Hostname: page-component-84b7d79bbc-rnpqb Total loading time: 0 Render date: 2024-07-30T06:37:25.696Z Has data issue: false hasContentIssue false
  • English
  • Français

Stress sensitivity in paranoia: poor-me paranoia protects against the unpleasant effects of social stress

Published online by Cambridge University Press:  05 June 2017

A. Udachina ,
R. P. Bentall ,
F. Varese  and
G. Rowse
A. Udachina*
Affiliation:
Greater Manchester Mental Health NHS Foundation Trust, UK
R. P. Bentall
Affiliation:
University of Liverpool, UK
F. Varese
Affiliation:
University of Manchester, UK
G. Rowse
Affiliation:
University of Sheffield, UK
*
*Address for correspondence: A. Udachina, Bramley Street Rehabilitation Unit, Greater Manchester West NHS Foundation Trust, Salford, M7 1YE, UK. (Email: alisaudachina@gmail.com)
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

The attributional theory of paranoia suggests that paranoid beliefs may protect individuals from low self-esteem and distress (Bentall et al. 2001). The current study tested this theory by investigating a hypothesis that paranoid beliefs in combination with low perceived deservedness of persecution (poor-me beliefs) confer protection against the distress caused by social but not activity related stress.

Methods

Paranoid symptoms, perceived deservedness of persecution, self-esteem, mood, and stress levels of individuals diagnosed with schizophrenia spectrum disorders (N = 91) and healthy controls (N = 52) were assessed in the context of daily life using the experience sampling method.

Results

Individuals holding poor-me beliefs (poor-me individuals) showed blunted sensitivity to social but not activity stress. In contrast, individuals holding paranoid beliefs in combination with high perceived deservedness of persecution (bad-me individuals) showed heightened sensitivity to social stress. No consistent differences in reactions to activity stress emerged. Although both poor-me and bad-me individuals reported low self-esteem, this disturbance was particularly characteristic of bad-me individuals.

Conclusions

The results suggest that poor-me paranoid beliefs may protect individuals against the distress associated with unpleasant social situations. The specificity of reactions to social stress is discussed in the context of wider literature. Future directions for research are suggested.

Keywords

deservednessexperience samplingparanoiapsychosisschizophreniastress sensitivity
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 16 , December 2017 , pp. 2834 - 2843
Copyright
Copyright © Cambridge University Press 2017 

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

Bentall, RP, Corcoran, R, Howard, R, Blackwood, N, Kinderman, P (2001). Persecutory delusions: a review and theoretical integration. Clinical Psychology Review 21, 1143–1192.CrossRefGoogle ScholarPubMed
Bentall, RP, De Sousa, P, Varese, F, Wickham, S, Sitko, K, Haarmans, M, Read, J (2014). From adversity to psychosis: pathways and mechanisms from specific adversities to specific symptoms. Social Psychiatry and Psychiatric Epidemiology 49, 1011–1022.CrossRefGoogle ScholarPubMed
Bentall, RP, Kinderman, P, Kaney, S (1994). The self, attributional processes and abnormal beliefs: towards a model of persecutory delusions. Behaviour Research and Therapy 32, 331–341.CrossRefGoogle Scholar
Cantor-Graae, E (2007). The contribution of social factors to the development of schizophrenia: a review of recent findings. Canadian Journal of Psychiatry-Revue Canadienne De Psychiatrie 52, 277–286.CrossRefGoogle Scholar
Chadwick, PDJ, Trower, P, Juusti-Butler, TM, Maguire, N (2005). Phenomenological evidence for two types of paranoia. Psychopathology 38, 327–333.CrossRefGoogle ScholarPubMed
Collip, D, Myin-Germeys, I, Van Os, J (2008). Does the concept of ‘Sensitization’ provide a plausible mechanism for the putative link between the environment and schizophrenia? Schizophrenia Bulletin 34, 220–225.CrossRefGoogle ScholarPubMed
Collip, D, Nicolson, NA, Lardinois, M, Lataster, T, Van Os, J, Myin-Germeys, I, Group (2011). Daily cortisol, stress reactivity and psychotic experiences in individuals at above average genetic risk for psychosis. Psychological Medicine 41, 2305–2315.CrossRefGoogle ScholarPubMed
Fornells-Ambrojo, M, Garety, PA (2005). Bad me paranoia in early psychosis: a relatively rare phenomenon. British Journal of Clinical Psychology 44, 521–528.CrossRefGoogle 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, Fowler, D, Kuipers, E, Dunn, G, Bebbington, P, Hadley, C (1998). The London-East Anglia randomized controlled trial of cognitive-behaviour therapy for psychosis IV: self-esteem and persecutory delusions. British Journal of Clinical Psychology 37, 415–430.CrossRefGoogle ScholarPubMed
Freeman, D, Garety, P, Kuipers, E (2001). Persecutory delusions: developing the understanding of belief maintenance and emotional distress. Psychological Medicine 31, 1293–1306.CrossRefGoogle ScholarPubMed
Freeman, D, Pugh, K, Vorontsova, N, Antley, A, Slater, M (2010). Testing the continuum of delusional beliefs: an experimental study using virtual reality. Journal of Abnormal Psychology 119, 83–92.CrossRefGoogle ScholarPubMed
Hafner, H, Maurer, K, Loffler, W, Riecherrossler, A (1993). The influence of age and sex on the onset and early course of schizophrenia. British Journal of Psychiatry 162, 80–86.CrossRefGoogle ScholarPubMed
Higgins, ET, Bond, RN, Klein, R, Strauman, T (1986). Self-discrepancies and emotional vulnerability – how magnitude, accessibility, and type of discrepancy influence affect. Journal of Personality and Social Psychology 51, 5–15.CrossRefGoogle ScholarPubMed
Hoffman, RE (2007). A social deafferentation hypothesis for induction of active schizophrenia. Schizophrenia Bulletin 33, 1066–1070.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Kay, SR, Opler, LA, Lindenmayer, JP (1988). Reliability and validity of the positive and negative syndrome scale for schizophrenics. Psychiatry Research 23, 99–110.CrossRefGoogle ScholarPubMed
Kinderman, P, Bentall, RP (1997). Causal attributions in paranoia and depression: internal, personal, and situational attributions for negative events. Journal of Abnormal Psychology 106, 341–345.CrossRefGoogle ScholarPubMed
Lataster, T, Wichers, M, Jacobs, N, Mengelers, R, Derom, C, Thiery, E, Van Os, J, Myin-Germeys, I (2009). Does reactivity to stress cosegregate with subclinical psychosis? A general population twin study. Acta Psychiatrica Scandinavica 119, 45–53.CrossRefGoogle ScholarPubMed
Leary, MR, Terdal, SK, Tambor, ES, Downs, DL (1995). Self-esteem as an interpersonal monitor: the sociometer hypothesis. Journal of Personality and Social Psychology 68, 518–530.CrossRefGoogle Scholar
Lyon, HM, Kaney, S, Bentall, RP (1994). The defensive function of persecutory delusions: evidence from attribution tasks. British Journal of Psychiatry 164, 637–646.CrossRefGoogle ScholarPubMed
Melo, S, Corcoran, R, Shryane, N, Bentall, RP (2009). The persecution and deservedness scale. Psychology and Psychotherapy-Theory Research and Practice 82, 247–260.CrossRefGoogle ScholarPubMed
Melo, S, Taylor, JL, Bentall, RP (2006). ‘Poor me’ versus ‘bad me’ paranoia and the instability of persecutory ideation. Psychology and Psychotherapy-Theory Research and Practice 79, 271–287.CrossRefGoogle ScholarPubMed
Melo, SS, Bentall, RP (2013). ‘Poor me’ versus ‘Bad me’ paranoia: the association between self-beliefs and the instability of persecutory ideation. Psychology and Psychotherapy-Theory Research and Practice 86, 146–163.CrossRefGoogle ScholarPubMed
Morgan, C, Gayer-Anderson, C (2016). Childhood adversities and psychosis: evidence, challenges, implications. World Psychiatry 15, 93–102.CrossRefGoogle ScholarPubMed
Morrison, AP, French, P, Lewis, SW, Roberts, M, Raja, S, Neil, ST, Parker, S, Green, J, Kilcommons, A, Walford, L, Bentall, RP (2006). Psychological factors in people at ultra-high risk of psychosis: comparisons with non-patients and associations with symptoms. Psychological Medicine 36, 1395–1404.CrossRefGoogle ScholarPubMed
Moutoussis, M, Williams, J, Dayan, P, Bentall, RP (2007). Persecutory delusions and the conditioned avoidance paradigm: towards an integration of the psychology and biology of paranoia. Cognitive Neuropsychiatry 12, 495–510.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Delespaul, P, Van Os, J (2003). The experience sampling method in psychosis research. Current Opinion in Psychiatry 16, S33–S38.CrossRefGoogle Scholar
Myin-Germeys, I, Van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409–424.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Van Os, J, Schwartz, JE, Stone, AA, Delespaul, PA (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry 58, 1137–1144.CrossRefGoogle ScholarPubMed
Nuechterlein, KH, Dawson, ME (1984). A heuristic vulnerability stress model of schizophrenic episodes. Schizophrenia Bulletin 10, 300–312.CrossRefGoogle ScholarPubMed
Oorschot, M, Kwapil, T, Delespaul, P, Myin-Germeys, I (2009). Momentary assessment research in psychosis. Psychological Assessment 21, 498–505.CrossRefGoogle ScholarPubMed
Palmier-Claus, JE, Dunn, G, Lewis, SW (2012). Emotional and symptomatic reactivity to stress in individuals at ultra-high risk of developing psychosis. Psychological Medicine 42, 1003–1012.Google ScholarPubMed
Palmier-Claus, JE, Myin-Germeys, I, Barkus, E, Bentley, L, Udachina, A, Delespaul, PAEG, Lewis, SW, Dunn, G (2011). Experience sampling research in individuals with mental illness: reflections and guidance. Acta Psychiatrica Scandinavica 123, 12–20.CrossRefGoogle ScholarPubMed
Reininghaus, U, Kempton, MJ, Valmaggia, L, Craig, TKJ, Garety, P, Onyejiaka, A, Gayer-Anderson, C, So, SH, Hubbard, K, Beards, S, Dazzan, P, Pariante, C, Mondelli, V, Fisher, HL, Mills, JG, Viechtbauer, W, Mcguire, P, Van Os, J, Murray, RM, Wykes, T, Myin-Germeys, I, Morgan, C (2016). Stress sensitivity, aberrant salience, and threat anticipation in early psychosis: an experience sampling study. Schizophrenia Bulletin 42, 712–722.CrossRefGoogle ScholarPubMed
Rietdijk, J, Ising, HK, Dragt, S, Klaassen, R, Nieman, D, Wunderink, L, Cuijpers, P, Linszen, D, Van Der Gaag, M (2013). Depression and social anxiety in help-seeking patients with an ultra-high risk for developing psychosis. Psychiatry Research 209, 309–313.CrossRefGoogle ScholarPubMed
Sartorius, N, Jablensky, A, Korten, A, Ernberg, G, Anker, M, Cooper, JE, Day, R (1986). Early manifestations and first-contact incidence of schizophrenia in different cultures. Psychological Medicine 16, 909–928.CrossRefGoogle ScholarPubMed
Selten, JP, Van Der Ven, E, Rutten, BPF, Cantor-Graae, E (2013). The social defeat hypothesis of schizophrenia: an update. Schizophrenia Bulletin 39, 1180–1186.CrossRefGoogle ScholarPubMed
STATACORP (2007). Stata Statistical Software, Release 9.2. Stata Corporation: College Station, TX, USA.Google Scholar
Stilo, SA, Di Forti, M, Mondelli, V, Falcone, AM, Russo, M, O’Connor, J, Palmer, E, Paparelli, A, Kolliakou, A, Sirianni, M, Taylor, H, Handley, R, Dazzan, P, Pariante, C, Marques, TR, Zoccali, R, David, A, Murray, RM, Morgan, C (2013). Social disadvantage: cause or consequence of impending psychosis? Schizophrenia Bulletin 39, 1288–1295.CrossRefGoogle ScholarPubMed
Thewissen, V, Bentall, RP, Lecomte, T, Van Os, J, Myin-Germeys, I (2008). Fluctuations in self-esteem and paranoia in the context of daily life. Journal of Abnormal Psychology 117, 143–153.Google ScholarPubMed
Trower, P, Chadwick, P (1995). Pathways to defense of the self: a theory of two types of paranoia. Clinical Psychology: Science and Practice 2, 263–278.Google Scholar
Udachina, A, Thewissen, V, Myin-Germeys, I, Fitzpatrick, S, O’Kane, A, Bentall, RP (2009). Understanding the relationships between self-esteem, experiential avoidance, and paranoia structural equation modelling and experience sampling studies. Journal of Nervous and Mental Disease 197, 661–668.CrossRefGoogle ScholarPubMed
Udachina, A, Varese, F, Oorschot, M, Myin-Germeys, I, Bentall, RP (2012). Dynamics of self-esteem in ‘Poor-Me’ and ‘Bad-Me’ paranoia. Journal of Nervous and Mental Disease 200, 777–783.CrossRefGoogle ScholarPubMed
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, Van Os, J, Bentall, RP (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671.CrossRefGoogle ScholarPubMed
Zubin, J, Spring, B (1977). Vulnerability: new view of schizophrenia. Journal of Abnormal Psychology 86, 103–126.CrossRefGoogle ScholarPubMed
Supplementary material: PDF

Udachina supplementary material

Supplementary Figure

Download Udachina supplementary material(PDF)
PDF 209.4 KB