Abstract：
BACKGROUND: Paranoia is a key feature of psychosis that can be highly debilitating. Theories of paranoia mostly interface with short-scale or cross-sectional data models, leaving the longitudinal course of paranoia underspecified.
METHODS: We develop an empirical characterisation of two aspects of paranoia - persecutory and referential delusions - in individuals with psychosis over 20 years. We examine delusional dynamics by applying a Graphical Vector Autoregression Model to data collected from the Chicago Follow-up Study (n = 135 with a range of psychosis-spectrum diagnoses). We adjusted for age, sex, IQ, and antipsychotic use.
RESULTS: We found that referential and persecutory delusions are central themes, supported by other primary delusions, and are strongly autoregressive - the presence of referential and persecutory delusions is predictive of their future occurrence. In a second analysis we demonstrate that social factors influence the severity of referential, but not persecutory, delusions.
CONCLUSIONS: We suggest that persecutory delusions represent central, resistant states in the cognitive landscape, whereas referential beliefs are more flexible, offering an important window of opportunity for intervention. Our data models can be collated with prior biological, computational, and social work to contribute toward a more complete theory of paranoia and provide more time-dependent evidence for optimal treatment targets.
METHODS: We develop an empirical characterisation of two aspects of paranoia - persecutory and referential delusions - in individuals with psychosis over 20 years. We examine delusional dynamics by applying a Graphical Vector Autoregression Model to data collected from the Chicago Follow-up Study (n = 135 with a range of psychosis-spectrum diagnoses). We adjusted for age, sex, IQ, and antipsychotic use.
RESULTS: We found that referential and persecutory delusions are central themes, supported by other primary delusions, and are strongly autoregressive - the presence of referential and persecutory delusions is predictive of their future occurrence. In a second analysis we demonstrate that social factors influence the severity of referential, but not persecutory, delusions.
CONCLUSIONS: We suggest that persecutory delusions represent central, resistant states in the cognitive landscape, whereas referential beliefs are more flexible, offering an important window of opportunity for intervention. Our data models can be collated with prior biological, computational, and social work to contribute toward a more complete theory of paranoia and provide more time-dependent evidence for optimal treatment targets.
摘要：
背景：妄想症是精神病的一个关键特征，可以高度衰弱。偏执狂的理论主要与短尺度或横截面数据模型有关，使偏执狂的纵向过程未指定。
方法：我们在20年以上的精神病患者中，对偏执狂的两个方面-迫害妄想和参照妄想进行了实证表征。我们通过将图形向量自回归模型应用于从芝加哥随访研究中收集的数据来检查妄想动力学（n=135，具有一系列精神病频谱诊断）。我们调整了年龄，性别,IQ,和抗精神病药的使用。
结果：我们发现指称和迫害妄想是中心主题，在其他主要妄想的支持下，并且具有强烈的自回归性-指称和迫害妄想的存在可以预测其未来的发生。在第二个分析中，我们证明了社会因素影响参照的严重程度，但不是迫害，妄想.
结论：我们建议迫害妄想代表中心，认知景观中的抵抗状态，而参照信仰更灵活，为干预提供了一个重要的机会窗口。我们的数据模型可以与以前的生物，计算，和社会工作有助于建立更完整的偏执狂理论，并为最佳治疗目标提供更多时间依赖性证据。
方法：我们在20年以上的精神病患者中，对偏执狂的两个方面-迫害妄想和参照妄想进行了实证表征。我们通过将图形向量自回归模型应用于从芝加哥随访研究中收集的数据来检查妄想动力学（n=135，具有一系列精神病频谱诊断）。我们调整了年龄，性别,IQ,和抗精神病药的使用。
结果：我们发现指称和迫害妄想是中心主题，在其他主要妄想的支持下，并且具有强烈的自回归性-指称和迫害妄想的存在可以预测其未来的发生。在第二个分析中，我们证明了社会因素影响参照的严重程度，但不是迫害，妄想.
结论：我们建议迫害妄想代表中心，认知景观中的抵抗状态，而参照信仰更灵活，为干预提供了一个重要的机会窗口。我们的数据模型可以与以前的生物，计算，和社会工作有助于建立更完整的偏执狂理论，并为最佳治疗目标提供更多时间依赖性证据。
