title: Predictors and mediators of trait anger across the psychosis continuum: The role of attachment style, paranoia and social cognition.
abstract: Anger in the context of psychosis has a significant impact on treatment outcomes and serious implications for risk management. Understanding mechanisms underlying anger will improve interventions and inform strategies for prevention. This study is the first to examine the relationships between anger and key theoretical drivers across different phases of the psychosis continuum. A battery including measures of theory of mind, attachment, hostile attribution bias, paranoia and anger was administered to 174 participants (14 ultra-high risk, 20 first-episode, 20 established psychosis, 120 non-clinical participants). We tested the model that insecure attachment, paranoia, impaired theory of mind and hostile attribution bias would predict trait anger using multiple regression. Attachment avoidance, paranoia and hostile attribution bias were significantly associated with anger but attachment anxiety and theory of mind were not. Mediation analysis showed that paranoia partially mediated the relationship between avoidant attachment and anger but hostile attribution bias did not. Findings emphasise the importance of interventions targeting paranoia to reduce anger and the potential of preventive strategies focused on attachment relationships in early life or adulthood to reduce adult paranoia and anger.
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom. Electronic address: Hannah.darrell@postgrad.manchester.ac.uk.
authors.forename: Hannah
authors.initials: H
authors.lastname: Darrell-Berry
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom. Electronic address: Sandra.bucci@manchester.ac.uk.
authors.forename: Sandra
authors.initials: S
authors.lastname: Bucci
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom. Electronic address: Jasper.palmier-claus@postgrad.manchester.ac.uk.
authors.forename: Jasper
authors.initials: J
authors.lastname: Palmier-Claus
authors.affiliation: Centre for Biostatistics, School of Health Sciences, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, United Kingdom. Electronic address: Richard.emsley@manchester.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Emsley
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Jean McFarlane Building, Oxford Road, Manchester M13 9PL, United Kingdom. Electronic address: Richard.drake@manchester.ac.uk.
authors.forename: Richard
authors.initials: R
authors.lastname: Drake
authors.affiliation: Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, 2nd Floor, Zochonis Building, Brunswick Street, Manchester M13 9PL, United Kingdom. Electronic address: Katherine.berry@manchester.ac.uk.
authors.forename: Katherine
authors.initials: K
authors.lastname: Berry
mesh_terms: D000293:Adolescent; D000328:Adult; D000786:Anger; D001007:Anxiety / Q000150:complications / Q000523:psychology; D005260:Female; D006791:Hostility; D006801:Humans; D008297:Male; D008960:Models, Psychological; D009769:Object Attachment; D010259:Paranoid Disorders / Q000150:complications / Q000523:psychology*; D010551:Personality; D010641:Phenotype; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology*; D012919:Social Behavior; D012938:Social Perception; D055815:Young Adult
keywords: Anger; Attachment; Attribution; Paranoia; Psychosis; Theory of mind