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Factor mixture analysis of paranoia in young people

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Abstract

Background

Paranoid thoughts are relatively common in the general population and can increase the risk of developing mental health conditions. In this study, we investigate the latent structure of paranoia in a sample of young people.

Methods

Cross-sectional survey; 243 undergraduate students (males: 44.9%) aged 24.3 years (SD 3.5). The participants completed the Green et al. Paranoid Thought Scales GPTS, a 32-item scale assessing ideas of social reference and persecution; the 12-item General Health Questionnaire (GHQ-12), and the 74-item Schizotypal Personality Questionnaire (SPQ). Confirmatory factor analysis (CFA) was used to confirm the two-factor structure of the GPTS. Factor mixture modeling analysis (FMMA) was applied to map the best combination of factors and latent classes of paranoia.

Results

The GPTS showed excellent internal reliability and test–retest stability. Convergent validity was good, with stronger links with measures of ideas of reference and of suspiciousness than with other measures of psychosis–proneness. CFA showed excellent fit for the two-factor solution. FMMA retrieved a three-class solution with 176 subjects (72.5%) assigned to a baseline class, 54 (22.2%) to a “suspicious and mistrustful” class, and 13 (5.3%) to a “paranoid thinking” class. Compared to the baseline class, the other two classes had a higher risk of psychological distress and psychosis–proneness.

Conclusions

The latent structure of paranoid thinking in young people appears dimensional. Although caution is advised when generalizing from studies on college students, screening for paranoid ideation in young people who complain about psychological distress might prove useful to prevent the development of severe and potentially debilitating conditions.

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References

  1. Akaike H (1987) Factor analysis and AIC. Psychometrika 52:317–332

    Article  Google Scholar 

  2. American Psychiatric Association (1987) Diagnostic and statistical manual of mental disorders (3rd edn Revised). Washington, DC: American Psychiatric Association

    Google Scholar 

  3. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  4. Bebbington PE, McBride O, Steel C, Kuipers E, Radovanovic M, Brugha T et al (2013) The structure of paranoia in the general population. Br J Psychiatry 202:419–427

    Article  PubMed  Google Scholar 

  5. Bekker PA, Merckens A, Wansbeek TJ (1994) Identification, equivalent models, and computer algebra. Academic Press, San Diego

    Google Scholar 

  6. Bell V, O’Driscoll C (2018) The network structure of paranoia in the general population. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-018-1487-0

    Article  PubMed  PubMed Central  Google Scholar 

  7. Bentall RP, Corcoran R, Howard R, Blackwood N, Kinderman P (2001) Persecutory delusions: a review and theoretical integration. Clin Psychol Rev 21(8):1143–1192

    Article  CAS  PubMed  Google Scholar 

  8. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476):307–310

    Article  CAS  PubMed  Google Scholar 

  9. Brennan P, Silman A (1992) Statistical methods for assessing observer variability in clinical measures. BMJ 304:1491–1494

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Browne MW, Cudeck R (1993) Alternative ways of assessing model fit. In: Bollen KA, Long JS (eds) Testing structural equation models. Sage, Newbury Park, pp 136–161

    Google Scholar 

  11. Burnham KP, Anderson DR (2002) Model selection and multimodel inference: a practical information-theoretic approach. Springer, New York

    Google Scholar 

  12. Cicero DC, Kerns JG, McCarthy DM (2010) The Aberrant Salience Inventory: a new measure of psychosis proneness. Psychol Assess 22(3):688–701

    Article  PubMed  Google Scholar 

  13. Druckman J, Kam C (2011) Students as EXPERIMENTAL PARTICIPANTS. In: Druckman J, Green D, Kuklinski J, Lupia A (eds) Cambridge handbook of experimental political science. Cambridge University Press, Cambridge, pp 41–57. https://doi.org/10.1017/CBO9780511921452.004

    Chapter  Google Scholar 

  14. Elahi A, Perez Algorta G, Varese F, McIntyre JC, Bentall RP (2017) Do paranoid delusions exist on a continuum with subclinical paranoia? A multi-method taxometric study. Schizophr Res 190:77–81

    Article  CAS  PubMed  Google Scholar 

  15. Ellett L, Lopes B, Chadwick P (2003) Paranoia in a nonclinical population of college students. J Nerv Mental Dis 191:425–430

    Article  Google Scholar 

  16. Firth J, Cotter J, Torous J, Bucci S, Firth JA, Yung AR (2016) Mobile phone ownership and endorsement of “mHealth” among people with psychosis: a meta-analysis of cross-sectional studies. Schizophr Bull 42(2):448–455

    Article  PubMed  Google Scholar 

  17. Firth J, Torous J (2015) Smartphone apps for schizophrenia: a systematic review. J Med Internet Res mHealth uHealth 3(4):e102. https://doi.org/10.2196/mhealth.4930

    Article  Google Scholar 

  18. Flora DB, Curran PJ (2004) An empirical evaluation of alternative methods of estimation for confirmatory factor analysis with ordinal data. Psychol Methods 9:466–491

    Article  PubMed  PubMed Central  Google Scholar 

  19. Fossati A, Raine A, Carretta I, Leonardi B, Maffei C (2003) The three-factor model of schizotypal personality: Invariance across age and gender. Personality Individ Differ 35:1007–1019

    Article  Google Scholar 

  20. Freeman D, Bentall RP (2017) The concomitants of conspiracy concerns. Soc Psychiatry Psychiatr Epidemiol 52(5):595–604

    Article  PubMed  PubMed Central  Google Scholar 

  21. Freeman D, Garety PA (2000) Comments on the contents of persecutory delusions: does the definition need clarification? Br J Clin Psychol 39:407–414

    Article  PubMed  CAS  Google Scholar 

  22. Freeman D, Garety PA, Bebbington PE, Smith B, Rollinson R,. Fowler D et al (2005) Psychological investigation of the structure of paranoia in a non-clinical population. Br J Psychiatry 186:427–435

    Article  PubMed  Google Scholar 

  23. Freeman D, Garety PA (2004) Paranoia: the psychology of persecutory delusions. Psychology Press, Hove

    Book  Google Scholar 

  24. Freeman D, Stahl D, McManus S, Meltzer H, Brugha T, Wiles N et al (2012) Insomnia, worry, anxiety and depression as predictors of the occurrence and persistence of paranoid thinking. Soc Psychiatry Psychiatr Epidemiol 47(8):1195–1203

    Article  PubMed  Google Scholar 

  25. Freeman D (2016) Persecutory delusions: a cognitive perspective on understanding and treatment. Lancet Psychiatry 3(7):685–692

    Article  PubMed  Google Scholar 

  26. Freeman D (2007) Suspicious mind: the psychology of persecutory delusions. Clin Psychol Rev 27:425–457

    Article  PubMed  Google Scholar 

  27. Galobardes B, Shaw M, Lawlor DA, Lynch JW, Smith GD (2006) Indicators of socioeconomic position (part 1). J Epidemiol Commun Health 60:7–12

    Article  Google Scholar 

  28. Garety PA, Bebbington P, Fowler D, Freeman D, Kuipers E (2007) Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychol Med 37(10):1377–1391

    Article  PubMed  Google Scholar 

  29. Goldberg DP (1972) The detection of psychiatric illness by questionnaire. Oxford University Press, London

    Google Scholar 

  30. Green CE, Freeman D, Kuipers E, Bebbington P, Fowler D, Dunn G et al (2008) Measuring ideas of persecution and social reference: the Green et al. Paranoid Thought Scales (GPTS). Psychol Med 38:101–111

    Article  CAS  PubMed  Google Scholar 

  31. Griggs S (2017) Hope and mental health in young adult college students: an integrative review. J Psychosoc Nurs Ment Health Serv 55(2):28–35

    Article  PubMed  Google Scholar 

  32. Guillemin F, Bombardier C, Beaton D (1993) Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. J Clin Epidemiol 46(12):1417–1432

    Article  CAS  PubMed  Google Scholar 

  33. Hanel PH, Vione KC (2016) Do student samples provide an accurate estimate of the general public? PLoS One 11(12):e0168354. https://doi.org/10.1371/journal.pone.0168354

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Hope V, Henderson M (2014) Medical student depression, anxiety and distress outside North America: a systematic review. Med Educ 48(10):963–979

    Article  PubMed  Google Scholar 

  35. Hu L, Bentler PM (1999) Cutoff criteria for fit indices in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model 6:1–55

    Article  Google Scholar 

  36. Ibáñez-Casas I, Femia-Marzo P, Padilla JL, Green CE, de Portugal E, Cervilla JA (2015) Spanish adaptation of the green paranoid thought scales. Psicothema 27(1):74–81

    PubMed  Google Scholar 

  37. Jack A, Egan V (2017) Childhood bullying, paranoid thinking and the misappraisal of social threat: trouble at school. School Mental Health 10:26–34

    Article  PubMed  PubMed Central  Google Scholar 

  38. Jack A, Egan V (2017) Trouble at school: a systematic review to explore the association between childhood bullying and paranoid thinking. Psychosis 9:260–270

    Article  Google Scholar 

  39. Johns LC, Cannon M, Singleton N, Murray RM, Farrell M, Brugha T et al (2004) Prevalence and correlates of self-reported psychotic symptoms in the British population. Br J Psychiatry 185:298–305

    Article  PubMed  Google Scholar 

  40. Johnson VE (2013) Revised standards for statistical evidence. Proc Natl Acad Sci USA 110:19313–19317

    Article  CAS  PubMed  Google Scholar 

  41. Kaymaz N, van Os J (2010) Extended psychosis phenotype—yes: single continuum—unlikely. Psychol Med 40:1963–1966

    Article  CAS  PubMed  Google Scholar 

  42. Kesting ML, Bredenpohl M, Klenke J, Westermann S, Lincoln TM (2013) The impact of social stress on self-esteem and paranoid ideation. J Behav Ther Exp Psychiatry 44(1):122–128

    Article  PubMed  Google Scholar 

  43. Kesting ML, Lincoln TM (2013) The relevance of self-esteem and self-schemas to persecutory delusions: a systematic review. Compr Psychiatry 54(7):766–789

    Article  PubMed  Google Scholar 

  44. Lenzenweger ME (2010) Schizotypy and schizophrenia: the view from experimental psychopathology. Guilford Press, New York

    Google Scholar 

  45. Lincoln TM, Keller E (2008) Delusions and hallucinations in students compared to the general population. Psychol Psychother 81:231–235

    Article  PubMed  Google Scholar 

  46. Lincoln TM, Hartmann M, Köther U, Moritz S (2015) Do people with psychosis have specific difficulties regulating emotions? Clin Psychol Psychother 22(6):637–646

    Article  PubMed  Google Scholar 

  47. Linscott RJ, van Os J (2010) Systematic reviews of categorical versus continuum models in psychosis: evidence for discontinuous subpopulations underlying a psychometric continuum. Implications for DSM-V, DSM-VI, and DSM-VII. Annu Rev Clin Psychol 6:391–419

    Article  PubMed  Google Scholar 

  48. Lubke GH, Muthén B (2005) Investigating population heterogeneity with factor mixture models. Psychol Methods 10:21–39

    Article  PubMed  Google Scholar 

  49. Mardia KV (1970) Measures of multivariate skewness and kurtosis with applications. Biometrika 57:519–530

    Article  Google Scholar 

  50. Massidda D (2015) fmaTools: Tools to Integrate the Package FactMixtAnalysis. R package version 0.0-3. https://github.com/DavideMassidda/fmaTools

  51. McDonald RP (1978) Generalizability in factorable domains: domain validity and generalizability: 1. Educ Psychol Meas 38(1):75–79

    Article  Google Scholar 

  52. McFadden D (1974) Conditional logit analysis of qualitative choice behavior. In: Zarembka P (ed) Frontiers in econometrics. Academic Press, New York, pp 104–142

    Google Scholar 

  53. Meyer EC, Lenzenweger MF (2009) The specificity of referential thinking: a comparison of schizotypy and social anxiety. Psychiatry Res 165(1–2):78–87

    Article  PubMed  Google Scholar 

  54. Nunnally JC, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw-Hill, Inc., New York

    Google Scholar 

  55. Park MS, Kang KJ, Jang SJ, Lee JY, Chang SJ (2018) Evaluating test-retest reliability in patient-reported outcome measures for older people: a systematic review. Int J Nurs Stud 79:58–69

    Article  PubMed  Google Scholar 

  56. Politi PL, Piccinelli M, Wilkinson G (1994) Reliability, validity and factor structure of the 12-item General Health Questionnaire among young males in Italy. Acta Psychiatr Scand 90:432–437

    Article  CAS  PubMed  Google Scholar 

  57. Preti A, Cella M (2010) Paranoid thinking as a heuristic. Early Interv Psychiatry 4(3):263–266

    Article  PubMed  Google Scholar 

  58. Preti A, Siddi S, Vellante M, Scanu R, Muratore T, Gabrielli M et al (2015) Bifactor structure of the schizotypal personality questionnaire (SPQ). Psychiatry Res 230:940–950

    Article  PubMed  Google Scholar 

  59. Preti A, Rocchi MBL, Sisti D, Mura T, Manca S, Siddi S et al (2007) The psychometric discriminative properties of the Peters et al. Delusions inventory: a receiver operating characteristic curve analysis. Compr Psychiatry 48:62–69

    Article  PubMed  Google Scholar 

  60. R Core Team (2017) R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna. http://www.Rproject.org/

  61. Raballo A, Cicero DC, Kerns JG, Sanna S, Pintus M, Agartz I et al (2017) Tracking salience in young people: a psychometric field test of the Aberrant Salience Inventory (ASI). Early Interv Psychiatry. https://doi.org/10.1111/eip.12449

    Article  PubMed  Google Scholar 

  62. Raine A (1991) The SPQ: a scale for the assessment of schizotypal personality based on DSM-III-R criteria. Schizophr Bull 17:555–564

    Article  CAS  PubMed  Google Scholar 

  63. Reynolds CA, Raine A, Mellingen K, Venables PH, Mednick SA (2000) Three-factor model of schizotypal personality: invariance across culture, gender, religious affiliation, family adversity, and psychopathology. Schizophr Bull 26(3):603–618

    Article  CAS  PubMed  Google Scholar 

  64. Rocchi MBL, Sisti D, Manca S, Siddi S, Mura T, Preti A (2008) Latent class analysis of delusion-proneness: exploring the latent structure of the Peters et al. Delusions Invent J Nerv Mental Dis 196:620–629

    Article  Google Scholar 

  65. Rosseel Y (2012) Lavaan: an R package for structural equation modeling. J Stat Softw 48:1–36

    Article  Google Scholar 

  66. Satorra A (2000) Scaled and adjusted restricted tests in multi-sample analysis of moment structures. In: Heijmans DDH, Pollock DSG, Satorra A (eds) Innovations in multivariate statistical analysis: a Festschrift for Heinz Neudecker. Kluwer Academic, Dordrecht, pp 233–247

    Chapter  Google Scholar 

  67. Schermelleh-Engel K, Moosbrugger H, Muller H (2003) Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res Online 8(2):23–74

    Google Scholar 

  68. Schultze-Lutter F, Michel C, Schmidt SJ, Schimmelmann BG, Maric NP, Salokangas RK et al (2015) EPA guidance on the early detection of clinical high risk states of psychoses. Eur Psychiatry 30(3):405–416

    Article  CAS  PubMed  Google Scholar 

  69. Schwarz G (1978) Estimating the dimension of a model. Ann Stat 6(2):461–464

    Article  Google Scholar 

  70. Shevlin M, Adamson G, Vollebergh W, de Graaf R, van Os J (2007) An application of item response mixture modelling to psychosis indicators in two large community samples. Soc Psychiatry Psychiatr Epidemiol 42:771–779

    Article  PubMed  Google Scholar 

  71. Snijders T (1992) Estimation on the basis of snowball samples: how to weight. Bull Soc Methodol 36:59–70

    Article  Google Scholar 

  72. Startup M, Sakrouge R, Mason OJ (2010) The criterion and discriminant validity of the Referential Thinking (REF) scale. Psychol Assess 22(1):65–69

    Article  PubMed  Google Scholar 

  73. Startup M, Startup S (2005) On two kinds of delusions of reference. Psychiatry Res 137:87–92

    Article  PubMed  Google Scholar 

  74. Thewissen V, Bentall RP, Oorschot M, Campo A, van Lierop J, van Os T, J., et al (2011) Emotions, self-esteem, and paranoid episodes: an experience sampling study. Br J Clin Psychol 50(2):178–195

    Article  PubMed  Google Scholar 

  75. van der Gaag M, van den Berg D, Ising H (2017) CBT in the prevention of psychosis and other severe mental disorders in patients with an at risk mental state: a review and proposed next steps. Schizophr Res. https://doi.org/10.1016/j.schres.2017.08.018

    Article  PubMed  Google Scholar 

  76. Viroli C (2012) Using factor mixture analysis to model heterogeneity, cognitive structure, and determinants of dementia: an application to the aging, demographics, and memory study. Stat Med 31:2110–2122

    Article  CAS  PubMed  Google Scholar 

  77. World Medical Association (2013) Declaration of Helsinki: ethical principles for medical research involving human subjects. J Am Med Assoc 310:2191–2194

    Article  CAS  Google Scholar 

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Funding

Research funded by Università di Cagliari (2012 CAR—Contributo d’ateneo per la ricerca, on the share attributed to Dr. Petretto). The funding body had no involvement in the design of the study, the collection, analysis and interpretation of data, the writing of the report, and the decision to submit the article for publication.

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Author notes

  1. Andrea Raballo

    Present address: Department of Medicine, Division of Psychiatry, Clinical Psychology and Rehabilitation, University of Perugia, Perugia, Italy

Authors and Affiliations

  1. Center of Liaison Psychiatry and Psychosomatics, University Hospital, University of Cagliari, Cagliari, Italy

    Antonio Preti & Mauro Giovanni Carta

  2. Section on Clinical Psychology, Department of Education, Psychology, Philosophy, University of Cagliari, Cagliari, Italy

    Antonio Preti, Rosanna Scanu, Debora Tronci, Mersia Gabbrielli, Tamara Muratore & Donatella Rita Petretto

  3. Genneruxi Medical Center, Via Costantinopoli 42, 09129, Cagliari, Italy

    Antonio Preti

  4. Kode Srl, Pisa, Italy

    Davide Massidda

  5. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Matteo Cella

  6. Department of Psychology, Psychopathology and Development Research, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Andrea Raballo

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  1. Antonio Preti
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Correspondence to Antonio Preti.

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Authors declare that they have no conflict of interest.

Ethical approval

The institutional review board approved the study protocol in accordance with the guidelines of the 1995 Declaration of Helsinki and their revisions.

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All participants provided informed consent. Participation was voluntary and with no compensation.

Appendix

Appendix

See Table 4 and Figs. 3 and 4.

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Preti, A., Massidda, D., Cella, M. et al. Factor mixture analysis of paranoia in young people. Soc Psychiatry Psychiatr Epidemiol 54, 355–367 (2019). https://doi.org/10.1007/s00127-018-1642-7

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