Journal
SCHIZOPHRENIA BULLETIN
Volume 37, Issue 6, Pages 1248-1256Publisher
OXFORD UNIV PRESS
DOI: 10.1093/schbul/sbq041
Keywords
Experience Sampling Method; persecutory ideation; cognitive model; negative emotions; anxiety; schizophrenia
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Funding
- Office of Rehabilitation Research and Development, Department of Veterans Affairs, National Institute of Mental Health [R01MH071410]
- UCSD Advanced Center for Interventions and Services Research [NIMH P30MH66248]
- CNRS ATIP
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Contemporary theoretical models of paranoia suggest that negative emotions, perceptual anomalies, and recent life events are important predictors of experiencing persecutory ideation. In the current experience sampling study, these factors are examined prospectively for the first time as predictors of the occurrence of persecutory ideation, as well as persecutory belief conviction, and associated distress in real time in the context of daily life. One hundred and forty five community-dwelling participants with schizophrenia or schizoaffective disorder completed self-report assessments generated by a personal digital assistant multiple times a day for 1 week. Their responses were time lagged to allow examination of dynamic prospective relationships between variables as they occur within days. Approximately half of the participants reported having some persecutory thoughts, with a total of 378 reported occurrences of persecutory thoughts across participants during the week. Negative emotional states of anxiety and sadness were significant predictors of the occurrence of subsequent persecutory ideation, but hallucinations and recent life events were not. In a subsample of people who had multiple persecutory thoughts, anxiety was a significant predictor of belief conviction and associated distress, while sadness was only predictive of distress. The findings are consistent with recent cognitive theory that proposes a causal role for negative emotional states in the formation and maintenance of persecutory ideation and suggest that persecutory ideation may be addressed indirectly by interventions targeting anxiety and depression.
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