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What makes one person paranoid and another anxious?

AUGUST 01, 2008

The first systematic investigation of the psychological differences between anxiety and paranoia has been reported by Dr Daniel Freeman and Katherine Pugh from the Department of Psychology, Institute of Psychiatry, King’s College London, and colleagues from University College London and Manchester University. The Wellcome Trust study, entitled What makes one person paranoid and another person anxious?  The differential prediction of social anxiety and persecutory ideation in an experimental situation is published in the August issue of Psychological Medicine.  
Traditionally there has been a clear division between neurosis and psychosis. Experiences such as anxiety and persecutory ideation were considered unrelated.  However in recent work by Dr Freeman and colleagues, a close association between anxiety and paranoia has been established.  Anxiety-related mechanisms are implicated in the development of paranoia. Nevertheless, paranoia and social anxiety are distinct experiences and in this experimental study the aim was to identify the distinguishing factors.
A sample of 200 London residents, broadly representative of the UK general population, were extensively assessed.  They then spent five minutes in a neutral social environment presented using immersive virtual reality.  After the experience the occurrence of social anxiety and paranoid thinking about the virtual reality characters was assessed. Consistent with the latest understanding of paranoia, many of the same assessment factors, such as levels of worry and interpersonal sensitivity, predicted social anxiety and paranoid reactions. However there was a different relationship for the presence of sensory distortions, called perceptual anomalies. More perceptual anomalies increased the likelihood of paranoia, less perceptual anomalies increased the likelihood of social anxiety. 
The conclusion is that what distinguishes someone who responds to a social situation in a paranoid way from someone who simply becomes anxious is (at least in part) the frequency of their anomalous experiences.  Persecutory ideas may be a type of anxious explanation for these unsettling internal experiences.

The papers authors are:  Daniel Freeman (King’s College London), Matthew Gittins (Manchester University), Katherine Pugh (King’s College London), Angus Antley (University College London), Mel Slater (University College London) and Graham Dunn (Manchester University).
For a full copy of the article please go to Psychological Medicine
For information about overcoming paranoid thoughts see:
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