Cognitive Control Processes in Paranoia: the Impact of Threat Induction on Strategic Cognition and Self-focused Attention

Background: Current clinical models emphasize certain cognitive processes in the maintenance of distressing paranoia. While a number of these processes have been examined in detail, the role of strategic cognition and self-focused attention remain under-researched.

Aims: This study examined the deployment of cognitive strategies and self-focused attention in people with non-clinical paranoia.

Method: An experimental design was used to examine the impact of a threat activation task on these processes, in participants with high and low non-clinical paranoia. Twenty-eight people were recruited to each group, and completed measures of anxiety, paranoid cognition, strategic cognition and self-focused attention.

Results: The threat activation task was effective in increasing anxiety in people with high and low non-clinical paranoia. The high paranoia group experienced more paranoid cognitions following threat activation. This group also reported greater use of thought suppression, punishment and worry, and less use of social control strategies when under threat. No differences were found between the groups on measures of self-focused attention.

Conclusions: This study shows that the threat activation task increased anxiety in people with high non-clinical paranoia, leading to increased paranoid thinking. The use of strategic cognition following threat activation varied dependent on level of non-clinical paranoia. If these differences are replicated in clinical groups, the strategies may be implicated in the maintenance of distressing psychosis, and may therefore be a valuable target for therapeutic intervention.