Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-26T07:51:55.720Z Has data issue: false hasContentIssue false

Concomitants of paranoia in the general population

Published online by Cambridge University Press:  24 August 2010

D. Freeman*
Affiliation:
King's College London, Institute of Psychiatry, London, UK
S. McManus
Affiliation:
National Centre for Social Research, London, UK
T. Brugha
Affiliation:
Department of Health Sciences, University of Leicester, Leicester, UK
H. Meltzer
Affiliation:
Department of Health Sciences, University of Leicester, Leicester, UK
R. Jenkins
Affiliation:
King's College London, Institute of Psychiatry, London, UK
P. Bebbington
Affiliation:
Department of Mental Health Sciences, University College London, London, UK
*
*Address for correspondence: D. Freeman, Ph.D., King's College London, Department of Psychology, PO Box 077, Institute of Psychiatry, Denmark Hill, London SE5 8AF, UK. (Email: [email protected])

Abstract

Background

Paranoia is an unregarded but pervasive attribute of human populations. In this study we carried out the most comprehensive investigation so far of the demographic, economic, social and clinical correlates of self-reported paranoia in the general population.

Method

Data weighted to be nationally representative were analysed from the Adult Psychiatric Morbidity Survey in England (APMS 2007; n=7281).

Results

The prevalence of paranoid thinking in the previous year ranged from 18.6% reporting that people were against them, to 1.8% reporting potential plots to cause them serious harm. At all levels, paranoia was associated with youth, lower intellectual functioning, being single, poverty, poor physical health, poor social functioning, less perceived social support, stress at work, less social cohesion, less calmness, less happiness, suicidal ideation, a great range of other psychiatric symptoms (including anxiety, worry, phobias, post-traumatic stress and insomnia), cannabis use, problem drinking and increased use of treatment and services.

Conclusions

Overall, the results indicate that paranoia has the widest of implications for health, emotional well-being, social functioning and social inclusion. Some of these concomitants may contribute to the emergence of paranoid thinking, while others may result from it.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bebbington, PE, Nayani, T (1995). The Psychosis Screening Questionnaire. International Journal of Methods in Psychiatric Research 5, 1120.Google Scholar
Bentall, RP, Rowse, G, Shryane, N, Kinderman, P, Howard, R, Blackwood, N, Moore, R, Corcoran, R (2009). The cognitive and affective structure of paranoid delusions. Archives of General Psychiatry 66, 236247.CrossRefGoogle ScholarPubMed
Ben-Zeev, D, Ellington, K, Swendsen, J, Granholm, E (2010). Examining a cognitive model of persecutory ideation in the daily life of people with schizophrenia: a computerized experience sampling study. Schizophrenia Bulletin. Published online: 28 April 2010. doi:10.1093/schbul/sbq041.Google ScholarPubMed
Brewin, CR, Rose, S, Andrews, B, Green, J, Tata, P, McEvedy, C, Turner, SW, Foa, EB (2002). Brief screening instrument for post-traumatic stress disorder. British Journal of Psychiatry 181, 158162.CrossRefGoogle ScholarPubMed
Brugha, TS, Sturt, E, MacCarthy, B, Potter, J, Wykes, T, Bebbington, PE (1987). The Interview Measure of Social Relationships: the description and evaluation of a survey instrument for assessing personal social resources. Social Psychiatry and Psychiatric Epidemiology 22, 123128.Google ScholarPubMed
Coleman, JS (1988). Social capital in the creation of human capital. American Journal of Sociology 94, s95–120.CrossRefGoogle Scholar
Combs, DR, Michael, CO, Penn, DL (2006). Paranoia and emotion perception across the continuum. British Journal of Clinical Psychology 45, 1931.CrossRefGoogle ScholarPubMed
Eaton, WW, Kessler, LG (eds) (1985). Epidemiologic Field Methods in Psychiatry: The NIMH Epidemiologic Catchment Area Program. Academic Press: Orlando, FL.Google Scholar
Forsell, Y, Henderson, AS (1998). Epidemiology of paranoid symptoms in an elderly population. British Journal of Psychiatry 172, 429432.CrossRefGoogle Scholar
Foster, C, Startup, H, Potts, L, Freeman, D (2010). A randomised controlled trial of a worry intervention for individuals with persistent persecutory delusions. Journal of Behavior Therapy and Experimental Psychiatry 41, 4551.CrossRefGoogle ScholarPubMed
Freeman, D (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychology Review 27, 425457.CrossRefGoogle ScholarPubMed
Freeman, D, Brugha, T, Meltzer, H, Jenkins, R, Stahl, D, Bebbington, P (2010 a). Persecutory ideation and insomnia: findings from the second British National Survey of Psychiatric Morbidity. Journal of Psychiatric Research. Published online: 28 April 2010. doi:10.1016/j.jpsychires.2010.03.018.CrossRefGoogle ScholarPubMed
Freeman, D, Freeman, J (2008). Paranoia: The 21st Century Fear. Oxford University Press: Oxford.CrossRefGoogle Scholar
Freeman, D, Freeman, J, Garety, P (2008 a). Overcoming Paranoid and Suspicious Thoughts. Basic Books: New York.Google Scholar
Freeman, D, Garety, PA, Bebbington, PE, Smith, B, Rollinson, R, Fowler, D, Kuipers, E, Ray, K, Dunn, G (2005). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry 186, 427435.CrossRefGoogle Scholar
Freeman, D, Pugh, K, Antley, A, Slater, M, Bebbington, P, Gittins, M, Dunn, G, Kuipers, E, Fowler, D, Garety, PA (2008 b). A virtual reality study of paranoid thinking in the general population. British Journal of Psychiatry 192, 258263.CrossRefGoogle ScholarPubMed
Freeman, D, Pugh, K, Vorontsova, N, Antley, A, Slater, M (2010 b). Testing the continuum of delusional beliefs: an experimental study using virtual reality. Journal of Abnormal Psychology 119, 8392.CrossRefGoogle ScholarPubMed
Freeman, D, Pugh, K, Vorontsova, N, Southgate, L (2009). Insomnia and paranoia. Schizophrenia Research 108, 280284.CrossRefGoogle ScholarPubMed
Harrow, M, Jobe, T, Astrachan-Fletcher, EB (2008). Prognosis of persecutory delusions in schizophrenia: a 20-year longitudinal study. In Persecutory Delusions (ed. Freeman, D., Bentall, R. and Garety, P.), pp. 7390. Oxford University Press: Oxford.CrossRefGoogle Scholar
Henquet, C, Di Forti, M, Murray, RM, van Os, J (2008). The role of cannabis in inducing paranoia and psychosis. In Persecutory Delusions (ed. Freeman, D., Bentall, R. and Garety, P.), pp. 267280. Oxford University Press: Oxford.CrossRefGoogle Scholar
Iancu, I, Poreh, A, Lehman, B, Shamir, E, Kotler, M (2005). The Positive and Negative Symptoms Questionnaire. Comprehensive Psychiatry 46, 6166.CrossRefGoogle ScholarPubMed
Jenkins, R, Meltzer, H, Bebbington, P, Brugha, T, Farrell, M, McManus, S, Singleton, N (2009). The British Mental Health Survey Programme: achievements and latest findings. Social Psychiatry and Psychiatric Epidemiology 44, 899904.CrossRefGoogle ScholarPubMed
Johns, LC, Cannon, M, Singleton, N, Murray, RM, Farrell, M, Brugha, T, Bebbington, P, Jenkins, R, Meltzer, H (2004). The prevalence and correlates of self-reported psychotic symptoms in the British population. British Journal of Psychiatry 185, 298305.CrossRefGoogle ScholarPubMed
Kawachi, I, Kennedy, BP, Lochner, K, Prothrow-Stith, D (1997). Social capital, income inequality, and mortality. American Journal of Public Health 87, 14911498.CrossRefGoogle ScholarPubMed
Kendler, KS, Campbell, J (2009). Interventionist causal models in psychiatry. Psychological Medicine 39, 881887.CrossRefGoogle ScholarPubMed
Kendler, KS, Gallagher, TJ, Abelson, JM, Kessler, RC (1996). Lifetime prevalence, demographic risk factors, and diagnostic validity of nonaffective psychosis as assessed in a US community sample. Archives of General Psychiatry 53, 10221031.CrossRefGoogle Scholar
Kish, L (1965). Survey Sampling. Wiley & Sons: London.Google Scholar
Krabbendam, L, van Os, J (2005). Schizophrenia and urbanicity: a major environmental influence – conditional on genetic risk. Schizophrenia Bulletin 31, 795799.CrossRefGoogle Scholar
Lewis, G, Pelosi, A, Araya, RC, Dunn, G (1992). Measuring psychiatric disorder in the community: a standardised assessment for use by lay interviewers. Psychological Medicine 22, 465468.CrossRefGoogle ScholarPubMed
Lincoln, TM, Peter, N, Schäfer, M, Moritz, S (2008). Impact of stress on paranoia: an experimental investigation of moderators and mediators. Psychological Medicine 39, 11291139.CrossRefGoogle ScholarPubMed
Lindström, E, Jedenius, E, Levander, S (2009). A symptom self-rating scale for schizophrenia (4S). Nordic Journal of Psychiatry 63, 368374.CrossRefGoogle ScholarPubMed
McManus, S, Meltzer, H, Brugha, T, Bebbington, P, Jenkins, R (2009). Adult Psychiatric Morbidity in England, 2007: Results of a Household Survey. National Centre for Social Research: London.Google Scholar
Miller, GA, Chapman, JP (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology 110, 4048.CrossRefGoogle ScholarPubMed
Moore, THM, Zammit, S, Lingford-Hughes, A, Barnes, TE, Jones, PB, Burke, M, Lewis, G (2007). Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. Lancet 370, 319328.CrossRefGoogle ScholarPubMed
Morrison, PD, Zois, V, McKeown, DA, Lee, TD, Holt, DW, Powell, JF, Kapur, S, Murray, RM (2009). The acute effects of synthetic intravenous ▵9-tetrahydrocannabinol on psychosis, mood and cognitive functioning. Psychological Medicine 39, 16071616.CrossRefGoogle Scholar
Myin-Germeys, I, van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409424.CrossRefGoogle ScholarPubMed
Nelson, HE (1982). The National Adult Reading Test. Nfer-Nelson: Windsor, Berks.Google Scholar
Office for National Statistics (ONS). 2006 mid-year household population estimates (http://www.statistics.gov.uk/about/data/methodology/specific/population/PEMethodology/).Google Scholar
Pedersen, CB, Mortensen, PB (2001). Evidence of a dose–response relationship between urbanicity during upbringing and schizophrenia risk. Archives of General Psychiatry 58, 10391046CrossRefGoogle ScholarPubMed
Peralta, V, Cuesta, MJ (1999). Dimensional structure of psychotic symptoms: an item-level analysis of SAPS and SANS symptoms in psychotic disorders. Schizophrenia Research 38, 1326.CrossRefGoogle ScholarPubMed
Putnam, RD (1995). Bowling alone: America's declining social capital. Journal of Democracy 6, 6578.CrossRefGoogle Scholar
Rutten, BPF, van Os, J, Dominguez, M, Krabbendam, L (2008). Epidemiology and social factors: findings from the Netherlands Mental Health Survey and Incidence and Incidence Study (NEMESIS). In Persecutory Delusions (ed. Freeman, D., Bentall, R. and Garety, P.), pp. 5371. Oxford University Press: Oxford.CrossRefGoogle Scholar
Saunders, JB, Aasland, OG, Babor, TF, Dela Fuente, JR, Grant, M (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption, part II. Addiction 88, 791804.CrossRefGoogle Scholar
Scott, J, Chant, D, Andrews, G, McGrath, J (2006). Psychotic-like experiences in the general community: the correlates of CIDI psychosis screen items in an Australian sample. Psychological Medicine 36, 231238.CrossRefGoogle Scholar
Siegrist, J (1996). Adverse health effects of high effort/low-reward conditions. Journal of Occupational Health Psychology 1, 2741.CrossRefGoogle ScholarPubMed
SPSS (2006). SPSS Base 15.0 User's Guide. SPSS Inc.: Chicago, IL.Google Scholar
Startup, H, Freeman, D, Garety, PA (2007). Persecutory delusions and catastrophic worry in psychosis: developing the understanding of delusion distress and persistence. Behaviour Research and Therapy 45, 523537.CrossRefGoogle ScholarPubMed
Thewissen, V, Myin-Germeys, I, Bentall, R, de Graaf, R, Vollebergh, W, van Os, J (2005). Hearing impairment and psychosis revisited. Schizophrenia Research 76, 99103.CrossRefGoogle ScholarPubMed
Tyrer, P, Nur, U, Crawford, M, Karlsen, S, MacLean, C, Rao, B, Johnson, T (2005). The social functioning questionnaire: a rapid and robust measure of perceived functioning. International Journal of Social Psychiatry 51, 265275.CrossRefGoogle ScholarPubMed
Van Os, J, Hanssen, M, Bijl, RV, Ravelli, A (2000). Strauss (1969) revisited: a psychosis continuum in the general population. Schizophrenia Research 45, 1120.CrossRefGoogle ScholarPubMed
Van Os, J, Linscott, RJ, Myin-Germeys, I, Delespaul, P, Krabbendam, L (2009). A systematic review and meta-analysis of the psychosis continuum. Psychological Medicine 39, 179195.CrossRefGoogle ScholarPubMed
Varghese, D, Scott, J, Welham, J, Bor, W, Najman, J, O'Callaghan, M, Williams, G, McGrath, J (2009). Psychotic-like experiences in major depression and anxiety disorders: a population-based survey in young adults. Schizophrenia Bulletin. Published online: 17 August 2009. doi:10.1093/schbul/sbp083.Google ScholarPubMed
Vázquez-Barquero, JL, Lastra, I, Nuñez, MJC, Castanedo, SH, Dunn, G (1996). Patterns of positive and negative symptoms in first episode schizophrenia. British Journal of Psychiatry 168, 693701.CrossRefGoogle ScholarPubMed
Vermissen, D, Janssen, I, Myin-Germeys, I, Mengelers, R, a Campo, J, van Os, J, Krabbendam, L (2008). Evidence for a relationship between mentalising deficits and paranoia over the psychosis continuum. Schizophrenia Research 99, 103110.CrossRefGoogle Scholar
Ware, JE, Kosinski, M, Keller, SD (1995). A 12-item short-form health survey. Construction of scales and preliminary tests of reliability and validity. Medical Care 34, 220233.CrossRefGoogle Scholar
WHO (1992). SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Geneva: World Health Organisation.Google Scholar
Zimbardo, PG, Andersen, SM, Kabat, LG (1981). Induced hearing deficit generates experimental paranoia. Science 212, 15291531.CrossRefGoogle ScholarPubMed