The structure of paranoia in the general population
The structure of paranoia in the general population
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DOI：
10.1192/bjp.bp.112.119032
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发表时间：
2013-06-01
影响因子：
10.5
通讯作者：
Freeman, Daniel
中科院分区：
文献类型：
--
作者：
Bebbington, Paul E.;McBride, Orla;Freeman, Daniel
背景精神病现象似乎与正常的经验和信念形成一个连续体，并可能建立在共同的情感人际关系的concerns.AimsWe测试的预测，偏执的想法是指数分布和层次安排在一般人群中，迫害的想法建立在更常见的认知不信任，方法项目选自DSM-IV轴II障碍结构化临床访谈（SCID-II）问卷和第二次英国全国精神病调查中的精神病筛查问卷（n=8580），使用验证性因素分析测试偏执发展的假定层次结构，潜在类别分析和因素混合模型分析。结果不同类型的偏执狂的频率范围从小于2%接近30%。这些项目的总分遵循几乎完美的指数分布（r=0.99）。我们的四个先验一阶因素得到了证实（人际敏感性;不信任;参考思想;迫害思想）。这些映射到四类个体受访者：一个罕见的，严重的，迫害类的所有项目因素，包括迫害的想法高度认可;一个准正常类的人际关系敏感，不信任和参考的想法，很少认可，没有迫害的想法;和两个中级班，其特征分别是对与不信任和参考观念有关的项目的相对较高的认可。结论偏执狂连续体对病因学有影响，机制和治疗的精神障碍，同时确认缺乏明确的区别，从正常的经验和过程。
BackgroundPsychotic phenomena appear to form a continuum with normal experience and beliefs, and may build on common emotional interpersonal concerns.AimsWe tested predictions that paranoid ideation is exponentially distributed and hierarchically arranged in the general population, and that persecutory ideas build on more common cognitions of mistrust, interpersonal sensitivity and ideas of reference.MethodItems were chosen from the Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II) questionnaire and the Psychosis Screening Questionnaire in the second British National Survey of Psychiatric Morbidity (n=8580), to test a putative hierarchy of paranoid development using confirmatory factor analysis, latent class analysis and factor mixture modelling analysis.ResultsDifferent types of paranoid ideation ranged in frequency from less than 2% to nearly 30%. Total scores on these items followed an almost perfect exponential distribution (r=0.99). Our four a priori first-order factors were corroborated (interpersonal sensitivity; mistrust; ideas of reference; ideas of persecution). These mapped onto four classes of individual respondents: a rare, severe, persecutory class with high endorsement of all item factors, including persecutory ideation; a quasi-normal class with infrequent endorsement of interpersonal sensitivity, mistrust and ideas of reference, and no ideas of persecution; and two intermediate classes, characterised respectively by relatively high endorsement of items relating to mistrust and to ideas of reference.ConclusionsThe paranoia continuum has implications for the aetiology, mechanisms and treatment of psychotic disorders, while confirming the lack of a clear distinction from normal experiences and processes.