Volatile view of the world contributes to paranoia

A study on people with schizophrenia sheds new light on pathological fears


Philadelphia, June 8, 2022

Our brains face a constant challenge: to accurately predict the immediate future while constantly remaining flexible enough to adapt to unforeseen changes. How we walk that line depends upon our life experiences, among other factors. Now, a new study shows that a prior belief that the world is a volatile and scary place can contribute to worry and paranoia.

Julia Sheffield, PhD, lead author of the study, said, “Paranoia can have a marked impact on one’s life, contributing to lower well-being, poorer social functioning, and increased violence towards oneself and others. It is therefore critical to identify cognitive processes that contribute to paranoid thinking and may be targetable with treatment.”

The study appears in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.

To better understand the roots of paranoid thinking, the researchers studied 42 participants with schizophrenia and 44 healthy controls. Participants performed a computer-based task in which they could draw from one of 3 virtual decks of cards to either win or lose points; they were encouraged to find the “best deck” with more winning cards. Schizophrenia participants engaged in “win-switching,” or changing decks even after drawing a winning card, about three times more than healthy participants. They also demonstrated an elevated “prior on volatility” – a computational parameter estimated from participant behavior that reflects how much the participant expects the task environment to change throughout the task.

Moreover, interviewer-rated and self-rated measures of paranoia were associated with higher win-switch rates and volatility priors. That suggests that a cognitive process known as belief-updating differs in individuals with schizophrenia and contributes to paranoia.

In contrast, unusual thoughts or anxiety did not contribute to win-switching or volatility, suggesting that the measure specifically associates with paranoia. Paranoia did, however, have an indirect effect on the relationship between elevated prior on volatility and more significant worry.

“The findings in this article implicate that, for individuals with schizophrenia, one’s prior belief that the world is volatile influences the experience of paranoia. The findings further suggest that paranoia has an indirect effect on the relationship between volatility and worry,” said Dr. Sheffield.

Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said, “This study provides us with novel evidence that a specific cognitive vulnerability that may be objectively measured and, in future studies, perhaps linked to specific neural symptoms, underlies the excessive fear and sense of constant threat that underlies paranoid thinking in individuals with psychotic illness.”

“Together,” Dr. Sheffield added, “these findings imply that one’s prior belief that the world is volatile contributes to paranoid thinking and worry in schizophrenia, making it a potential target for treatment.”

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Notes for editors
The article is "Belief updating and paranoia in individuals with schizophrenia," by Julia Sheffield, Praveen Suthaharan, Pantelis Leptourgos and Philip Corlett (https://doi.org/10.1016/j.bpsc.2022.03.013). It appears as an Article in Press in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier.

Copies of this paper are available to credentialed journalists upon request; please contact Rhiannon Bugno at BPCNNI@sobp.org or +1 254 522 9700. Journalists wishing to interview the authors may contact Julia Sheffield at Julia.sheffield@vumc.org or +1 615-343-3839.

The authors’ affiliations and disclosures of financial and conflicts of interests are available in the article.

Cameron S. Carter, MD, is Professor of Psychiatry and Psychology and Director of the Center for Neuroscience at the University of California, Davis. His disclosures of financial and conflicts of interests are available here.

About Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is an official journal of the Society of Biological Psychiatry, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal focuses on studies using the tools and constructs of cognitive neuroscience, including the full range of non-invasive neuroimaging and human extra- and intracranial physiological recording methodologies. It publishes both basic and clinical studies, including those that incorporate genetic data, pharmacological challenges, and computational modeling approaches. The 2020 Impact Factor score for Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is 6.204. www.sobp.org/bpcnni

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Media contact
Rhiannon Bugno, Editorial Office
Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
+1 254 522 9700
BPCNNI@sobp.org