Everyday paranoia in social context across diagnostic boundaries: An experience sampling study

Introduction: Changes in paranoia are often linked to altered social functioning. Everyday paranoia interacts with the current social environment, both in patients with psychotic disorders and in healthy individuals. This study focused on outpatients with various mental health diagnoses as well as healthy controls to investigate the effect of social context on momentary paranoia. Methods: Thirty-seven patients with schizophrenia, depression, or bipolar disorder and 26 healthy controls completed self-report questionnaires measuring trait paranoia and psychiatric symptoms severity. Participants then completed an Experience Sampling Method (ESM) part with notification prompts received 10 times per day for six consecutive days. The ESM items assessed momentary paranoia and current social environment. Results: Patients reported higher trait paranoia and higher overall momentary paranoia than healthy controls. They also spent more time alone. Additionally, momentary paranoia in patients was higher in more distant company while it was unrelated to how familiar the present company was. Discussion: The current findings support the urge for therapeutic interventions that address social isolation and highlight the importance of subjective evaluations of social situations in relation to everyday paranoia. Future research should consider multiple perspectives on social context, including subjective evaluation as well as affective experience.