TY - JOUR
T1 - Modelling the Longitudinal Dynamics of Paranoia in Psychosis: A Temporal Network Analysis Over 20 Years
AU - Barnby, Joseph
AU - Haslbeck, Jonas
AU - Rosen, Cherise
AU - Harrow, Martin
PY - 2023/1
Y1 - 2023/1
N2 - Paranoia is a highly debilitating, core element of psychosis, although is poorly managed. Theories of paranoia mostly interface with short-scale or cross-sectional data models, leaving the longitudinal course of paranoia underspecified. Here, we develop an empirical characterisation of two aspects of paranoia - persecutory and referential delusions - in individuals with psychosis over 20 years. We examine delusional dynamics by applying a Graphical Vector Autoregression Model to data collected from the Chicago Follow-up Study. We adjusted for age, sex, IQ, and antipsychotic use. We found that referential and persecutory delusions are central themes, supported by other primary delusions, and are strongly autoregressive. In a second analysis we demonstrate that social factors influence the severity of referential, but not persecutory, delusions. We suggest that persecutory delusions represent central, resistant states in the cognitive landscape, whereas referential beliefs are more flexible, offering an important window of opportunity for intervention. Our data models can be collated with prior biological, computational, and social work to contribute toward a more complete theory of paranoia and provide more time-dependent evidence for optimal treatment targets.
AB - Paranoia is a highly debilitating, core element of psychosis, although is poorly managed. Theories of paranoia mostly interface with short-scale or cross-sectional data models, leaving the longitudinal course of paranoia underspecified. Here, we develop an empirical characterisation of two aspects of paranoia - persecutory and referential delusions - in individuals with psychosis over 20 years. We examine delusional dynamics by applying a Graphical Vector Autoregression Model to data collected from the Chicago Follow-up Study. We adjusted for age, sex, IQ, and antipsychotic use. We found that referential and persecutory delusions are central themes, supported by other primary delusions, and are strongly autoregressive. In a second analysis we demonstrate that social factors influence the severity of referential, but not persecutory, delusions. We suggest that persecutory delusions represent central, resistant states in the cognitive landscape, whereas referential beliefs are more flexible, offering an important window of opportunity for intervention. Our data models can be collated with prior biological, computational, and social work to contribute toward a more complete theory of paranoia and provide more time-dependent evidence for optimal treatment targets.
U2 - https://www.medrxiv.org/content/10.1101/2023.01.06.23284268v2
DO - https://www.medrxiv.org/content/10.1101/2023.01.06.23284268v2
M3 - Article
JO - Schizophrenia Research
JF - Schizophrenia Research
SN - 0920-9964
ER -