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Updated: Apr 7, 2026

Measuring Attentional Biases for Threat in Children and Adults

Measuring Attentional Biases for Threat in Children and Adults

Published on: October 19, 2014

Attentional bias in paranoia: systematic review and meta-analysis

Laura Eid¹, Chloe Hampshire², George Vamvakas³

¹Department of Psychosis Studies, https://ror.org/0220mzb33Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.

|April 5, 2026

Abstract

Background:

Paranoia is a transdiagnostic symptom and is associated with cognitive and social impairments. Attentional bias toward threat is thought to maintain paranoia.

Aims:

Despite many studies, attentional biases in paranoia have not been systematically summarised, which was the aim of the current work.

Method:

We conducted a systematic review and meta-analysis, identifying 10 964 studies, of which 35 met inclusion criteria for review and 15 for meta-analysis.

Results:

Findings showed a significant negative attentional bias (average standardised effect size 0.26; 95% CI 0.01-0.52; p = 0.046). Preliminary indications suggested bias was strongest for paranoia-related stimuli (average effect size 0.30; 95% CI 0.03-0.57; p = 0.027) and stronger for words than faces (average effect size 0.41; 95% CI 0.05-0.77; p = 0.027), but more data is needed to confirm these effects. Limitations were primarily statistical and included likely underestimation of the overall effect size of the association between negative attentional bias and paranoia and a lack of sufficient studies to robustly examine moderators.

Conclusions:

Summarising this literature provides a rationale for existing and new interventions for paranoia that target biased attentional mechanisms.

Keywords:

Psychosis attention bias cognition meta-analysis paranoia systematic review threat

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