External Shame as a Mediator between Paranoia and Social Safeness in Psychosis

Abstract

Background

The overactivation of the threat‐defence system combined with an underdeveloped affiliative system has been emphasised as important in psychosis, usually leading to negative affect and impaired social functioning. Difficulties in feeling safe and content in relationships with others, common in individuals with psychotic symptoms, have been linked to two specific outputs of the threat‐defence system: Paranoid ideation and external shame. This study sought to explore the associations between paranoid ideation, external shame, and social safeness.

Methods

Participants diagnosed with psychotic disorders (N = 37) completed a series of self‐report questionnaires.

Results

Results showed a significant negative association between social safeness and external shame and frequency of paranoid ideation, while external shame was positively associated with both frequency and distress of paranoid ideation. Results revealed that the relationship between frequency of paranoid ideation and social safeness was mediated by external shame.

Conclusions

These findings suggest that feelings of being inferior and subordinate in the eyes of others increases vulnerability to difficulties in social connectedness and safeness. Treatment for paranoid ideation could benefit from integrating strategies to help patients deal with shame.

Key words:

• external shame
• paranoid ideation
• psychosis
• social safeness
• threat system

Funding: None.

Conflict of interest: None.

Funding: None.

Conflict of interest: None.

Notes

Funding: None.

Conflict of interest: None.