Dr Monica Sood

Paranoia broadly refers to beliefs that others are a threat, with limited or no evidence of this. It ranges from mild beliefs such as “people are talking about me” to extreme delusions such as “there is a conspiracy against me”. Paranoia is common in people with a clinical psychosis diagnosis (e.g., schizophrenia) and also common in the general population.

Research shows that people with paranoia tend to have insecure attachment styles, meaning that they may not feel comfortable or safe with others. Different types of insecure attachment styles have been identified.

• Those with an insecure-anxious attachment style often feel a strong fear of rejection or abandonment, leading to clinginess or a heightened need for reassurance in relationships. They may constantly worry about whether others truly care for them and feel unworthy of love or attention.
• Those with an insecure-avoidant attachment style typically feel uncomfortable with closeness or emotional intimacy, often leading them to distance themselves from others. They may suppress their emotions and prioritise self-reliance, fearing vulnerability or rejection.

By contrast, individuals with a secure attachment style feel safe and secure with others, are comfortable with both intimacy and independence, and are able to trust and rely on others without fear of rejection. This sense of security helps them maintain healthy relationships, cope with difficult feelings, and reduces the likelihood of experiencing paranoia.

Importantly, these attachment styles are usually seen as dimensions – meaning that we all differ in levels of attachment anxiety and avoidance. Those with low attachment anxiety and avoidance are typically seen as “secure”.

In a recent study, we examined how attachment impacts paranoia, examining the role of emotion regulation – how we manage our feelings. Some emotion regulation strategies are seen as helpful because they often reduce difficult feelings (e.g., sadness) and increase typically enjoyable feelings (e.g., happiness), such as positive reappraisal (re-evaluating difficult events in a positive light). Some strategies are seen as unhelpful because they may increase difficult feelings, such as rumination (rehearsing negative thoughts or events), catastrophisation (focusing on the worst thing that could happen), and suppression (stopping yourself from thinking about certain events).

Research shows that people high in attachment anxiety typically ruminate or catastrophise (known as hyperactivating emotion regulation strategies given heightened sensitivity to perceived threats and rejection), whereas people high in attachment avoidance typically suppress their emotions (known as deactivating emotion regulation strategies given a tendency to downplay attachment needs and emotional dependence). People with a secure attachment style usually rely on more helpful strategies such as positive reappraisal, allowing them to manage stress and maintain healthy relationships. In our research, we sought to examine whether these strategies explain how attachment impacts paranoia.

We recruited people from the general population with high levels of paranoia and asked them to complete self-report questionnaires of their attachment style, paranoia levels, and general use of emotion regulation strategies in times of distress.

We found that people with high levels of paranoia use emotion regulation strategies that are consistent with their insecure attachment styles – those high in attachment anxiety used more rumination and catastrophisation (hyperactivating strategies), and those high in attachment avoidance used more suppression (deactivating strategies). Both hyperactivating and deactivating strategies were linked to greater levels of paranoia.

These findings suggest that our attachment styles influence how we regulate our emotions and, in turn, our paranoia levels. We are conducting further research to understand whether these emotion regulation strategies cause changes in paranoia in clinical and non-clinical groups with paranoia. This research is important because it shows that our attachment styles are likely to impact how we deal with intense feelings and paranoia. Current psychological therapies do not routinely assess or target attachment style and emotion regulation; this research suggests that doing so will likely improve recovery for people with paranoia.

This blog is based on the following scientific publication:  Sood, M., Carnelley, K.B., & Newman-Taylor, K (2022). Do emotion regulation strategies mediate the attachment-paranoia association? An experimental study of repeated attachment-imagery priming and stress buffering. Psychology and Psychotherapy: Theory, Research, and Practice, 95(3), 781–806. https://doi.org/10.1111/papt.12398

Dr. Monica Sood, PhD is a Postdoctoral Research Fellow in the School of Psychology, Centre for Innovation in Mental Health and Centre for Research on Self and Identity. Her research is funded by the Economic and Social Research Council, South Coast DTP.