DEFINITION

• Paranoia is a response to perceived threats that is heavily influenced by anxiety and fear, existing along a continuum of normal, reality-based experience to delusional beliefs.
• Paranoid symptoms represent a spectrum with a range of severities:[1]
  • Subclinical social evaluative concerns (e.g., fear of rejection, anxiety about vulnerabilities)
  • Passive ideas of reference (e.g., a person having suspicious beliefs that they are being talked about or watched)
  • Persecutory threats toward oneself (e.g., others have malicious intent to actively inflict harm, deceive, exploit, or condemn the person for a specific reason)

• The content of paranoid thoughts varies greatly among individuals.
  • These expectations may be supported by loosely related or no objective evidence.
  • Individuals may find hidden meanings or associations between things, ideas, or events that support their beliefs.

• Paranoia can negatively impact an individual’s mood and ability to engage in daily life.
  • Paranoid individuals may have trouble maintaining social connections due to doubting the loyalty and trustworthiness of others.
  • Of all delusion types, persecutory delusions are tied to greatest amount of negative affect; paranoia can produce low or anxious mood and can also be triggered by these moods.[2]

• Paranoia can be a symptom of psychosis.
  • In the context of a psychotic episode, delusional paranoid thoughts may be accompanied by related hallucinations.