Examining the Joint Contribution of Trauma and Adverse Neighborhood Characteristics to Paranoid Ideation: A Multi-Method Approach in a Transdiagnostic Sample.

Abstract

Paranoid ideation is common in psychosis and is associated with impairment. Multiple cognitive factors influence paranoid ideation, including lack of belief flexibility and hostile attributions. Separately, negative affect precedes and maintains later paranoid ideation. Research on what provokes these cognitive and affective biases highlights the influence of trauma and environmental stress. Traumatic experiences are a reliable risk factor for psychotic disorders and suspiciousness. Prior literature examining trauma and paranoid ideation only uses broad indicators of positive symptoms or single-item assessments. Aside from trauma, environmental research identifies two major facets that contribute to the development and maintenance of psychotic symptoms: neighborhood deprivation and crime. Population studies show that individuals who reside in deprived neighborhoods are more likely to experience increased paranoid ideation. Crime may also influence perceptions of threat and hostility and has been related to paranoid ideation. Neighborhood deprivation and crime can be measured through objective assessments and neighborhood perceptions. Evidence suggests that neighborhood perceptions impact paranoid ideation, above and beyond area-level assessments of neighborhood features, but findings vary. Although trauma, neighborhood deprivation, and crime have been shown to impact paranoid ideation, few have examined these constructs in Tandem. The current study seeks to examine the association between individual-level (i.e., trauma, neighborhood perceptions) and system-level (i.e., neighborhood deprivation and crime) factors and paranoid ideation. Results indicated that greater trauma and perceptions of neighborhood violence concurrently contributed to more severe paranoid ideation. However, administrative data on neighborhood deprivation and crime were not related. These results indicate that violence perceptions interact with existing vulnerabilities in exacerbating perpetuating psychotic symptomatology. Thus, interventions focused on reducing paranoia in this population would benefit from considering past traumas and one's current environment.