Cognitive Flexibility as a Mediator in the Relationship Between Generalized Anxiety and Paranoid Ideation: The Role of Perceived Control

J Cogn Psychother. 2024 Nov 11;38(4):294-309. doi: 10.1891/JCP-2023-0034.

Abstract

The clinical literature encourages further exploration of the relationship between anxiety and paranoid ideation with the overall objective of identifying processes that mitigate such relationship, thus establishing targets for cognitive intervention. Empirical studies demonstrate that increased levels of anxiety precede the emergence of paranoid cognitions. Yet, possible mediators are still to be investigated. In all, 273 adults completed a battery of standardized questionnaires, and collated data were analyzed statistically. Generalized anxiety was positively associated with paranoid ideation, for both ideas of reference and persecutory beliefs. Although the relationship was not mediated by cognitive flexibility in its entirety, perceived control over internal experiences and external events, an essential constituent of cognitive flexibility, acted as a significant mediator. The results highlight the importance of increasing adaptive perceptions of control among individuals experiencing generalized anxiety, which would likely reduce the co-occurrence of paranoid ideation and lower the risk of transitioning into clinical levels of paranoia.

Keywords: cognitive flexibility; cognitive intervention; generalized anxiety; paranoia; paranoid ideation; perceived control.

MeSH terms

  • Adult
  • Anxiety Disorders
  • Cognition / physiology
  • Female
  • Humans
  • Internal-External Control
  • Male
  • Middle Aged
  • Paranoid Disorders*
  • Surveys and Questionnaires
  • Young Adult