American Psychiatric Pub.Google Scholar
Appels, A. P. W. M., Höppener, P., & Mulder, P. (1987). A questionnaire to assess premonitory symptoms of myocardial infarction. International Journal of Cardiology, 17, 15–24.CrossRefGoogle ScholarPubMed
Bell, V., & Freeman, D. (2014). A pilot trial of cognitive behavioural therapy for interpersonal sensitivity in individuals with persecutory delusions. Journal of Behavior Therapy and Experimental Psychiatry, 45, 441–446.10.1016/j.jbtep.2014.06.001CrossRefGoogle ScholarPubMed
Bentall, R. P., Corcoran, R., Howard, R., Blackwood, N., & Kinderman, P. (2001). Persecutory delusions: A review and theoretical integration. Clinical Psychology Review, 21, 1143–1192.CrossRefGoogle ScholarPubMed
Chumaeva, N., Hintsanen, M., Juonala, M., Raitakari, O. T., & Keltikangas-Järvinen, L. (2010). Sex differences in the combined effect of chronic stress with impaired vascular endothelium functioning and the development of early atherosclerosis: The Cardiovascular Risk in Young Finns study. BMC Cardiovascular Disorders, 10, 34.CrossRefGoogle ScholarPubMed
Cloninger, C. R., Przybeck, T. R., Svrakic, D. M. and Wetzel, R. D. (1994). The Temperament and Character Inventory (TCI): A guide to its development and use. St. Louis, MO: Center for Psychobiology of Personality, Washington.Google Scholar
Coid, J. W., Ullrich, S., Bebbington, P., Fazel, S., & Keers, R. (2016). Paranoid ideation and violence: Meta-analysis of individual subject data of 7 population surveys. Schizophrenia Bulletin, 42, 907–915.10.1093/schbul/sbw006CrossRefGoogle ScholarPubMed
Copeland, W., Shanahan, L., Jane Costello, E., & Angold, A. (2009). Configurations of common childhood psychosocial risk factors. Journal of Child Psychology and Psychiatry, 50, 451–459.10.1111/j.1469-7610.2008.02005.xCrossRefGoogle ScholarPubMed
Corcoran, R., Cummins, S., Rowse, G., Moore, R., Blackwood, N., Howard, R., & Bentall, R. P. (2006). Reasoning under uncertainty: Heuristic judgments in patients with persecutory delusions or depression. Psychological Medicine, 36, 1109–1118.CrossRefGoogle ScholarPubMed
Dawson, D. A., Grant, B. F., Stinson, F. S., & Chou, P. S. (2005). Psychopathology associated with drinking and alcohol use disorders in the college and general adult populations. Drug and Alcohol Dependence, 77, 139–150.CrossRefGoogle ScholarPubMed
Derogatis, L. R. (1986). Manual for the Symptom Checklist 90 Revised (SCL-90R). Baltimore, MD.Google Scholar
D'Souza, D. C., Perry, E., MacDougall, L., Ammerman, Y., Cooper, T., Braley, G., … Krystal, J. H. (2004). The psychotomimetic effects of intravenous delta-9-tetrahydrocannabinol in healthy individuals: Implications for psychosis. Neuropsychopharmacology, 29, 1558.CrossRefGoogle Scholar
Elahi, A., Algorta, G. P., Varese, F., McIntyre, J. C., & Bentall, R. P. (2017). Do paranoid delusions exist on a continuum with subclinical paranoia? A multi-method taxometric study. Schizophrenia Research, 190, 77–81.CrossRefGoogle ScholarPubMed
el Bouhaddani, S., van Domburgh, L., Schaefer, B., Doreleijers, T. A., & Veling, W. (2019). Psychotic experiences and trauma predict persistence of psychosocial problems in adolescence. European Child & Adolescent Psychiatry, 28, 1597–1606.CrossRefGoogle Scholar
Freeman, D. (2007). Suspicious minds: The psychology of persecutory delusions. Clinical Psychology Review, 27, 425–457.CrossRefGoogle ScholarPubMed
Freeman, D. (2016). Persecutory delusions: A cognitive perspective on understanding and treatment. The Lancet Psychiatry, 3, 685–692.CrossRefGoogle ScholarPubMed
Freeman, D., Dunn, G., Startup, H., Pugh, K., Cordwell, J., Mander, H., … Kingdon, D. (2015). Effects of cognitive behaviour therapy for worry on persecutory delusions in patients with psychosis (WIT): A parallel, single-blind, randomised controlled trial with a mediation analysis. The Lancet Psychiatry, 2, 305–313.10.1016/S2215-0366(15)00039-5CrossRefGoogle ScholarPubMed
Freeman, D., & Garety, P. (2014). Advances in understanding and treating persecutory delusions: A review. Social Psychiatry and Psychiatric Epidemiology, 49, 1179–1189.CrossRefGoogle ScholarPubMed
Freeman, D., Garety, P. A., Bebbington, P. E., Smith, B., Rollinson, R., Fowler, D., … Dunn, G. (2005). Psychological investigation of the structure of paranoia in a non-clinical population. The British Journal of Psychiatry, 186, 427–435.CrossRefGoogle Scholar
Freeman, D., McManus, S., Brugha, T., Meltzer, H., Jenkins, R., & Bebbington, P. (2011). Concomitants of paranoia in the general population. Psychological Medicine, 41, 923–936.CrossRefGoogle ScholarPubMed
Freeman, D., Pugh, K., Antley, A., Slater, M., Bebbington, P., Gittins, M., … Garety, P. (2008). Virtual reality study of paranoid thinking in the general population. The British Journal of Psychiatry, 192, 258–263.CrossRefGoogle ScholarPubMed
Freeman, D., Stahl, D., McManus, S., Meltzer, H., Brugha, T., Wiles, N., & Bebbington, P. (2012). Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking. Social Psychiatry and Psychiatric Epidemiology, 47, 1195–1203.CrossRefGoogle ScholarPubMed
Gobin, C. M., Banks, J. B., Fins, A. I., & Tartar, J. L. (2015). Poor sleep quality is associated with a negative cognitive bias and decreased sustained attention. Journal of Sleep Research, 24, 535–542.CrossRefGoogle ScholarPubMed
Grant, B. F., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J., & Pickering, R. P. (2004). Co-occurrence of 12-month alcohol and drug use disorders and personality disorders in the United States: Results from the National Epidemiologic Survey on Alcohol and Related Conditions. Archives of General Psychiatry, 61, 361–368.CrossRefGoogle ScholarPubMed
Gutiérrez, F., Vall, G., Peri, J. M., Gárriz, M., & Garrido, J. M. (2014). A hierarchical model of normal and abnormal personality up to seven factors. Comprehensive Psychiatry, 55, 326–335.CrossRefGoogle ScholarPubMed
Hall-Lande, J. A., Eisenberg, M. E., Christenson, S. L., & Neumark-Sztainer, D. (2007). Social isolation, psychological health, and protective factors in adolescence. Adolescence, 42, 265–286.Google Scholar
Heinrichs, R. W., & Sam, E. P. (2012). Schizophrenia and crime: How predictable are charges, convictions and violence. International Journal of Mental Health and Addiction, 10, 122–131.CrossRefGoogle Scholar
Hepworth, C., Startup, H., & Freeman, D. (2011). Developing treatments of persistent persecutory delusions: The impact of an emotional processing and metacognitive awareness intervention. The Journal of Nervous and Mental Disease, 199, 653–658.CrossRefGoogle ScholarPubMed
Hintsanen, M., Gluschkoff, K., Dobewall, H., Cloninger, C. R., Keltner, D., Saarinen, A. & Pulkki-Råback, L. (2019). Parent–child-relationship quality predicts offspring dispositional compassion in adulthood: A prospective follow-up study over three decades. Developmental Psychology, 55, 216–225.CrossRefGoogle ScholarPubMed
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.10.1080/10705519909540118CrossRefGoogle Scholar
Jetha, M. K., Goldberg, J. O., & Schmidt, L. A. (2013). Temperament and its relation to social functioning in schizophrenia. International Journal of Social Psychiatry, 59, 254–263.CrossRefGoogle Scholar
Johns, L. C., & Van Os, J. (2001). The continuity of psychotic experiences in the general population. Clinical Psychology Review, 21, 1125–1141.CrossRefGoogle ScholarPubMed
Jönsson, E. G., Cichon, S., Gustavsson, J. P., Grünhage, F., Forslund, K., Mattila-Evenden, M., … Nöthen, M. M. (2003). Association between a promoter dopamine D2 receptor gene variant and the personality trait detachment. Biological Psychiatry, 53, 577–584.CrossRefGoogle ScholarPubMed
Kesting, M. L., Bredenpohl, M., Klenke, J., Westermann, S., & Lincoln, T. M. (2013). The impact of social stress on self-esteem and paranoid ideation. Journal of Behavior Therapy and Experimental Psychiatry, 44, 122–128.CrossRefGoogle ScholarPubMed
Lincoln, T. M., Lange, J., Burau, J., Exner, C., & Moritz, S. (2009a). The effect of state anxiety on paranoid ideation and jumping to conclusions. An experimental investigation. Schizophrenia Bulletin, 36, 1140–1148.CrossRefGoogle ScholarPubMed
Lincoln, T. M., Peter, N., Schäfer, M., & Moritz, S. (2009b). Impact of stress on paranoia: An experimental investigation of moderators and mediators. Psychological Medicine, 39, 1129–1139.CrossRefGoogle Scholar
Marteinsdottir, I., Tillfors, M., Furmark, T, & Anderberg, U., & Ekselius, L. (2003). Personality dimensions measured by the Temperament and Character Inventory (TCI) in subjects with social phobia. Nordic. Journal of Psychiatry, 57, 29–35.Google Scholar
Meesters, C., & Appels, A. (1996). An interview to measure vital exhaustion. II. Reliability and validity of the interview and correlations of vital exhaustion with personality characteristics. Psychology and Health, 11, 573–581.CrossRefGoogle Scholar
Moritz, S., Bentall, R. P., Kolbeck, K., & Roesch-Ely, D. (2018). Monocausal attribution and its relationship with reasoning biases in schizophrenia. Schizophrenia Research, 193, 77–82.CrossRefGoogle Scholar
Moritz, S., Köther, U., Hartmann, M., & Lincoln, T. M. (2015). Stress is a bad advisor. Stress primes poor decision making in deluded psychotic patients. European Archives of Psychiatry and Clinical Neuroscience, 265, 461–469.CrossRefGoogle ScholarPubMed
Morse, J. Q., & Lynch, T. R. (2004). A preliminary investigation of self-reported personality disorders in late life: Prevalence, predictors of depressive severity, and clinical correlates. Aging & Mental Health, 8, 307–315.CrossRefGoogle ScholarPubMed
Myers, E., Startup, H., & Freeman, D. (2011). Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: A pilot trial. Journal of Behavior Therapy and Experimental Psychiatry, 42, 330–336.10.1016/j.jbtep.2011.02.004CrossRefGoogle ScholarPubMed
Olsen, L. R., Mortensen, E. L., & Bech, P. (2004). The SCL-90 and SCL-90R versions validated by item response models in a Danish community sample. Acta Psychiatrica Scandinavica, 110, 225–229.CrossRefGoogle Scholar
Opjordsmoen, S. (1989). Delusional disorders: I. Comparative long-term outcome. Acta Psychiatrica Scandinavica, 80, 603–612.CrossRefGoogle ScholarPubMed
Pulkki-Råback, L., Elovainio, M., Hakulinen, C., Lipsanen, J., Hintsanen, M., Jokela, M., … Keltikangas-Järvinen, L. (2015). Cumulative effect of psychosocial factors in youth on ideal cardiovascular health in adulthood: The Cardiovascular Risk in Young Finns Study. Circulation, 131, 245–253.CrossRefGoogle ScholarPubMed
Raitakari, O. T., Juonala, M., Rönnemaa, T., Keltikangas-Järvinen, L., Räsänen, L., Pietikäinen, M., … Jula, A. (2008). Cohort profile: The cardiovascular risk in Young Finns Study. International Journal of Epidemiology, 37, 1220–1226.10.1093/ije/dym225CrossRefGoogle ScholarPubMed
Reeve, S., Sheaves, B., & Freeman, D. (2015). The role of sleep dysfunction in the occurrence of delusions and hallucinations: A systematic review. Clinical Psychology Review, 42, 96–115.CrossRefGoogle ScholarPubMed
Retterstol, N. (1966). Paranoid and paranoiac psychoses. Springfield, IL: Charles C. Thomas Publisher.Google Scholar
Riggio, H. R., & Kwong, W. Y. (2009). Social skills, paranoid thinking, and social outcomes among young adults. Personality and Individual Differences, 47, 492–497.CrossRefGoogle Scholar
Saarinen, A., Hintsanen, M., Hakulinen, C., Pulkki-Råback, L., Lehtimäki, T., Raitakari, O., & Keltikangas-Järvinen, L. (2018). The co-occurrence between depressive symptoms and paranoid ideation: A population-based longitudinal study. Journal of Affective Disorders, 229, 48–55.CrossRefGoogle ScholarPubMed
Saarinen, A., Rosenström, T., Hintsanen, M., Hakulinen, C., Pulkki-Råback, L., Lehtimäki, T., … Keltikangas-Järvinen, L. (2018). Longitudinal associations of temperament and character with paranoid ideation: A population-based study. Psychiatry Research, 261, 137–142.CrossRefGoogle ScholarPubMed
Schmitz, N., Hartkamp, N., Kiuse, J., Franke, G. H., Reister, G., & Tress, W. (2000). The symptom check-list-90-R (SCL-90-R): A German validation study. Quality of Life Research, 9, 185–193.CrossRefGoogle ScholarPubMed
Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A., & King, J. (2006). Reporting structural equation modeling and confirmatory factor analysis results: A review. The Journal of Educational Research, 99, 323–338.CrossRefGoogle Scholar
Scott, A. J., Rowse, G., & Webb, T. L. (2017). A structural equation model of the relationship between insomnia, negative affect, and paranoid thinking. PloS one, 12, e0186233.CrossRefGoogle ScholarPubMed
Tackett, J. L., Kushner, S. C., Herzhoff, K., Smack, A. J., & Reardon, K. W. (2014). Viewing relational aggression through multiple lenses: Temperament, personality, and personality pathology. Development and Psychopathology, 26, 863–877.CrossRefGoogle ScholarPubMed
Thewissen, V., Bentall, R. P., Oorschot, M., à Campo, J., van Lierop, T., van Os, J., & Myin-Germeys, I. (2011). Emotions, self-esteem, and paranoid episodes: An experience sampling study. British Journal of Clinical Psychology, 50, 178–195.CrossRefGoogle Scholar
Tone, E. B., & Davis, J. S. (2012). Paranoid thinking, suspicion, and risk for aggression: A neurodevelopmental perspective. Development and Psychopathology, 24, 1031–1046.CrossRefGoogle ScholarPubMed
Van Os, J. (2003). Is there a continuum of psychotic experiences in the general population. Epidemiology and Psychiatric Sciences, 12, 242–252.10.1017/S1121189X00003067CrossRefGoogle Scholar
Verdoux, H, & van Os, J. (2002). Psychotic symptoms in non-clinical populations and the continuum of psychosis. Schizophrenia Research, 54, 59–65.CrossRefGoogle ScholarPubMed
Verdoux, H., Gindre, C., Sorbara, F., Tournier, M., & Swendsen, J. D. (2003). Effects of cannabis and psychosis vulnerability in daily life: An experience sampling test study. Psychological Medicine, 33, 23–32.CrossRefGoogle ScholarPubMed
Waller, H., Emsley, R., Freeman, D., Bebbington, P., Dunn, G., Fowler, D., … Garety, P. (2015). Thinking Well: A randomised controlled feasibility study of a new CBT therapy targeting reasoning biases in people with distressing persecutory delusional beliefs. Journal of Behavior Therapy and Experimental Psychiatry, 48, 82–89.10.1016/j.jbtep.2015.02.007CrossRefGoogle ScholarPubMed
Watson, D. (2001). Dissociations of the night: Individual differences in sleep-related experiences and their relation to dissociation and schizotypy. Journal of Abnormal Psychology, 110, 526.CrossRefGoogle ScholarPubMed
Westermann, S., Kesting, M. L., & Lincoln, T. M. (2012). Being deluded after being excluded? How emotion regulation deficits in paranoia-prone individuals affect state paranoia during experimentally induced social stress. Behavior Therapy, 43, 329–340.CrossRefGoogle ScholarPubMed
Zohar, A. H., Zwir, I., Wang, J., Cloninger, C. R., & Anokhin, A. P. (2019). The development of temperament and character during adolescence: The processes and phases of change. Development and Psychopathology, 31, 601–617.CrossRefGoogle ScholarPubMed
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