Self-esteem and evaluative beliefs in paranoia

Background and objectives: Psychological models have implicated negative self-esteem as an important factor underlying paranoia. However, research investigating the role of self-esteem in paranoia suffers from poor conceptual and methodological understanding, resulting in conflicting findings. Central to this problem is the use of measures investigating global self-esteem and self-evaluative beliefs interchangeably. In the present study we aimed to analyze differences in self-esteem domains and self-evaluation.

Methods: The present study used interviews and questionnaires to compare a clinical sample of participants who were currently paranoid (n = 55) with healthy controls (n = 57) on global self-esteem domains and negative evaluative beliefs, in order to investigate the multi-faceted role of "the self".

Results: There was no significant difference in self-esteem domains between groups, highlighting that self-esteem is preserved in currently paranoid individuals. However, the paranoid group had significantly more negative evaluative beliefs. Interestingly, our global measures of self-esteem and measures of negative evaluative beliefs were uncorrelated, highlighting the importance of understanding the differences underlying these concepts.

Limitations: This study does not address dynamic aspects of self-esteem and self-evaluation.

Conclusions: The present study provides undeniable evidence to investigate self-concept dimensions separately. These findings must be considered by researchers interested in the role of the self in the onset and maintenance of paranoia.