'Poor me' versus 'bad me' paranoia and the instability of persecutory ideation

To investigate whether there are two stable types of paranoia, 'poor me' and 'bad me', as described by Trower and Chadwick (1995), and whether beliefs about the deservedness of persecution are associated with psychological measures.

In-patients experiencing persecutory delusions were assigned either to 'poor me' (PM) or 'bad me'(BM) groups, according to their rating of a perceived deservedness scale, which was repeated on subsequent assessments. Participants were assessed for depression (BDI); construction of the self (Self-to-Others Scale); autonomy and sociotropy (PSI); perceived parental behaviour (PBI); attributional style (ASQ) and, meaningful daily events (DEI, devised for the study). A healthy control group was also assessed.

Many patients' perceived deservedness of persecution varied across time, so that some patients were PM at one point in time but BM at another. BM paranoia was associated with high levels of depression. PM and BM patients groups both scored higher than the controls on the subscales of Self-to-Others Scale and on the PSI. PM patients exhibited a marked self-serving bias on the ASQ, and reported less parental care on the PSI, compared to the BM patients. Both groups reported less PBI mother care than the controls. BM patients reported more failure events than PM patients or controls. PM patients reported more loss of control events than the than BM patients and controls.

PM and BM paranoia may represent separate phases of an unstable phenomenon. The findings are consistent with an attributional account of paranoid thinking.