Paranoid Ideation in Gay Men: The Roles of Psychological Emptiness, Identity Loss, Loneliness, and Identity Resilience.

Background/Objectives: Gay men face mental health inequalities compared to the general population but there is limited evidence concerning the risk of paranoid ideation in this population and none that examines the cognitive-affective factors that may predispose gay men to paranoid ideation or protect against it. Methods: A sample of 257 gay men in the United Kingdom participated in a cross-sectional correlational survey study and completed measures of psychological emptiness, identity loss, loneliness, identity resilience, and subclinical paranoid ideation. Results: Hierarchical multiple regression showed that psychological emptiness was strongly associated with paranoid ideation, followed by identity loss. A moderated mediated generalized linear model showed that psychological emptiness and identity loss were associated directly with higher paranoid ideation and indirectly through the mediation of loneliness. Identity resilience moderated the relationships between identity loss and loneliness and between identity loss and paranoid ideation, essentially weakening them. Conclusions: Psychological emptiness and identity loss may operate as diagnostic cognitive-affective dispositions that are associated with paranoid ideation in gay men. Interventions that focus on developing a stable identity characterized by meaning and purpose may be effective against paranoid ideation and reduce the risk of severe psychopathology.