Bridging the gap between body image and paranoia-like thoughts

Background: A feeling of vulnerability is believed to be the foundation upon which paranoia is built. Factors that may increase vulnerability include negative affective states, low self-esteem and high social rejection sensitivity. Body image, which is one aspect of overall self-esteem, has recently been shown to be associated with paranoia, and this relationship is likewise thought to be based on increased feeling of vulnerability. However, little is known about factors underlying this association. Methods: In this online study conducted on a non-clinical sample, self-report data assessing paranoia-like thoughts, body image, self-esteem, negative emotions, rejection sensitivity as well as various attitudes and beliefs related to body appearance were collected. Results: The results revealed a significant serial mediation effect of negative emotions, self-esteem and rejection sensitivity in the relationship between body image and paranoia-like thoughts. Parallel mediation analysis showed an effect of social criticism as the only one of four studied groups of beliefs related to body appearance in the relationship between paranoia-like thoughts and body image. Paranoia-like thoughts were increased in people who were not satisfied with their body, both as a result of feeling too thin and overweight. Conclusions: Body image is an important factor related to paranoia-like thoughts, through its association with increased vulnerability and negative general self-view. The importance of negative emotions, low self-esteem and high rejection sensitivity, as well as the role of critical comments and lack of perceived acceptance was emphasized as a potential (socially-focused) mechanisms paving the way from negative body image to paranoia-like thoughts.