title: Paranoia in the Community: A Social Identity Approach
Creators: name: Elahi, A
Publisher: name: University of Liverpool Repository
Year: 2019

description: Individuals experience psychosis when their thoughts and emotions are so impaired that they lose touch with reality. Psychosis consists of many symptoms, of which paranoia is the most common. It is important to assess the structure of paranoia as, should paranoia exist on a continuum, examining paranoia in general population samples may inform interventions and preventative strategies for individuals who experience clinical levels of paranoia. Research has consistently shown that elevated rates of paranoia, and psychosis in general, are apparent in ethnic minority populations in Britain. Here, paranoia will be assessed in various community samples using the Social Identity Approach (SIA). The SIA was developed to explain intergroup relations and consists of the Self-Categorisation Theory (SCT) and the Social Identity Theory (SIT). The SIT was recently posited to explain the higher rates of psychotic symptoms, such as paranoia, in immigrant and ethnic minority populations. It suggests that the elevated rates of mental illnesses in these groups are a result of social identity processes. As detailed in Chapter 1, many other explanations have been made to explain the high rates of psychotic symptoms in majority and minority populations. These will be discussed but the focus of Chapter 1 will be the SIA, in particular the SIT. The four empirical studies in my thesis examined the latent structure of paranoia and the relationship between social stressors, social identities and paranoia in majority and minority populations. In Chapter 2, I synthesised research on the structure of paranoia and critiqued the methodology used in previous studies. In Chapter 3, using data from the general population, individuals with an at-risk mental state (ARMS) and individuals who had been clinically diagnosed, I assessed the latent structure of paranoia using up-to-date taxometric methods. My findings strongly supported previous research that paranoia is best represented by a continuum rather than a taxon. In Chapter 4, I discussed the application of the SIA to explain levels of paranoia in the community. Specifically, I proposed that identifying with social groups can buffer people against paranoia that is associated with social stress. In Chapter 5, I examined this suggestion in a general population sample. I investigated whether the relationship between financial stress and paranoia was mediated by self-esteem and whether neighbourhood identification moderated this relationship. I assessed the same relationship in students who moved away from home to attend university, specifically testing the protective value of their current host town identity and their previous hometown identity. My results suggested that strong neighbourhood identification protected people in the general population from paranoia associated with financial stress by furnishing them with self-esteem. The same effect was observed for students when they identified with their new host town but not their previous hometown. Thus, highlighting the importance of identifying with one’s local community in order to mitigate the effects of stress on paranoia. In Chapter 6, I applied the SIA to ethnic minority populations and discussed the role of negative social interactions (negative contact) in contributing to elevated rates of paranoia. Chapter 7 examined the relationship between negative contact with White British people and paranoia in an African-Caribbean sample and whether this relationship was moderated by British identification. Further, I examined whether the relationship was mediated by self-esteem and/or powerful others locus of control (LoC). The interactive relationship between negative contact and British identification on paranoia was mediated by LoC, but not self-esteem. Specifically, I found that increased negative contact predicted higher levels of paranoia through a stronger powerful others LoC, but only when British identification was strong. In Chapter 8, the importance of perceived discrimination as a risk factor for paranoia and the use of implicit identity measures was outlined. Students who were born in England, and of Pakistani heritage, were recruited in Chapter 9. Their explicit and implicit Pakistani and English identities were tested as moderators of the effect of perceived discrimination on paranoia. Participants’ implicit Pakistani identification moderated the relationship between perceived discrimination and paranoia, such that, high levels of perceived discrimination were associated with high levels of paranoia when implicit Pakistani identification was low. Interestingly, these results fit with the results from Chapter 7 where it was found that identifying with the group that was a source of negative contact (British identity) was associated with high levels of paranoia and in Chapter 9, it appears that identifying with the group that was not the source of perceived discrimination (implicit Pakistani identity) protected against paranoia. In Chapter 10, I integrated and summarised the findings of my studies and examined how they build on previous research. Limitations of the studies were detailed, and clinical and policy implications were discussed. I suggested potential avenues for future research examining stressor-identity-paranoia relationships. Overall, my studies suggest that paranoia exists on a continuum, therefore, assessing paranoia in general population samples may inform interventions and preventative treatments for clinical paranoia. The studies highlight the importance of maintaining strong identification with groups that are meaningful and are a source of positivity, particularly identities associated with one’s local community. However, identifying with the majority culture may be harmful when combined with adverse social experiences within that culture. The findings also emphasise the importance of positive majority-minority intergroup relationships in improving community mental health.