Paranoia, Functioning, and the Moderating Effect of Well-Being in a Community Sample of Adolescents

Paranoid ideation is a relatively common experience in adolescence, yet it has not been well-explored in relation to psychological well-being and functioning in general population samples of youth. The current study aimed to investigate the relations between paranoia (operationalized as "persecutory ideation"), well-being, and two domains of functioning, social (e.g., interpersonal relationships) and role (e.g., school and home responsibilities), in adolescence.

This nonclinical sample of adolescents (n = 462, aged 14-17 years, 50% male, 50% female) was recruited from the United Kingdom and the United States via an online survey in 2022.

Correlations indicated significant associations between persecutory ideation, in the negative direction, and well-being, in the positive direction, with both social and role functioning. With respect to social, but not role, functioning, these associations remained significant in linear regression analyses controlling for the effects of depression, past-year bullying/victimization, and past-year adverse life events. A subsequent analysis indicated that the association between persecutory ideation and social functioning was moderated by well-being. Persecutory ideation was significantly associated with social functioning at the lowest level of well-being (1 SD below the mean), but not at moderate (mean) or high (1 SD above the mean) levels of well-being.

Results suggest that among adolescents, persecutory ideation is negatively associated with functioning. Furthermore, novel findings suggest that well-being may buffer the association between persecutory ideation and social functioning. Therapeutic interventions targeting well-being may be helpful for youth experiencing paranoia, especially with respect to maintaining relationships and social connectedness.