Self-Confidence and Paranoia: An Experimental Study Using an Immersive Virtual Reality Social Situation.

BACKGROUND Paranoia may build directly upon negative thoughts about the self. There have been few direct experimental tests of this hypothesis. AIMS The aim of the study was to test the immediate effects of manipulating self-esteem in individuals vulnerable to paranoia. METHOD A two condition cross-over experimental test was conducted. The participants were 26 males reporting paranoid ideation in the past month. Each participant experienced a neutral immersive virtual reality (VR) social environment twice. Before VR participants received a low self-confidence manipulation or a high self-confidence manipulation. The order of manipulation type was randomized. Paranoia about the VR avatars was assessed. RESULTS The low self-confidence manipulation, relative to the high self-confidence manipulation, led to significantly more negative social comparison in virtual reality and higher levels of paranoia. CONCLUSIONS Level of self-confidence affects the occurrence of paranoia in vulnerable individuals. The clinical implication is that interventions designed to improve self-confidence may reduce persecutory ideation.