Social defeat predicts paranoid appraisals in people at high risk for psychosis

Background: The experience of social defeat may increase the risk of developing psychotic symptoms and psychotic disorders. We studied the relationship between social defeat and paranoid appraisal in people at high risk for psychosis in an experimental social environment created using Virtual Reality (VR). Method: We recruited UHR (N= 64) participants and healthy volunteers (N= 43). Regression analysis was used to investigate which baseline measures predicted paranoid appraisals during the VR experience. Results: At baseline, UHR subjects reported significantly higher levels of social defeat than controls (OR = .957, (CI) .941-.973, p <.000). Following exposure to the VR social environment, the UHR group reported significantly more paranoid appraisals than the controls (p <.000). Within the UHR sample, paranoid appraisals were predicted by the level of social defeat at baseline, as well as by the severity of positive psychotic and disorganised symptoms. Conclusion: In people who are at high risk of psychosis, a history of social defeat is associated with an increased likelihood of making paranoid appraisals of social interactions. This is consistent with the notion that social defeat increases the risk of developing psychosis.