Biopsychosocial Predictors of Paranoia in the Attenuated Psychosis Syndrome

Abstract

Despite a consensus that psychosocial adversity plays a role in the onset of psychosis, the nature of this role and the underlying neurobiological mechanisms remain unclear. This study examined the complex relationship between perceived ethnic discrimination (PED) and paranoid ideation and its mediating factors, in individuals with Attenuated Psychotic Syndrome (APS) using a virtual reality paradigm to objectively quantify paranoia. Secondly, a sensory gating deficit, indexed by P50 Event Related Potential (ERP) abnormalities was examined, and the combined effect of electrophysiological sensory gating deficits and psycho-social adversity on the development of psychosis was explored. Results showed that perceived maternal neglect and antipathy in childhood, PED and perceived social support were key factors in young adults with APS. Also PED was positively correlated with persecutory paranoia. Furthermore, individuals with APS displayed sensory gating impairments. Therefore, perceived exposure to adverse experiences and sensory gating deficits observed in individuals with APS are present before the first episode and are consistent with current biopsychosocial models in which early psychosocial stress, later psychosocial adversity and neurocognitive functioning plays a key role in the development of psychosis.