Understanding attributional biases, emotions and self-esteem in 'poor me' paranoia: findings from an early psychosis sample

Abstract

Objectives: Trower and Chadwick's (1995) theory of two types of paranoia ('poor me' and 'bad me') provides a framework for understanding the seemingly contradictory evidence on persecutory delusions. Paranoia has been argued to defend against low self-esteem, but people with persecutory delusions report high levels of emotional distress and, in some instances, low self-worth. The current study investigates attributions and emotions in a sample of people with early psychosis who have persecutory delusions. 'Poor me' paranoia has been found to be more frequent than 'bad me' paranoia in the early stages of psychosis. Anger and a tendency to blame other people are hypothesized to characterize 'poor me' paranoia.

Design and methods: The study had a cross-sectional design. Twenty individuals with early psychosis, 21 clinical controls with depression and 32 healthy volunteers completed a thorough assessment of emotions and attributions.

Results: The 'poor me' paranoia group showed higher levels of anger, anxiety and depression than the non-clinical control group. Self-esteem and guilt were however preserved. A tendency to blame others but not themselves was characteristic of the 'poor me' paranoia group whereas people in the clinical control group tended to self-blame for failures. Anger, but not self-esteem, was associated with an attributional bias characterized by blaming other people instead of oneself.

Conclusions: In conclusion, anger, a previously overlooked emotion in the study of persecutory delusions, warrants further attention. The other-directed nature of this emotion highlights the potential role of interpersonal schemas in understanding paranoia.