Bridging the gap between body image and paranoia-like thoughts

A feeling of vulnerability is believed to be one of the foundations upon which paranoia is built. Factors that may increase vulnerability include negative affective states, low self-esteem and high social rejection sensitivity. Body image, which is one aspect of the overall self-esteem, has recently been shown to be associated with paranoia. However, little is known about factors underlying this association. In this online study conducted on a non-clinical sample (n = 539, 65.5% of female), self-report data assessing paranoia-like thoughts, body image, self-esteem, negative emotions, rejection sensitivity as well as various attitudes and beliefs related to body appearance were collected. The results revealed a significant serial mediation effect of negative emotions, self-esteem and rejection sensitivity in the relationship between body image and paranoia-like thoughts. Parallel mediation analysis showed an effect of social criticism as the only one of four studied groups of beliefs related to body appearance in the relationship between paranoia-like thoughts and body image. Moreover, paranoia-like thoughts were increased in people who were not satisfied with their body, both as a result of feeling too thin and overweight. To conclude, body image is an important factor related to paranoia-like thoughts, through its association with increased vulnerability and negative general self-view. The findings highlight the importance of negative emotions, low self-esteem and high rejection sensitivity, as well as the role of critical comments and lack of perceived acceptance as potential (socially-focused) mechanisms paving the way from negative body image to paranoia-like thoughts.