The interplay among paranoia, social relationships and negative affectivity in a heterogeneous clinical sample: A network analysis

Previous evidence suggests paranoia affects people’s functioning in interpersonal relationships. However, less is known about the interconnections among specific aspects of paranoia and domains of social relationships. The goal of the current study was to explore the interplay among different aspects of paranoia, social relationships and negative affectivity (depression, anxiety and social anxiety) in a diverse clinical sample using network analysis. A sample of 366 participants (84.4% female) with a history of mental illness was recruited online. The mean age was 35.31 years. Data were modelled using the Gaussian Graphical Model with regularization. The network included the following scales: R-GPTS, SAD-D, National Institute of Health Toolbox Adult Social Relationship scales, PHQ-9 and GAD-7. The results revealed substantial connections between aspects of paranoia (ideas of reference and ideas of persecution) and both perceived hostility and perceived rejection. Furthermore, significant associations of ideas of reference with social anxiety and loneliness with depression were observed. Perceived rejection and loneliness were the most central nodes in the estimated network. The current study provides robust evidence for the interconnections of paranoia, social relationships and negative affectivity, present across different diagnoses. This further supports the transdiagnostic approach to paranoia research and the related important role of social relationships.