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Using the evidence base for social anxiety to understand and treat paranoia: a single case experimental design

Published online by Cambridge University Press:  15 April 2019

Stephanie Hicks
Stephanie Hicks*
Affiliation:
Department of Clinical Psychology, University of Bath, Claverton Down, Bath BA2 7AY, UK
*
Email: [email protected]
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Abstract

Research suggests that paranoia and social anxiety can be understood as part of the same continuum, having shared processes such as the anticipation of threat, cognitive biases, poor self-concept, worry and safety-seeking behaviours. There is limited research on whether evidence-based interventions for social anxiety could be used with individuals who experience paranoia; however, an existing brief intervention study using techniques taken from cognitive behavioural therapy (CBT) for social anxiety has had promising results.

This paper uses a single-case experimental design to explore whether using a clinical model of the maintenance of paranoia followed by CBT for social anxiety can be an effective formulation and intervention method in cases where social anxiety processes appear to be maintaining paranoid thoughts. This may be an effective formulation and intervention method, resulting in a reduction in anxiety and a reduction in the distress associated with paranoid thoughts. The clinical implications are discussed along with limitations and recommendations for further research.

Key learning aims

  1. (1) To describe shared processes in social anxiety and paranoia.

  2. (2) To identify the benefits and limitations of using a clinical model of paranoia and CBT for social anxiety for formulation and intervention with individuals experiencing paranoia.

  3. (3) To identify areas where further research is warranted in treatment for individuals experiencing paranoia.

Keywords

CBTformulationinterventionparanoiasingle case experimental designsocial anxiety
Type
Case Study
Information
the Cognitive Behaviour Therapist , Volume 12 , 2019 , e23
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019 

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References

Further reading

Freeman, D. (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychology Review, 27, 425–257.CrossRefGoogle ScholarPubMed
Newman-Taylor, K., & Stopa, L. (2013). The fear of others: a pilot study of social anxiety processes in paranoia. Behavioural and Cognitive Psychotherapy, 41, 66–88.CrossRefGoogle ScholarPubMed

References

Beck, A.T., Emery, G., & Greenberg, R.L. (1985). Anxiety Disorders and Phobias: A Cognitive Perspective. New York, USA: Basic Books.Google Scholar
Carleton, R.N., Collimore, K.C., & Asmundson, G.J.G. (2007). Social anxiety and fear of negative evaluation: construct validity of the BFNE-II. Journal of Anxiety Disorders, 21, 131–141.CrossRefGoogle ScholarPubMed
Clark, D.M. (2005). A cognitive perspective on social phobia. In The Essential Handbook of Social Anxiety for Clinicians (ed. Crozier, R. & Alden, L.E.). Chichester, UK: Wiley.Google Scholar
Clark, D.M., Ehlers, A., Hackmann, A., McManus, F., Fennell, M., Grey, N., Waddington, L., & Wild, J. (2006). Cognitive therapy versus exposure and applied relaxation in social phobia: a randomized control trial. Journal of Consulting and Clinical Psychology, 74, 568–578.CrossRefGoogle Scholar
Clark, D.M., & Wells, A. (1995). A cognitive model of social phobia. In Social Phobia: Diagnosis, Assessment and Treatment (ed. Heimberg, R.G., Liebowitz, M.R., Hope, D.A. & Schneier, F.R.). New York, USA: Guildford Press.Google Scholar
Evans, C., Connell, J., Barkham, M., Margison, F., McGrath, G., Mellor-Clark, J., & Audin, K. (2002). Towards a standardised brief outcome measure: psychometric properties and utility of the CORE-OM. British Journal of Psychiatry, 180, 51–60.CrossRefGoogle ScholarPubMed
Freeman, D. (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychology Review, 27, 425–257.CrossRefGoogle ScholarPubMed
Freeman, D. (2016). Persecutory delusions: a cognitive perspective on understanding and treatment. The Lancet Psychiatry, 3, 685–692.CrossRefGoogle ScholarPubMed
Freeman, D., Garety, P.A., Bebbington, P.E., Smith, B., Rollinson, R., Fowler, D., Kuipers, E., Ray, K., & Dunn, G. (2005). Psychological investigation of the structure of paranoia in a non-clinical population. British Journal of Psychiatry, 186, 427–435.CrossRefGoogle Scholar
Freeman, D., Waller, H., Harpur-Lewis, R.A., Moore, R., Garety, P., Bebbington, P., Kuipers, E., Emsly, R., Dunn, G., Fowler, D., & Jolley, S. (2015). Urbanicity, persecutory delusions, and clinical intervention: the development of a brief CBT module for helping patients with persecutory delusions enter social urban environments. Behavioural and Cognitive Psychotherapy, 43, 42–51.CrossRefGoogle ScholarPubMed
Harvey, A.G., Clark, D.M., Ehlers, A., & Rapee, R.M. (2000). Social anxiety and self-impression: cognitive preparation enhances the beneficial effects of video feedback following a stressful social task. Behaviour Research and Therapy, 38, 1183–1192.CrossRefGoogle Scholar
Leigh, E., & Clark, D.M. (2016). Cognitive Therapy for Social Anxiety Disorder in Adolescents. Unpublished treatment manual.Google Scholar
Michail, M., Birchwood, M., & Tait, L. (2017). Systematic review of cognitive-behavioural therapy for social anxiety disorder in psychosis. Brain Sciences, 7, 45.CrossRefGoogle ScholarPubMed
Muntingh, A.D.T., van der Feltz-Cornelis, C.M., van Marwijk, H.W.J., Spinhoven, P., Penninx, W.J.H., & van Balkom, A.J.L.M. (2011). Is the Beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in The Netherlands study of depression and anxiety (NESDA). BMC Family Practice, 12, 66.CrossRefGoogle Scholar
Newman-Taylor, K., & Stopa, L. (2013). The fear of others: a pilot study of social anxiety processes in paranoia. Behavioural and Cognitive Psychotherapy, 41, 66–88.CrossRefGoogle ScholarPubMed
Ritter, V., Ertel, C., Beil, K., Steffens, M.C., & Stangier, U. (2013). In the presence of social threat: implicit and explicit self-esteem in social anxiety disorder. Cognitive Therapy and Research, 37, 1101–1109.CrossRefGoogle Scholar
Savulich, G., Freeman, D., Shergill, S., & Yiend, J. (2015). Interpretation biases in paranoia. Behaviour Therapy, 46, 110–124.CrossRefGoogle ScholarPubMed
Startup, H., Pugh, K., Dunn, G., Cordwell, J., Mander, H., Černis, E., Wingham, G., Shirvell, K., Kingdon, D., & Freeman, D. (2016). Worry processes in patients with persecutory delusions. British Journal of Clinical Psychology, 55, 387–400.CrossRefGoogle ScholarPubMed
Tiernan, B., Tracey, R., & Shannon, C. (2014). Paranoia and self-concepts in psychosis: a systematic review of the literature. Psychiatry Research, 216, 303–313.CrossRefGoogle ScholarPubMed
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