EXPLORING THE ROLES OF SOCIAL ANXIETY, TRAUMA, AND URBANICITY IN THE RELATION BETWEEN POSITIVE AND NEGATIVE SYMPTOMS IN PSYCHOSIS

Abstract

Background: Research shows that positive and negative symptoms of schizophrenia are separate but related factors. However, it is unclear which specific symptoms may drive this relation or whether there are moderating factors. Moreover, it is unknown whether the relation between positive and negative symptoms is specific to schizophrenia or exists for individuals with psychosis regardless of diagnosis. Research is needed that looks specifically at individual symptoms within positive and negative symptom domains in a sample of mixed diagnoses. The current study examines whether paranoia, a positive symptom, and deficits in motivation and pleasure, a negative symptom, are correlated with one another in a transdiagnostic sample of individuals with psychosis. Literature suggests that paranoia and deficits in motivation and pleasure are both interpersonal in nature. This shared interpersonal characteristic suggests that these symptoms may be linked through social stressors. Method: Participants were 38 people with psychosis and six people without a psychiatric diagnosis. They completed the Clinical Assessment Interview for Negative Symptoms (CAINS), including the Motivation and Pleasure (MAP) subscale; the Green et al. Paranoid Thought Scales (GPTS), including Social Reference (SR) and Persecution (P); the Social Interaction Anxiety Scale (SIAS); the Self-Beliefs Related to Social Anxiety scale (SBSA), including Unconditional Beliefs (UB); the Trauma History Questionnaire (THQ); and the Neighborhood Health Questionnaire (NHQ), including Activities with Neighbors (AN). Results: Inconsistent with hypotheses, neither GPTS nor its subscales was significantly correlated with CAINS MAP. GPTS was significantly correlated with SIAS, SBSA, and THQ totals; in exploratory analyses, the GPTS SR was significantly correlated with SBSA UB. CAINS MAP was significantly correlated with NHQ AN. Conclusions: This study revealed novel associations between paranoia and social anxiety cognitions and between motivation and pleasure deficits and neighborhood socialization. We explore reasons for null results (e.g., limitations with the transdiagnostic approach; low symptomatology in the sample). Future directions include examination of other positive and negative symptoms; investigation into facets of social anxiety and their overlap with paranoia; and assessment of urbanicity/neighborhood health and its relation to paranoia.