Mistrust and negative self‐esteem: Two paths from attachment styles to paranoia

Anton Martinez, Maximilian Agostini, Azzam Al-Suhibani, Richard P. Bentall*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

5 Citations (Scopus)
31 Downloads (Pure)


Objectives.Paranoia is known to be associated with insecure attachment, with negative self esteem as a mediator, but this pathway is insufficient to explain the paranoid individual’s beliefs about malevolent others. Mistrust is a likely additional factor as it is a core feature of paranoid thinking also associated with insecure attachment styles. In this study, we tested whether mistrust–operationalized as judgements about the trustworthiness of unfamiliar faces–constitutes a second pathway from insecure attachment to paranoia.Design.The design of the study was cross-sectional.Methods.A nationally representative British sample of 1,508 participants aged 18–86,50.8% female, recruited through the survey company Qualtrics, completed measurements of attachment style, negative self-esteem, and paranoid beliefs. Usable data were obtained from 1,121 participants. Participants were asked to make trustworthiness judgements about computer-generated faces, and their outcomes were analysed by conducting signal detection analysis, which provided measures of bias (the tendency to assume untrustworthiness in conditions of uncertainty) and sensitivity (accuracy indistinguish between trustworthy and untrustworthy faces). Results. Results using structural equation modelling revealed a good model fit(RMSEA=.071, 95% CI: 0.067–0.075,SRMR=.045, CFI=.93, TLI=.92). We observed indirect effects through bias towards mistrust both for the relationship between attachment anxiety and avoidance (β=.003, 95% CI:0.001–0.005,p<.001) and attachment anxiety and paranoia (β=.003, 95% CI 0.002–0.006,p<.001). We observed an indirect effect through negative self-esteem only for the relationship between attachment anxiety and paranoia (β=.064, 95% CI:0.053–0.077,p<.001). Trust judgements and negative self-esteem were not associated with each other.Conclusions.We find that a bias towards mistrust is associated with greater paranoia.We also find indirect effects through bias towards mistrust between attachment styles and paranoia. Finally, we reaffirm the strong indirect effect through negative self-esteem between attachment anxiety and paranoia. Limitations of the study are discussed
Original languageEnglish
Pages (from-to)391-406
Number of pages16
JournalPsychology and Psychotherapy: Theory, Research and Practice
Issue number3
Early online date13-Dec-2020
Publication statusPublished - Sep-2021

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