A dimensional latent structure of paranoia implies that the processes involved in sub-clinical paranoia may be similar to those in clinical paranoia.

A substantial body of literature suggests that migrants are at greater risk of developing psychotic symptoms, such as paranoia, compared to non-migrants. To date, researchers have been unable to identify the primary cause of this effect, finding scarce support for biological, diagnostic, and economic explanations. Social determinants have received little empirical attention in this domain, which we assert is a critical gap in the literature. Here, we propose that the social identity approach offers a framework to help explain the elevated rates of psychosis among migrants, and in turn inform policies and interventions to address this important mental health issue. We propose that cultural identities play a central role in mitigating the psychological precursors of psychosis and that disidentification and social disconnection subsequent to migration could initiate or exacerbate psychosis for multiple generations. We draw together research from social and clinical psychology to detail a social identity approach to psychosis in migrant populations, and make recommendations for future research.

Debt and financial insecurity are associated with stress, low self-worth and poor health. Joining and identifying with social groups (social identification) promotes better health and higher self-esteem. Here, we examined whether identifying with one's local neighbourhood protected people from developing mental health symptoms associated with financial stress. We analysed data from a general population survey (Study 1, N= 4319) and a student mental health survey (Study 2, N= 612) conducted in the North West of England. We administered measures of financial stress, self-esteem, neighbourhood identity and mental health, and conducted moderated mediation analyzes to test our predictions. Study 1 (population survey) demonstrated that stronger identification with one's local neighbourhood attenuated the adverse effects of financial stress on self-esteem and subsequent mental health. Study 2 (student survey) showed that strong host town identities buffered students from mental health symptoms related to financial stress. Strong hometown identities, however, showed no buffering effect. The findings suggest that one way financial stress impacts mental health is by eroding self-esteem. Identifying with one's current place of residence appears to disrupt this pathway, whilst identifying with one's previous place of residence does not provide the same psychological protection.

Objectives: People from ethnic minority groups experience higher rates of paranoid delusions compared with people from ethnic majority groups. Identifying with social groups has been shown to protect against mental health symptoms; however, no studies have investigated the relationship between social identification and paranoia in ethnic minority populations. Here, we investigated the association between British identification and paranoia in a sample of people from African and African-Caribbean backgrounds living in the United Kingdom. We also assessed the role of potential mediating (self-esteem and locus of control) and moderating (contact with White British people) factors. Design: Cross-sectional quantitative survey design. Methods: We recruited 335 people from African and African-Caribbean backgrounds who completed on-line self-report measures of identification with Great Britain, self-esteem, locus of control, positive and negative contact with White British people, and paranoia. Results: A parallel moderated mediation model indicated that British identification was associated with lower paranoia when participants experienced primarily positive contact with White British people. British identification was associated with higher paranoia when participants had primarily negative contact with White British people. Both effects were mediated by changes in locus of control, but self-esteem was not implicated in either pathway. Conclusions: Identification with the majority culture is associated both positively and negatively with paranoid beliefs depending on the types of social interactions people experience. The findings have implications for preventative social prescribing initiatives and for understanding the causes of the high rates of psychosis in ethnic minority populations.

IntroductionOver 800 000 people die due to suicide each year and suicide presents a huge psychological, economic and social burden for individuals, communities and countries as a whole. Low-income and middle-income countries (LMICs) are disproportionately affected by suicide. The strongest risk factor for suicide is a previous suicide attempt, and other types of self-harm have been found to be robust predictors of suicidal behaviour. An approach that brings together multiple sectors, including education, labour, business, law, politics and the media is crucial to tackling suicide and self-harm. The WHO highlights that evaluations of the knowledge and attitudes that priority groups, not only healthcare staff, have of mental health and suicidal behaviour are key to suicide prevention strategies. The aim of this systematic review is to examine the knowledge, attitudes and experiences different stakeholders in LMICs have of self-harm and suicide.Methods and analysisMEDLINE, Embase, PsycINFO, CINAHL, BNI, Social Sciences and Cochrane Library will be searched. Reviewers working independently of each other will screen search results, select studies for inclusion, extract and check extracted data, and rate the quality of the studies using the Strengthening the Reporting of Observational studies in Epidemiology and Critical Appraisals Skills Programme checklists. In anticipation of heterogeneity, a narrative synthesis of quantitative studies will be provided and metaethnography will be used to synthesise qualitative studies.Ethics and disseminationEthical approval is not required. A report will be provided for the funding body, and the systematic review will be submitted for publication in a high-impact, peer-reviewed, open access journal. Results will also be disseminated at conferences, seminars, congresses and symposia, and to relevant stakeholders.PROSPERO registration numberCRD42019135323.