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Aberrant adapting of beliefs under stress: a mechanism relevant to the formation of paranoia?

Published online by Cambridge University Press:  14 September 2021

Katarina Krkovic Open the ORCID record for Katarina Krkovic [Opens in a new window] ,
Ulrike Nowak ,
Mathias K. Kammerer ,
Antonia Bott  and
Tania M. Lincoln Open the ORCID record for Tania M. Lincoln [Opens in a new window]
Katarina Krkovic*
Affiliation:
Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
Ulrike Nowak
Affiliation:
Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
Mathias K. Kammerer
Affiliation:
Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
Antonia Bott
Affiliation:
Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
Tania M. Lincoln
Affiliation:
Department of Clinical Psychology and Psychotherapy, Universität Hamburg, Hamburg, Germany
*
Author for correspondence: Katarina Krkovic, E-mail: katarina.krkovic@uni-hamburg.de
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Abstract

Background

Difficulties in the ability to adapt beliefs in the face of new information are associated with psychosis and its central symptom – paranoia. As cognitive processes and psychotic symptoms are both known to be sensitive to stress, the present study investigated the exact associations between stress, adapting of beliefs [reversal learning (RL), bias against disconfirmatory evidence (BADE), and jumping to conclusions (JTC)] and paranoia. We hypothesized that paranoia would increase under stress and that difficulties in adapting of beliefs would mediate or moderate the link between stress and paranoia. Furthermore, we hypothesized that the investigated effects would be strongest in the group of individuals diagnosed with a psychotic disorder.

Methods

We exposed 155 participants (38 diagnosed with a psychotic disorder, 40 individuals with attenuated psychotic symptoms, 39 clinical controls diagnosed with an obsessive-compulsive disorder, and 38 healthy controls) to a control condition and a stress condition, in which we assessed their levels of paranoia and their ability to adapt beliefs. We applied multilevel models to analyze the data.

Results

Paranoia was higher in the stress condition than in the control condition, b = 1.142, s.e. = 0.338, t(150) = 3.381, p < 0.001. RL, BADE, and JTC did not differ between conditions and did not mediate or moderate the association between stress and paranoia (all ps > 0.05).

Conclusions

The results support the assumption that stress triggers paranoia. However, the link between stress and paranoia does not seem to be affected by the ability to adapt beliefs.

Keywords

Belief updatingdelusionsinformation processingreinforcement learningschizophrenia
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 5 , April 2023 , pp. 1881 - 1890
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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