Emotions, self-esteem, and paranoid episodes: An experience sampling study
Abstract
OBJECTIVES. The evidence to date for a causal role of emotions in the generation of paranoid symptoms is scarce, mainly because of a lack of studies investigating the longitudinal association between emotional processes and paranoia. The primary aim of this study was to investigate whether momentary emotional experiences (anxiety, depression, anger/irritability) and self-esteem predicted the onset and duration of a paranoid episode. We also studied whether levels of emotional experiences and self-esteem were respectively higher and lower during a paranoid episode. DESIGN. A 1-week, prospective momentary assessment study. METHODS. Data were collected using the experience sampling method, a structured self-assessment diary technique. The sample consisted of 158 individuals who ranged across the paranoia continuum. Participants with a psychotic disorder were recruited from in-patient and out-patient mental health services. Participants without psychotic disorder were sampled from the general population. RESULTS. Specific aspects of emotional experience were implicated in the onset and persistence of paranoid episodes. Both an increase in anxiety and a decrease in self-esteem predicted the onset of paranoid episodes. Cross-sectionally, paranoid episodes were associated with high levels of all negative emotions and low level of self-esteem. Initial intensity of paranoia and depression was associated with longer, and anger/irritability with shorter duration of paranoid episodes. CONCLUSIONS. Paranoid delusionality is driven by negative emotions and reductions in self-esteem, rather than serving an immediate defensive function against these emotions and low self-esteem. Clinicians need to be aware of the central role of emotion-related processes and especially self-esteem in paranoid thinking.
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Increases in negative affect were associated with increases in paranoia in experience sampling.
“For example, Kramer et al. (2014) used experience sampling to examine the moment-to-moment interplay between negative affect and the experience of paranoia, reporting that increases in negative affect were associated with increases in paranoia (see also, [34]).”
From A structural equation model of the relationship between insomnia, negative affect, and paranoid thinking (2017) · cites this paper as [34]
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“Non-affective cognitive disturbance in psychosis has had the greater focus (e.g. Hemsley, 1993; Frith, 1992; Kapur, 2003; Green et al., 2004), but the emotional route to delusions is gaining evidential support (e.g. Lincoln et al., 2010b; Ben-Zeev et al., 2011; Thewissen et al., 2011).”
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- Authors
- Thewissen, V., Bentall, R. P., Oorschot, M., à Campo, J., van Lierop, T., van Os, J., & Myin‐Germeys, I.
- Affiliations
- Maastricht University Medical Centre (NL)
- Bangor University (GB)
- Corresponding author
- Thewissen, Viviane
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2011-03-02
- Volume
- 50
- Issue
- 2
- Pages
- 178-195
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W1519776696
- Cited by
- 236
- References
- 79
- Citations by year
- 2026: 3 · 2025: 16 · 2024: 14 · 2023: 11 · 2022: 12 · 2021: 17 · 2020: 23 · 2019: 18 · 2018: 24 · 2017: 15 · 2016: 18 · 2015: 15 · 2014: 12 · 2013: 13 · 2012: 15
- FWCI
- 8.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- DSpace (Open University in the Netherlands) (publishedVersion)
- Lirias (submittedVersion)
- DSpace (Open University in the Netherlands) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- 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, self-esteem, anxiety, depression, anger, irritability, negative emotions, persecutory delusions, psychosis
- MeSH terms
- Adult, Affect, Anger, Anxiety, Delusions, Depression, Emotions, Female, Hallucinations, Humans, Irritable Mood, Male, Middle Aged, Paranoid Disorders, Personality Assessment, Prospective Studies, Schizophrenia, Paranoid, Self Concept, Statistics as Topic, Young Adult
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