Racial Disparities in the Expression of Paranoia
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorIndiana University
About this trial
Paranoia is a pattern of thinking in which people feel suspicious or believe others may want to harm them. It can occur in many people, not only those with a mental health diagnosis, and it can affect daily life, relationships, and overall well-being. Research has consistently shown that Black Americans report higher levels of paranoia than White Americans, even when they do not have a clinical diagnosis. However, the reasons for this difference are not well understood.
The goal of this study is to better understand why these differences exist. In the experimental part of the study, researchers will use a randomized design to test whether exposure to stressful experiences related to race leads to higher levels of paranoia among Black American participants. The study will also examine factors that may strengthen or weaken this effect, such as individual experiences and personal characteristics.
By identifying how stressful experiences related to race influence paranoia, this research aims to improve how paranoia is measured and understood across different groups. These findings may help researchers and clinicians use more accurate and culturally appropriate tools to assess psychosis-related experiences in diverse populations.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
18 years of age or older
Self-identify as non-Hispanic Black or African American
Currently reside in the United States
Speak and read English
Disqualifiers
Younger than 18 years of age
Do not self-identify as non-Hispanic Black or African American
Do not currently reside in the United States
Do not speak or read English
Trial design
Design model
Single group
Treatments tested in this trial
Guided Visual Imagery Task
BehavioralParticipants complete an online, audio-guided visual imagery task designed to experimentally prime social experiences under standardized conditions. After brief instructions to imagine themselves actively participating in each scene, participants complete practice trials with neutral content and then are randomized to listen to one audio-recorded scenario matched to their assigned condition. Each trial includes a brief relaxation period, an instruction period, a guided imagery listening period, and a short recovery period. Scenarios are approximately 30 seconds and are delivered via headphones/speakers within the survey platform. Following the imagery task, participants complete post-task self-report assessments capturing current (state) experiences, including state paranoia and manipulation checks (e.g., imagery vividness and task engagement). The task is administered once in a single session.
Treatment groups
480 Participants
are divided into 4 treatment groupsGroup A: Blatant Race-Related Adverse Experience ImageryExperimental treatment 1 intervention
Group B: Subtle Race-Related Adverse Experience ImageryExperimental treatment 1 intervention
Group C: Neutral Control ImageryPlacebo comparator 1 intervention
Group D: Social Exclusion ImageryExperimental treatment 1 intervention
Trial outcomes
Primary outcomes
1
State Paranoia
Self-reported paranoia will be assessed immediately following the experimental task to capture acute, experimentally induced changes in paranoia. State paranoia will be measured using the Revised Green Paranoid Thought Scale (R-GPTS; Green et al., 2019), an 18-item validated Likert-type measure appropriate for clinical and nonclinical samples. Scores range from 0-72, with higher scores indicating greater state paranoia. The R-GPTS includes two subscales: (1) Ideas of Reference and (2) Ideas of Persecution. Items are summed to generate subscale and total scores. The scale demonstrates excellent internal consistency (α \> .90), and prior work (Wolny et al., revisions submitted) established measurement invariance across Black and White American participants.
Time frame
Immediately post-intervention (single session)Secondary outcomes
1
Affective Response
Self-reported affective responses will be assessed before and after the experimental task to characterize changes in emotional valence and arousal following exposure to the guided imagery scenarios. Affect will be measured using two Self-Assessment Manikin (SAM; Bradley \& Lang, 1994) single-item ratings: (1) Valence, ranging from 1 (Unpleasant) to 9 (Very pleasant), with higher scores indicating more pleasant affect; and (2) Arousal, ranging from 1 (Calm) to 9 (Aroused), with higher scores indicating greater emotional activation.
Time frame
Pre-intervention and immediately post-interventionOther outcomes
1
Imagery Vividness and Task Engagement
Self-reported ratings of imagery vividness, task engagement, and perceived realism will be obtained immediately post-task to evaluate the quality and consistency of engagement with the guided imagery scenarios. Accordingly, participants will complete a structured Participation and Reflection Engagement Check. After listening to the assigned scene, participants will briefly describe the scenario as they experienced it (1-2 sentences or short phrases) across four domains: (1) Context (where and when the event took place and who was involved), (2) Experience (what occurred and the actions of those involved), (3) Feelings (emotional responses at the time and currently), and (4) Aftermath (immediate consequences and any changes in behavior or outlook). These responses will be used to verify attention, engagement, and comprehension of the guided imagery task.
Time frame
Immediately post-intervention2
Perceived Stress During Task
Self-reported ratings of stress and emotional intensity experienced during the guided imagery task, collected immediately following task completion. Perceived Stress * "How stressful was this task?" * 1 (Not at all) to 4 (Very stressful) * Higher scores = greater perceived stress. Perceived Controllability * "To what extent did you feel in control?" * 1 (Not at all) to 7 (Extremely) * Higher scores = greater perceived control. Emotional Intensity * "How emotionally impactful was the task?" = 1 (Not at all) to 7 (Extremely) * Higher scores = greater emotional intensity.
Time frame
Immediately post-interventionSponsors and contacts
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Indiana University
Lead sponsor
National Institute of Mental Health (NIMH)
Collaborator
Source ClinicalTrials.gov