Paranoia is defined as beliefs of persecution, conspiracies and threats in the absence of any corroborating evidence (Freeman, 2007). In addition to clinical populations, paranoia also exists in non-clinical populations and is arranged on a continuum from mild suspicion to severe distressing delusions (Freeman et al., 2005). According to evolutionary theory, paranoia is an adaptive response that allows prevention of social threats such as conspiracy and persecution by others (Gilbert & et al, 2005; Matos, Pinto-Gouveia, & Gilbert, 2013).
Early life experiences have been found to increase vulnerability to paranoid thinking and, accordingly, attachment theory has been proposed as a key model in explaining this causal pathway (Lavin & et al, 2020). One systematic review of healthy individuals and psychiatric patients have revealed that increased anxious and avoidant attachment are associated with paranoia (Dančík & et al, 2023). Previous studies have reported a relationship between insecure attachment styles and paranoia in clinical and non-clinical samples (Pickeringa, Simpsona & Bentall, 2008; Sitko & et al, 2014; Wickham, Sitko & Bentall, 2015; Hutton, Ellett & Berry, 2017; Sood & Newman-Taylor, 2020; Murphy et al, 2020; Lavin et al., 2019). Insecure attachment may be association with paranoia because both involve a mistrust and negative view of other (Bentall & Fernyhough, 2008).
In this regard, attachment theory suggests that the availability and responsiveness of primary attachment figures over time leads to the formation of internal working models (Bowlby, 1969). These internal working models influence perceptions of interactions and operate as templates for future relationships (Collins & Read, 1994). Working models affect cognitions, emotions and behaviors in interpersonal relationships and lie on two orthogonal dimensions: anxiety and avoidance (Brennan, Clark & Shaver, 1998). An anxious attachment style, is characterized by a negative view of the self, and a positive view of others, worry in relation to others, and increased negative affect. In contrast, avoidant attachment, is characterized by a positive view of the self, and a negative view of others, and is associated with social withdrawal and the suppression of negative affect (Mikulincer & Shaver, 2016). Evidence suggests that anxious and avoidant attachment is associated with both clinical and nonclinical paranoia (Murphy & et al, 2020). Recent studies show that paranoia has a stronger relationship with anxious attachment (Lavin & et al, 2020); For example, the results of a review study revealed that paranoia was significantly related to anxious attachment and the strength of this relationship did not differ between clinical and non-clinical samples (Murphy & et al, 2020). Whereas, results of a study found a stronger relationship between paranoia and avoidant attachment (Berry, Barrowclough & Wearden, 2007). In another study conducted by Berry et al., anxious and avoidant attachment were related to paranoia and hallucinations in a college student sample (Berry & et al, 2006). In general, during the last decade, an increasing number of studies have shown the relationship between both dimensions of attachment and paranoia in different samples, including: the general population (Meins & et al ,2008), individuals at high risk for developing psychosis (Russo & et al, 2018) and patients diagnosed with schizophrenia (Strand, Goulding & Tidefors, 2015).
Insecure attachment as a non-specific risk factor for psychopathology is related to the tendency to experience shame (Remondi & et al, 2023). Shame is strongly related to early relationships with primary caregivers and occurs in response to perceived rejection or separation from attachment figures (Schore, 1998). Results of one study showed that the mother's critical and negative attitude during a challenging activity at 24 months is related to the experience of shame and avoidance at 36 months (Kelley, Brownell & Campbell, 2000). A study on 209 college students aged 19 to 24 found a significant relationship between insecure attachment with low self-esteem and high feelings of shame (Passanisi & et al., 2015). In addition, previous studies demonstrated that insecurely attached individuals are more prone to experience feelings of shame as compared to their securely attached counterparts (Gross and Hansen, 2000; Wei et al., 2005). In one study, both the insecure attachment dimensions had significant indirect effects on psychological distress through dispositional shame. Also, shame as a strong emotion predicted aspects of poor psychological functioning (Remondi & et al., 2023). Shame associated with withdrawal from others is likely to increase paranoia because fears about people's intentions are not revised through interactions with supportive others (Freeman et al., 2002). In this regard, some studies have investigated the relationship between shame and paranoia (Gilbert, et al, 2005; Matos, Pinto-Gouveia & Duarte, 2012; Matos et al., 2013; Mills et al., 2007; Pinto-Gouveia et al., 2014). According to the hierarchical model of paranoia, concerns about social judgment, fear of rejection, feeling of vulnerability, and the perception that the world is dangerous have been conceptualized at the bottom of the paranoia hierarchy (Freeman et al., 2005). Indeed, early dysfunctional interactions with attachment figures in early life can be organized into internal working models of self as worthless, undesirable, or defective (shame) and others as threatening, powerful, superior, hostile, and judgmental (paranoia) (Matos & Pinto-Gouveia, 2010; Matos, Pinto-Gouveia, & Costa, 2013).
Shapiro (1965) noted that self-consciousness is often related to paranoia, and suggested that awareness of attention in relation to another person can create feelings of exposure and vulnerability. Humans evolved in a world of scarcity, disease, and injury, that these self-conscious emotions can have adaptive interpersonal functions. The evolutionary roots of human social valuation are key to understanding the self-conscious emotions (Sznycer, 2019). Laing (1969) presented suspiciousness as an aspect of self-consciousness. Self-consciousness means focusing on one's thoughts, feelings, and attitudes, which is accompanied by a tendency to focus on observable aspects (self-monitoring). Increased self-focused attention has been shown in most forms of psychopathology (Ingram, 1990). This heightened awareness of oneself or severe self-consciousness has always been seen as a central trait of paranoia and misleads individuals that they are the center of others' attention (Cameron, 1943, Fenigstein, 1984, Greenwald, 1980, Kraepelin, 1968, Laing, 1969).
On the other hand, according to Muris and colleagues (2014), there is currently limited evidence supporting a connection between insecure attachment and the dysregulation of self-conscious emotions. Their study indicated that insecure attachment contributes to heightened self- conscious emotion. Lopez et al (1997) found, in a sample of 142 undergraduate students (average age of 21 years), that individuals with insecure attachment, particularly those exhibiting an ambivalent style, tend to experience higher levels of shame compared to securely attached individuals. Additionally, Lech, Andersson, and Holmqvists (2012) study revealed a correlation between high emotion consciousness and secure attachment, while low emotion consciousness was associated with insecure attachment.
Although there is strong evidence that there is a relationship between attachment and paranoia, little is known about the mediating mechanisms of this relationship (Partridge, Maguire & Newman-Taylor, 2022), and we expect shame to play this role.
It is clear that not all people with an insecure attachment style experience paranoia symptoms and that individual differences play an important role in this process. Therefore, the potential role of moderating variables that can strengthen or weaken this relationship is also important. In the present study, we investigate whether self-consciousness moderates this relationship?
On the other hand, most research in attachment and paranoia has been completed in Western countries. So another gap in the literature, is to examine these relationships in non-Western cultures.