Relationships between attachment insecurity, beliefs about the self and others, paranoia, and social functioning across the psychosis continuum.

OBJECTIVES

Self-beliefs and other-regarding beliefs are related to attachment experiences and may contribute to paranoid beliefs and social functioning difficulties in psychosis. However, their relationships have not been examined jointly from an ecological perspective, while considering different degrees of psychosis risk.

DESIGN

Relationships between avoidant and anxious attachment, self-beliefs and other-regarding beliefs, paranoia, and social functioning in daily-life were examined across the psychosis continuum of familial risk.

METHODS

The sample comprised 29 patients with non-affective psychotic disorders (Mage = 39.07, SD = 9.91, 20.68% female), 17 first-degree relatives (Mage = 37.36, SD = 13.86, 64.71% female) and 26 controls (Mage = 36.15, SD = 8.1, 34.6% female). Avoidant and anxious attachment were assessed with the Psychosis Attachment Measure. Self-beliefs, beliefs about others, paranoia, and time spent alone were assessed for one week in participants' daily lives using the Experience Sampling Method. Multilevel models were used to investigate cross-sectional and temporal relationships between the variables.

RESULTS

Less positive self-beliefs and beliefs about others were related to paranoia, but only self-beliefs mediated the association between attachment insecurity and paranoia. People who were alone more frequently held less positive self-beliefs and beliefs about others, and being alone at a specific point in time was related to less positive self-beliefs. Attachment insecurity was unrelated to the amount of time spent alone.

CONCLUSIONS

Less positive self-beliefs and beliefs about others were related to higher paranoia levels and fewer social interactions in daily-life. These associations were present in all groups, supporting their utility as cognitive treatment targets in diverse therapeutic contexts.