The architecture of paranoia in the general population: A self-report and ecological momentary assessment study
Open accessAbstract
Paranoia is a common delusion type found in clinical and non-clinical populations. A hierarchical, dimensional model of paranoia in the general population has been proposed, with four categories representing increasing levels of paranoia: interpersonal sensitivity (IP), mistrust (M), ideas of reference (IR), persecutory ideas (PI). What is currently lacking and could provide insights into etiology is a comprehensive clinical characterization of the lower end of the paranoia spectrum, psychological domains that are associated with symptom severity, and how paranoia and its structure fluctuate over time. This study conducted both cross-sectional and longitudinal surveys with 802 participants from the German population assessing paranoia and general psychopathology. Data was collected through Ecological Momentary Assessment (EMA). Several statistical approaches were used including confirmatory factor analysis (CFA), latent class analysis (LCA) and mixed modelling analyses (ME). Paranoid experiences appear to be a common phenomenon that occur in people with and without mental illness. Subjects clustered into four paranoia severity subgroups (IP, M, IR, PI) and showed significant associations in various psychological domains like increased psychiatric symptoms and maladaptive coping. Paranoia fluctuates over time in all four severity subgroups, but the hierarchical subgrouping was stable. Both persecutory ideations and interpersonal sensitivity were significant predictors of paran…
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Persecutory delusions are the extreme end of a spectrum of paranoia in the general population.
“They are the extreme end of a spectrum of paranoia in the general population.”
From A counterweight model for understanding and treating persecutory delusions. (2025) · cites this paper as Neidhart, Mohnke, Vogel, & Walter, 2024
Many people have a few paranoid thoughts, and a few people have many paranoid thoughts.
“Many people have a few paranoid thoughts, and a few people have many paranoid thoughts (Bebbington et al., 2013; Freeman et al., 2005; Neidhart, Mohnke, Vogel, & Walter, 2024).”
From A counterweight model for understanding and treating persecutory delusions. (2025) · cites this paper as Neidhart, Mohnke, Vogel, & Walter, 2024
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“…clinical delusion, where persecutory ideas are associated with increased loneliness, poverty, poor physical health and social functioning, as well as with other symptoms such as anxiety, worries and phobias (Freeman, 2016; Freeman et al., 2011; Reeve et al., 2015; Wilson et al., 2020).”
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“The Maladaptive and Adaptive Coping Styles Scale (MAX) by Moritz et al. (2016) measures coping strategies across three dimensions: maladaptive coping, adaptive coping, and avoidance, with 21 items on a 4-point Likert scale (1 = not true, 4 = true).”
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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
“Many people have a few paranoid thoughts, and a few people have many paranoid thoughts (Bebbington et al., 2013; Freeman et al., 2005; Neidhart, Mohnke, Vogel, & Walter, 2024).”
- Authors
- Neidhart, M., Mohnke, S., Vogel, B. O., & Walter, H.
- Affiliations
- Heidelberg University (DE)
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Neidhart, Maja
- Venue
- Schizophrenia Research
- Publisher
- Elsevier BV
- Published
- 2024-09
- Volume
- 271
- Pages
- 206-219
- ISSN
- 0920-9964 (ISSN-L)
- OpenAlex
- W4400905745
- Cited by
- 9
- References
- 10
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 1
- FWCI
- 2.65
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Schizophrenia Research (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (419410789, MO 3704/1-1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- paranoia, delusions
- MeSH terms
- Ecological Momentary Assessment, Adolescent, Adult, Aged, Cross-Sectional Studies, Female, Germany, Humans, Longitudinal Studies, Male, Middle Aged, Paranoid Disorders, Young Adult, Self Report
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