Paranoia and interpersonal functioning across the continuum from healthy to pathological - Network analysis.

OBJECTIVE: Previous research has suggested that paranoia is associated with impaired social functioning in patients with schizophrenia and healthy individuals with high levels of paranoid ideation. This study analysed the relationship between paranoia and interpersonal functioning across the paranoia continuum using network analysis.

METHOD: Levels of paranoid ideation and interpersonal functioning were measured in a non-clinical sample (N = 853) and in patients with schizophrenia spectrum disorders (N = 226). Network analyses were used to examine the nature of paranoia's relation to interpersonal functioning in both populations.

RESULTS: Although the most central characteristic of paranoia in both samples was the feeling of being talked about behind one's back, across samples, individual characteristics were differentially related to various aspects of interpersonal functioning. Among clinical individuals, difficulties in interpersonal functioning were related to perceived previous experiences of being treated poorly by others, whereas among the non-clinical sample, interpersonal functioning was related to negative beliefs about others.

CONCLUSIONS: The current results support previous findings linking paranoid ideation to interpersonal functioning in both clinical and non-clinical samples. Patterns of these relationships differed slightly across groups. Results in general support a continuum model of paranoia.

PRACTITIONER POINTS: Network analyses were used to identify central aspects of persecutory ideation in both clinical and non-clinical samples. Qualitative assessment of clinical and non-clinical networks revealed similar central symptoms and supported a continuum model of paranoia. Central aspects of paranoia, that is, feeling that others have talked about oneself behind one's back, being disappointed by others, and having distressing feelings of being watched by others, were associated with deficits in interpersonal functioning in both samples. Central aspects of paranoia may be beneficial targets for psychosocial interventions aimed at reducing paranoid ideation and improving interpersonal functioning. Demographic characteristics for this study differed between samples which may limit generalization of findings. Future research is needed to explore temporal associations and moment-to-moment dynamics between paranoid ideation and problems in interpersonal functioning.