Objectives The study examined (1) the role of experiential avoidance (EA), conceptualized as intolerance towards aversive mental states, in paranoid delusions and (2) the mechanisms underlying EA. DesignA 6-day prospective momentary assessment study. MethodsParanoid patients (N=41) were studied using the experience sampling method (ESM), a structured diary technique, assessing psychopathology and current context in daily life. ResultsThe results showed that both low self-esteem and EA contributed to paranoid thinking. The relationship between low self-esteem and paranoia was partially mediated by EA and the relationship between EA and paranoia was partially mediated by low self-esteem. The detrimental effect of EA on self-esteem was more pronounced under high activity-related stress. Both EA and social stress were independently associated with low self-esteem. EA was associated with self-esteem instability. ConclusionsOur results implicate mental control strategies in the development of paranoia and are compatible with the attributional model of paranoia, which suggests that persecutory delusions arise as a result of dysfunctional attempts to avoid unpleasant thoughts about the self.
- experiential avoidance
- experience sampling method