Paranoia: From Passive Social-Threat Perception to Misattunement in Social Interaction

Paranoia, defined as the unfounded belief that others intend to cause harm, negatively affects individuals across the continuum from healthy to pathological. Despite a definition that is explicitly social, paranoia is often studied as an isolated characteristic of the person who is experiencing it. In the current review, we propose that the study of paranoia could be advanced by adopting a perspective focused on its interactional nature. Specifically, we hypothesize that aberrant dynamic interaction and/or misattunement between social partners may be a critical component in the formation and maintenance of paranoia. We also speculate that the relationship between paranoia and social functioning is bidirectional in which poor interpersonal functioning is both a result of and a contributor to paranoia. This approach may identify novel mechanisms and potential treatment targets.