Shame triggers paranoid symptoms in adolescents with elevated psychosis proneness

Paranoia is common in psychotic disorders, tends to cause suffering, and is difficult to successfully treat. Knowledge about causes and precursors of paranoia is needed to enable prevention. Theoretical models stress the significance of negative affect in the emergence of paranoia. Experimental research is needed to test these assumptions. It was expected that shame as a specific negative emotion would trigger paranoid symptoms, especially in adolescents with elevated psychosis proneness. In an experimental online study, 297 adolescents from the general population (14-17 years) were randomly assigned to a shame induction versus comparison condition. The induction successfully induced shame, but there were no differences between the groups in paranoid symptoms. However, there was a significant indirect effect from the induction on paranoid symptoms through shame but not through any of the other investigated affective states (anxiety, sadness, happiness, anger). As expected, psychosis proneness served as a moderator. Among participants with elevated psychosis proneness (n = 115), paranoid symptoms were higher in the shame group than in the comparison group (d = 0.37, p = .048). Results imply that shame triggers paranoid symptoms in adolescents with elevated psychosis proneness. If further corroborated, shame and how to deal with it could be worthy targets of interventions to prevent paranoia.