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There is no accepted definition of belief and it is likely that the everyday use of the term does not represent a single neuropsychological entity. Nevertheless, cognitive neuropsychiatry is likely to be useful in understanding belief-related phenomena, as it does not necessarily require the focus of study to be a unitary construct. The label 'delusion' is likely to be an umbrella term for a variety of pathologies that lead a person to make an unlikely belief-claim or to have an unlikely belief attributed to them on the basis of their behaviour, in tandem with the person experiencing significant distress and / or causing social stress. Social network analyses and case studies suggested that the traditional psychopathological boundaries of delusion are influenced by socio-cultural developments and that the diagnostic criteria need revising. Despite the central role of anomalous perceptual experience in many delusion formation models, it is unclear whether it is a necessary condition. A new, valid measure of perceptual anomalies, the Cardiff Anomalous Perceptions Scale (CAPS), was developed, and a study of delusional patients suggested that pathological levels of anomalous experience are not necessary for delusion formation. A principal components analysis suggested three factors underlying anomalous experience in the general population: 'clinical psychosis', 'chemosensation' and 'temporal lobe experience'. A study using transcranial magnetic stimulation indicated that disrupting the left lateral temporal cortex in healthy participants can alter processes related to magical thinking, suggesting these areas play a causal role in delusion formation. To investigate the determinants of pragmatically pathological beliefs, as opposed to simply 'magical' ones, participants with religious beliefs (Christians and Pagans) were compared to non-religious controls and delusional patients. Pagans reported similar levels of anomalous experience to psychotic patients, but were no more distressed than the general population, suggesting distress is the more important factor in delusion formation.

Despite the robust evidence base highlighting that paranoia is common in the nonclinical population, interventions to reduce non-clinical paranoia have not yet been examined. The aim of the study was to (I) investigate the effect of a brief mindfulness task on non-clinical paranoia, measured using a behavioural indicator (the Prisoner's Dilemma Game; PDG), and (2) determine whether Chadwick et al's (2005) model of responding mindfully to psychotic sensations applies to non-clinical paranoia, examining the relationship between cognitive processes and facets of mindfulness with paranoia. A student sample was used for the study (N = 60). Participants were randomly allocated to one of two conditions, brief mindfulness or control condition. Changes in paranoia and mindfulness were examined at baseline and following the intervention. Participants also completed trait measures of cognitive processes (experiential avoidance, judgement and rumination), mindfulness and paranoia. Three key findings emerged from the study; (1) state paranoia decreased and state mindfulness increased in both conditions, suggesting that both paranoia and mindfulness are amenable to experimental manipulation; (2) the findings suggest that the PDG provides a behavioural signature of state paranoia and (3) the cross sectional analysis suggests that cognitive processes operating in psychotic symptoms, as identified in Chadwick et al's (2005) model, also appear to occur in non-clinical paranoia. The findings provide further support to an emerging evidence base regarding mindfulness and paranoia and provide a foundation for further research into the application of mindfulness to non-clinical paranoia.

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A wealth of research evidence has been accumulating over the last two decades, highlighting the association of childhood trauma and psychosis. The literature review evaluates empirical evidence and builds upon the previous literature reviews in this area. In addition, the literature review examines the theoretical bases and the underlying psychological factors that contribute to the relationship between childhood trauma and psychosis. It concluded that despite a large body of literature on the association between childhood trauma and psychosis, there is a paucity of empirical research which investigates other forms of childhood trauma, such as, bullying. The empirical paper investigates whether ‘anxiety’, ‘depression’, ‘interpersonal sensitivity’, and/or negative beliefs would mediate the relationship between childhood bullying and paranoid thinking in people with psychosis. Data were collected through self-report measures on demographics, childhood bullying (‘direct aggression’, ‘indirect aggression’), ‘anxiety’, ‘depression’, ‘interpersonal sensitivity’, ‘other-self negative beliefs’, ‘self-self negative beliefs’, ‘self-other negative beliefs’, and paranoid thinking (‘ideas of social reference’, ‘persecution’). A significant association was found between childhood bullying and paranoid thinking. ‘Interpersonal sensitivity’ was found to mediate the relationship between childhood bullying (‘direct aggression’, ‘indirect aggression’) and ‘ideas of social reference’, indicating the importance of the Rejection Sensitivity Model in the understanding of paranoid thinking in victims of childhood bullying. Clinical and research implications, as well as, directions for future research are highlighted.

No description available.

Background. Previous studies have shown that the use of simulated social environments permits paranoid thinking to be studied. These studies have used a cognitive model of paranoia and suggest that anxiety is an important part of the paranoid experience. Additionally, research addressing the relationship of childhood trauma to psychosis indicates that psychotic symptoms are related to childhood abuse and neglect. The aim of the study was to explore the role of anxiety and childhood trauma in psychotic and anxious participants using a simulated social encounter task. Method. 15 individuals with paranoid delusions (diagnosed with a psychotic disorder), 11 with anxiety disorders and 14 non-clinical controls experienced a simulated social encounter task populated by four filmed characters instructed to behave neutrally (n=40). After the task, the participants completed questionnaires to describe their experience of the situation. 5 questionnaires were used to study paranoid thoughts. The first two were the Details of Threat questionnaire and the VR questionnaire. The other 3 were designed specifically for the study (faces, trust and power questionnaires). Additionally, the Beck Anxiety and Depression Inventories and also a childhood trauma questionnaire were used as indicators of emotional distress. Results. Appraisals from the clinical participants but not from the non-clinical ones were persecutory. The psychological variables from the cognitive model that predicted persecutory ideation were anxiety and neglect. Further, over-sensitivity towards the neutral faces of the characters distinguished again, clinical and non-clinical participants. Conclusions. Paranoid thinking was elicited in clinical participants (anxious and psychotic) by a simulation of a social situation but not in normal controls. Anxiety and two forms of childhood trauma (physical and emotional neglect) were closely associated to persecutory thoughts. The results provide support for the cognitive model of paranoid delusions suggesting that anxiety and neglect underlay paranoid thinking. The study also shows the usefulness of simulations in clinical research.

A growing body of research demonstrates that paranoia is common in the general population. Four studies are presented that investigate factors associated with paranoia and naturalistic change in non-clinical groups. First, two experimental studies examine paranoia in the context of the Prisoner's Dilemma Game (PDG), an interpersonal research paradigm, where two players have the choice to cooperate or compete with each other. The dominant and rational choice for both players is to compete, however each players' individual reward would be greater if they both played cooperatively. Study 1 found that higher state paranoia was associated with the choice to compete. However the competitive choice can be selected due to distrust of the other player, or in order to maximise personal gain. The second experimental study employs a Three-Choice version of the PDG (PDG-Alt) that includes the option to withdraw, the rational choice when distrust of the other player is high. Higher state paranoia was associated with the withdrawal choice. These studies conclude that the withdrawal choice in the PDG –Alt provides a potential behavioral marker of state paranoia. Second, two studies examine naturalistic change in nonclinical paranoia. Idiosyncratic accounts of a single past paranoid experience are elicited and variations in dimensions known to be important in clinical paranoia are examined. Results show that levels of preoccupation, distress, impact on well being and conviction that harm was intentional significantly reduce over time. However the amount of time passed since the experience occurred is not significantly associated with level of change. Finally, in Study 4 a qualitative investigation is presented that identifies themes associated with change in nonclinical experiences of paranoia. The thesis concludes with a discussion of the theoretical, clinical and research implications of the findings.