title: The Beliefs about Paranoia Scale: Confirmatory factor analysis and tests of a metacognitive model of paranoia in a clinical sample.
abstract: This study aimed to confirm the factor structure of the Beliefs about Paranoia Scale (BaPS), a self-report measure to assess metacognitive beliefs about paranoia, and to test hypotheses of a metacognitive model. We hypothesised that positive and negative beliefs about paranoia would be associated with severity of suspiciousness, and that the co-occurrence of positive and negative beliefs would be associated with increased suspiciousness. A total of 335 patients meeting criteria for a schizophrenia spectrum disorder completed the BaPS, the Positive and Negative Syndromes Scale (PANSS), and the Psychotic Symptom Rating Scales (PSYRATS). Confirmatory factor analysis verified that the three BaPS subscales (negative beliefs about paranoia, paranoia as a survival strategy, and normalizing beliefs) were an adequate fit of the data. Ordinal regression showed that positive beliefs about paranoia as a survival strategy and negative beliefs were both associated with severity of suspiciousness. This was the first study to show that the co-occurrence of positive and negative beliefs was associated with increased suspiciousness. All hypotheses were confirmed, suggesting that a metacognitive approach has utility for the conceptualization of paranoia. Clinical implications suggest a role for metacognitive therapy, including strategies such as detached mindfulness and worry postponement.
authors.affiliation: Psychosis Research Unit, Greater Manchester West NHS Trust, UK. Electronic address: elizabeth.murphy@gmw.nhs.uk.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Murphy
authors.affiliation: Psychosis Research Unit, Greater Manchester West NHS Trust, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Tully
authors.affiliation: Psychosis Research Unit, Greater Manchester West NHS Trust, UK; School of Psychological Sciences, University of Manchester, UK.
authors.forename: Melissa
authors.initials: M
authors.lastname: Pyle
authors.affiliation: Institute of Health and Wellbeing, University of Glasgow, UK.
authors.forename: Andrew I
authors.initials: AI
authors.lastname: Gumley
authors.affiliation: Faculty of Medicine, University of Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Kingdon
authors.affiliation: School of Health in Social Science, University of Edinburgh, UK.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwannauer
authors.affiliation: The Institute of Neuroscience, Newcastle University, UK.
authors.forename: Douglas
authors.initials: D
authors.lastname: Turkington
authors.affiliation: Psychosis Research Unit, Greater Manchester West NHS Trust, UK; School of Psychological Sciences, University of Manchester, UK.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Morrison
mesh_terms: D000328:Adult; D003469:Culture; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D000067489:Metacognition; D008875:Middle Aged; D009483:Neuropsychological Tests; D010259:Paranoid Disorders / Q000523:psychology*; D012565:Schizophrenic Psychology; D057566:Self Report; D055815:Young Adult
keywords: Cognitive; Metacognition; Persecutory delusions; Questionnaire; Schizophrenia