Paranoia and negative schema about the self and others: A systematic review and meta-analysis
Open accessAbstract
Negative self and negative other schema have been implicated in the development of paranoia. The current study provides a meta-analysis, narrative review and quality appraisal of quantitative studies investigating the relationship between negative self and negative other schema and paranoia across the paranoia continuum. A systematic search identified 43 eligible studies; 25 were included in the meta-analysis. Meta-analytic findings demonstrated a medium to large relationship between paranoia and negative self-schema (r = 0.46, 95% CI 0.39 to 0.53) and negative other schema (r = 0.48, 95% CI 0.38 to 0.56). The magnitude of associations was similar across people with and without psychosis. Findings demonstrated that associations between negative self-schema and paranoia were not always statistically significant when controlling for confounding variables, particularly depression. The association between negative other schema and paranoia tended to remain significant when controlling for confounding variables. Findings also demonstrated that negative schema may mediate relationships between adverse experiences in childhood and paranoia. Overall, findings support theoretical proposals that both negative self and negative other schema are associated with paranoia. Longitudinal studies are required to confirm the direction of effects. Findings provide support for incorporating and targeting negative self and negative other schema in psychological formulations and therapeutic work.
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The person may feel inherently vulnerable in regards to other people due to negative self-beliefs.
“We then broaden out into a discussion of how the person may feel inherently vulnerable in regards to other people due to negative self-beliefs (Collett, Pugh, Waite, & Freeman, 2016; Humphrey et al., 2021; Waite et al., 2023).”
From A counterweight model for understanding and treating persecutory delusions. (2025) · cites this paper as Humphrey et al., 2021
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A counterweight model for understanding and treating persecutory delusions.
Freeman, D., Isham, L., & Waite, F. (2025) · Psychological Medicine · doi:10.1017/s0033291725001242 · Cited by 15 · see citing works
“We then broaden out into a discussion of how the person may feel inherently vulnerable in regards to other people due to negative self-beliefs (Collett, Pugh, Waite, & Freeman, 2016; Humphrey et al., 2021; Waite et al., 2023).”
- Authors
- Humphrey, C., Bucci, S., Varese, F., Degnan, A., & Berry, K.
- Affiliations
- Manchester Academic Health Science Centre (GB)
- Corresponding author
- Berry, Katherine
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2021-12
- Volume
- 90
- Pages
- 102081
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W3197457856
- Cited by
- 34
- References
- 19
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 6 · 2023: 8 · 2022: 5
- FWCI
- 0.86
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- paranoia, negative self-schemas, psychosis, depression, childhood adversity, schema therapy, psychological formulation
- MeSH terms
- Humans, Longitudinal Studies, Paranoid Disorders, Psychotic Disorders, Self Concept
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