Paranoid ideation during a simulated social encounter in people with either psychosis with persecutory delusions or anxiety disorder.

ABSTRACT Reason for Study To evaluate differences in the perception of threat by patients, with either psychosis in whom persecutory delusions are a key symptom or patients with an anxiety disorder. Method A between groups design in which patients who met DMS-IV criteria for psychosis, with persecutory delusions (n=20), were compared to patients with anxiety disorders (n=20) as well as a matched healthy control group (n=20). Participants observed videos of social encounters and rated the actors on four scales measuring different aspects of paranoid ideation. Semi-structured interviews were used to explore reports of perceived threat. Results The patient groups did not differ on any of the paranoid ideations measures ( p>.10) but both produced significantly higher scores than the healthy controls on all measures (p <.01 ) . However, patients with persecutory delusions inferred more detailed, negative attributes about the actors and failed to integrate the perception of hostile intent with other attributes. Major conclusions Anxiety causes paranoid ideas during person perception in non-psychotic as well as psychotic patients. We propose that cognitive processing in patients with persecutory delusions is characterized by poor integration of perceptual attributes and inadequate meta-cognition during person perception.