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The Experience Sampling Method (ESM) - a structured diary technique – has been used to investigate paranoid experiences as they occur in daily life. This thesis explores the contribution of ESM research to our knowledge about paranoid beliefs and includes a novel investigation of paranoia using ESM. Section 1. The literature investigating paranoid beliefs using ESM was systematically reviewed. The review found that ESM has contributed to our knowledge about a range of factors relevant to the paranoid process, including emotional factors, substance use, methodological issues, assessment and treatment, and genes. The review outlines methodological advantages as well as limitations of the reviewed research and discusses directions for future research. Section 2. The empirical investigation tested a hypothesis that paranoid beliefs combined with low perceived deservedness of persecution (Poor-me [PM] beliefs) may protect individuals against distress caused by stressful life events. The study also aimed to replicate a previous finding that PM beliefs enhance subsequent self-esteem. ESM was used to assess individuals diagnosed with schizophrenia and healthy controls. The results showed that PM beliefs were associated with attenuated emotional sensitivity to social but not activity stress. In contrast, paranoid beliefs combined with high perceived deservedness of persecution (Bad-me [BM] beliefs) were associated with hypersensitivity to social stress. There was a negative association between paranoia and subsequent self-esteem; the impact of paranoia on self-esteem was greater at higher levels of deservedness. These results suggest that PM beliefs may protect the individuals against the distress associated with stressful social encounters.

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Literature review: Seventeen studies utilising the Child Attitude Toward Illness Scale (Austin & Huberty, 1993) in paediatric research were reviewed. The review found that a range of biopsychosocial factors (e.g. condition severity, depression, worry, self-efficacy, family functioning) were associated with attitude toward illness. It is theoretically and clinically important to further understand the nature of these relationships through the development of well-designed studies and theoretical models. Assessment of children’s attitudes towards their illness in clinical and research settings will provide greater understanding of the impact of chronic illness and aid development of appropriate interventions. A number of methodological limitations exist in this area of research that reduces the strength of conclusions that can be drawn. Research report This cross-sectional study measured the generic and health-related quality of life (QoL) and attitude towards illness of 72 children aged six to 18 with chronic kidney disease (CKD). Generic QoL for patients was comparable with previously collected norms. CKD stage, age, time since diagnosis, and time receiving current treatment were unrelated to the outcomes. There was no impact of gender on QoL but males had more negative illness attitudes than females. Pre-emptive transplant patients rated both generic and health-related QoL higher than those in other treatment groups did, but there were no treatment effects on illness attitudes. Findings are discussed in relation to previous research that has predominantly focused on health-related QoL in paediatric patients. Recommendations for future research are made and the clinical and theoretical implications for practice are described.

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