The best laid schemas of paranoid patients: autonomy, sociotropy and need for closure

Some theories implicate abnormal self-schemas in the development of psychosis in general and in paranoid delusions in particular. Patients with delusions may also be highly intolerant of ambiguity. No study has yet compared remitted and currently ill paranoid patients on schema measures, or on tolerance of ambiguity. Currently ill psychotic patients with persecutory delusions, patients whose persecutory delusions had remitted, and normal participants completed the Personal Style Inventory (PSI), a self-schema measure, and the Need for Closure Scale (NCS), a measure of intolerance of ambiguity. Acutely ill patients scored higher than normal participants on the PSI autonomy scale. This difference became nonsignificant when depression was included as a covariate. Ill and remitted patients scored higher than normal participants on the NCS. This difference could not be explained entirely by comorbid depression. Currently paranoid and remitted paranoid patients are highly intolerant of ambiguity. It is possible that this contributes to their performance on reasoning measures. The role of self-schemas in paranoid thinking needs to be studied further.