An Experimental Investigation into the Effect of State-Anxiety on State-Paranoia in People Experiencing Psychosis

Megan Cowles, Lorna Hogg

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Background: There is strong evidence to suggest that anxiety is associated with paranoia in clinical and non-clinical samples. However, no research to date has directly manipulated anxiety to investigate if state-Anxiety has a causal role in state-paranoia in clinical populations. Aims: To investigate whether an anxious-mood induction leads to greater paranoia than a neutral-mood induction in people experiencing psychosis and paranoia and, if so, whether this is predicted by anxiety over and above other variables. Method: 22 participants with a psychosis-spectrum diagnosis took part in a two condition cross-over experimental design. Participants underwent a neutral-mood and an anxious-mood induction with levels of state-Anxiety, state-Affect and state-paranoia being measured before and after each condition. Results: State-paranoia was significantly higher after the anxious condition compared with the neutral condition. State-Anxiety and negative-Affect were significant predictors of levels of state-paranoia after the anxious condition. When both predictors were included in a regression model, only negative-Affect was a significant predictor of state-paranoia after the anxious condition. There were a number of methodological limitations. Conclusions: State-Anxiety and negative-Affect may both be involved in the maintenance of paranoia in clinical populations, as predicted by cognitive models. Negative-Affect may be the strongest predictor of state-paranoia in clinical populations. Reasons for this are discussed, as well as the implications. Interventions that seek to reduce negative state-Affect may be beneficial in managing state-paranoia. Further research is warranted to explore the suggested clinical and theoretical implications of these findings.

Original languageEnglish
Pages (from-to)52-66
Number of pages15
JournalBehavioural and Cognitive Psychotherapy
Issue number1
Early online date25 Jun 2018
Publication statusPublished - 1 Jan 2019


  • affect
  • anxiety
  • paranoia
  • psychosis
  • schizophrenia

ASJC Scopus subject areas

  • Clinical Psychology


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