Paranoia
Paranoia is characterized by an excessive mistrust or suspicion of others, often involving the false belief that others intend harm or are acting maliciously. It can range from mild concerns about others’ intentions to more severe persecutory delusions, where beliefs are held with high conviction and cause significant distress and impairment. Paranoia is a symptom present across multiple psychiatric diagnoses, including schizophrenia, anxiety, and depression.
A persecutory belief is central to paranoia, defined by two key elements: the expectation of harm and the attribution of intentionality behind it. For example, a person might believe others are conspiring against them or trying to confuse or annoy them deliberately. In its most extreme form, paranoia manifests as persecutory delusions, often seen in psychosis, where over 70% of individuals experiencing a first episode report such beliefs.
Paranoia exists on a continuum in the general population. While mild socio-evaluative concerns, such as thinking others are talking about you, are common, only a minority develop severe delusions. Cognitive and social processes likely contribute to paranoia, which clusters around themes of mistrust, interpersonal sensitivity, ideas of reference, and persecution.
Paranoia can severely disrupt social interactions, increase distress, and lead to withdrawal. When disabling, it becomes a clinical concern requiring intervention to alleviate its distressing impact.
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