Social defeat predicts paranoid appraisals in people at high risk for psychosis.
BACKGROUND
The experience of social defeat may increase the risk of developing psychotic symptoms and psychotic disorders. We studied the relationship between social defeat and paranoid appraisal in people at high risk for psychosis in an experimental social environment created using Virtual Reality (VR).


METHODS
We recruited UHR (N=64) participants and healthy volunteers (N=43). Regression analysis was used to investigate which baseline measures predicted paranoid appraisals during the VR experience.


RESULTS
At baseline, UHR subjects reported significantly higher levels of social defeat than controls (OR=.957, (CI) .941-.973, p<.000). Following exposure to the VR social environment, the UHR group reported significantly more paranoid appraisals than the controls (p<.000). Within the UHR sample, paranoid appraisals were predicted by the level of social defeat at baseline, as well as by the severity of positive psychotic and disorganised symptoms.


CONCLUSIONS
In people who are at high risk of psychosis, a history of social defeat is associated with an increased likelihood of making paranoid appraisals of social interactions. This is consistent with the notion that social defeat increases the risk of developing psychosis.
King's College London, Institute of Psychiatry, Psychology & Neuroscience, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom. Electronic address: Lucia.Valmaggia@kcl.ac.uk.
Lucia R
LR
Valmaggia
King's College London, Institute of Psychiatry, Psychology & Neuroscience, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
Fern
F
Day
King's College London, Institute of Psychiatry, Psychology & Neuroscience, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
Philippa
P
Garety
University of Oxford, Department of Psychiatry, United Kingdom.
Daniel
D
Freeman
Department of Computer Science, University College London, Gower Street, London, United Kingdom.
Angus
A
Antley
Department of Computer Science, University College London, Gower Street, London, United Kingdom; Event Lab, Faculty of Psychology, ICREA-University of Barcelona, Barcelona, Spain.
Mel
M
Slater
Department of Computer Science, University College London, Gower Street, London, United Kingdom.
David
D
Swapp
Maastricht University, The Netherlands.
Inez
I
Myin-Germeys
King's College London, Institute of Psychiatry, Psychology & Neuroscience, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
Philip
P
McGuire
D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D010259:Paranoid Disorders / Q000150:complications* / Q000175:diagnosis*; D062706:Prodromal Symptoms; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications* / Q000523:psychology*; D012044:Regression Analysis; D012931:Social Environment; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014584:User-Computer Interface; D055815:Young Adult
Appraisal; Paranoia; Psychosis; Social defeat; Ultra High Risk; Virtual Reality