Two forms of paranoia noted: “Poor Me” and “Bad Me”

Two forms of paranoia noted: “Poor Me” and “Bad Me”

Nov. 30, 2005
Special to World Science

Traditionally, paranoia is defined as a delusion of persecution. The paranoid person thinks people are “out to get” him or her.

Now, some researchers say mounting evidence suggests paranoia, traditionally considered one condition, really takes two forms.

In the first, the paranoiac believes the persecution is unfair. This is called “Poor Me” paranoia. In the second, the patient thinks he actually deserves to be persecuted. This is dubbed “Bad Me” paranoia.

The theory isn’t new; it was first proposed a decade ago, and has gained some acceptance in the psychological community. But its proponents say there has been a need for further evidence.

Thus, the two psychologists who developed the idea—Paul Chadwick of the University of Southampton, U.K., and Peter Trower of the University of Birmingham, U.K.—conducted a new study to test it.

Along with two other colleagues, they analyzed a sample of 53 people diagnosed as paranoid to see if the details of their condition matched with certain specific predictions of their hypothesis. The hypothesis claims paranoia can be associated with higher or lower self-esteem, corresponding to “Poor Me” and “Bad Me” respectively.

The researchers said they arranged for independent experts to evaluate the patients and score them on a variety of tests.

As expected, “the Bad Me group manifested significantly lower self-esteem than the Poor Me group,” the researchers wrote in a paper describing their findings. The Bad Me group was also more depressed, they added. The paper appears in the Nov. 1 issue of the research journal Psychopathology.

One might argue, the researchers noted, that the lower self-esteem among the Poor Me group simply results from their greater depression, rather than a difference in the type of delusion itself.

But the study “showed that this was not so—the Poor Me/Bad Me groups still differed significantly in scores on these two variables even when depression was removed from the equation,” they wrote.

But some other aspects of the study didn’t clearly support the proposal, they acknowledged.

For one thing, the findings failed to bear out another prediction of the theory: that Poor Me paranoia would be associated with higher anger levels.

Another weakness of the study, they asserted, was the sample of patients was chosen based on which patients could be conveniently recruited. Thus it wasn’t totally random and might not reflect the wider population of paranoiacs.

Nonetheless, the researchers argued that on balance the findings support their hypothesis.

“In Bad Me, others’ malevolence is seen as deserved—the self is consciously experienced as bad/unworthy and the mistreatment by others as a punishment for this,” they explained.

But they cautioned that not all paranoiacs might fit into these two types, and that some people might change from one type to the other. Nonetheless, the distinction might be useful to psychologists, because it could help improve treatments, they added.

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LINKS/RESOURCES

Study by Chadwick et al.
Information on paranoia from mentalhealth.com
Paranoia information from thesite.org.uk, by YouthNet UK
National Alliance on Mental Illness (USA)