The network structure of paranoia dimensions and its mental health correlates in the general population: The core role of loneliness

Paranoid ideas are the most common abnormal beliefs in the schizophrenia spectrum, are also prevalent in non clinical populations, and are highly correlated with other mental health problems such as anxiety, depression and low levels of well-being. Two previous studies with the same British population sample used confirmatory factor analysis and network analysis to show that the spectrum of paranoid beliefs is made up of four factors or dimensions (i.e., interpersonal sensitivity, mistrust, ideas of reference and ideas of persecution). The aims of this study are: 1) to explore the distribution and the structure of paranoid beliefs in a Spanish general population by applying the network approach and 2) to use network analysis to explore for the first time whether specific domains of paranoid ideation (i.e., dimensions) are specifically associated with mental health correlates such as depression, anxiety, loneliness, and well-being. We found a continuous distribution of paranoid beliefs among the 1328 individuals constituting the sample (e.g., 29,2 % did not endorse any items, 4.6 % endorsed half of the items, while 0.8 % endorsed all paranoid items). Paranoid ideas form three dimensions; interpersonal sensitivity, mistrust, and ideas of persecution (ideas of reference did not form a separate factor). The network model showed that loneliness has a pivotal role in connecting paranoid ideation with general psychopathology measures (i.e., depression, anxiety, loneliness and well-being). Research and clinical implications derived from our findings are also discussed.

Automated summary

Paranoid ideas are common abnormal beliefs in the schizophrenia spectrum and are prevalent in non clinical populations. They are highly correlated with mental health problems such as anxiety, depression, and low levels of well-being. This study explored the distribution and structure of paranoid beliefs in a Spanish general population using network analysis. The study also examined the specific associations between domains of paranoid ideation and mental health correlates such as depression, anxiety, loneliness, and well-being. The findings showed a continuous distribution of paranoid beliefs and identified three dimensions of paranoid ideas: interpersonal sensitivity, mistrust, and ideas of persecution. The network model revealed the pivotal role of loneliness in connecting paranoid ideation with general psychopathology measures.