Wingham, G; (2016) The role of interpersonal contingency and self-focused attention in the development of trust in clinical paranoia: a virtual reality study. Doctoral thesis , UCL (University College London).

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Abstract

Aims: Research into interpersonal processes involved in paranoia remains limited. This study aimed to assess the feasibility of using interactive virtual reality in a clinical sample with psychosis and persecutory delusions. The study aimed to replicate an experiment which found healthy individuals high in paranoia showed a hypersensitivity to contingent behaviour which increased their perceived trust towards the avatar. A further aim was to investigate the impact of self-focused attention on the perception of interpersonal contingency and trust. Method: Eighteen male participants with psychosis and paranoia completed the virtual reality exercise. Participants entered a virtual flat and interviewed a virtual flatmate whose non-verbal responses were either high or low in contingency in relation to the participant. Trust towards the avatar was measured by self-report and behaviour towards the virtual flatmate, operationalised as interpersonal distance. Focus of attention, affect and immersion in the virtual reality scenario were assessed. Results: Overall, participants enjoyed and were immersed in the interactive virtual reality environment. Interpersonal distance was predicted by severity of persecutory delusions and negative affect. Exploratory graphic analyses showed no evidence of hypersensitivity to avatar contingency or moderating effect of self-focus attention. Persecutory delusion severity was associated with other-focus attention, which in turn, unexpectedly, predicted higher self-focused attention. Conclusions: Interactive virtual reality is a safe and feasibility research tool for individuals with clinical paranoia. Severity of persecutory delusions, rather than environmental manipulation, predicted trust. However, the lack of power in the current study prevents clear conclusions about the impact of interpersonal contingency on trust in clinical paranoia from being drawn. Replication is required with a larger sample and a more ambiguous scenario.

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