Racial Disparities in the Expression of Paranoia

Project Summary Paranoia, a core feature of psychosis and a clinically significant transdiagnostic construct, manifests dimensionally in the population and significantly impacts social functioning and well-being across the severity spectrum. This proposal addresses critical knowledge gaps in understanding the dynamics contributing to the persistent observation of heightened paranoia among Black Americans compared to their White counterparts, irrespective of clinical status. Specific Aim 1 bridges current knowledge gaps by identifying both risk and resilience factors that may mediate and moderate the relationship between group status and self-reported paranoia in Black and White Americans using self-report survey methodology. To our knowledge, we are the first team to systematically investigate the intricate interplay between both individual- and group-level factors that may influence heightened paranoia endorsements observed among Black Americans. Furthermore, while adverse experiences related to race have been implicated as a potential driver of group differences in paranoia, the correlational nature of current research limits causal inferences. Specific Aim 2 addresses this limitation by employing a randomized experimental paradigm to test the causal relationship between exposure to adverse experiences related to race and increased paranoia among Black Americans. In addition, we will meticulously examine the factors that may influence the magnitude of experimental effects, shedding light on nuanced factors at play. By elucidating these dynamics and causal pathways, the proposed research will refine the understanding of paranoia expression across groups—providing crucial information for culturally sensitive and accurate measurement of the psychosis spectrum within diverse populations.