INVESTIGATING THE ROLE OF SELF-ESTEEM AND SOCIAL RANK IN SUBCLINICAL PARANOIA

Abstract

There is a developing literature advocating a social rank approach to understanding psychotic experiences. A systematic review of the research in this area found suggestive evidence for associations between low social rank and important outcomes in psychosis including voice-distress, persecutory ideation and comorbid anxiety and depression. It has been difficult to separate out the effects of existing low rank from ‘down-ranking’ that may occur in response to experiences of psychosis and patienthood. Studying non-clinical groups is one way to minimise the impact of reactive changes of this kind. This study used a cross-sectional internet survey design to explore associations between self-esteem, social comparison and two dimensions of persecutory ideation (Persecution and Deservedness) in a large university sample (N = 534). Self-esteem and social comparison variables added significantly to the prediction of persecution and deservedness, after controlling for the effects of anxiety and depression. Negative self-esteem showed the strongest correlation with paranoia, and was also the strongest predictor in the regression models. Correlations between social comparison dimensions and paranoia were smaller in magnitude. In the multiple regression, Persecution was predicted by low social attractiveness and group fit, but high social rank. ‘Poor me’ and ‘bad-me’ paranoid groups were identified and compared. ‘Bad-me’ paranoia was associated with lower positive and higher negative self-esteem, lower social rank and lower social attractiveness. Persecutory ideation appears to be related to both low self-esteem and inferior social comparisons. The findings support the targeting of negative self-evaluations within interventions for psychosis.