Mechanisms of the relationship between dysfunctional body image and paranoia-like thoughts. A study within the network analysis framework and using ecological momentary interventions on a non-clinical sample

Negative body image, understood as dissatisfaction with one’s physical appearance, has been consistently linked to poorer mental health outcomes, including depressive and anxiety symptoms as well as suicidal ideation. Given that humans are inherently social beings, individual well-being is strongly shaped by the quality of interpersonal relationships. A crucial factor influencing these relationships is interpersonal trust. While some individuals readily trust others, others exhibit a pervasive lack of trust, which may manifest as paranoia. Paranoia is characterized by beliefs that other people are a primary source of threat or harm and exists on a continuum ranging from mild, non-clinical paranoia-like thoughts (e.g., ideas of reference or suspicions of being judged or criticized) to severe persecutory delusions observed in psychotic disorders. Importantly, paranoia-like thoughts are relatively common in the general population and can cause substantial distress even outside clinical contexts. Emerging evidence suggests a significant association between negative body image and paranoia-like thoughts. The theoretical model proposes that body image may function as an interpersonal vulnerability factor: individuals who perceive their bodies negatively may feel more exposed to social scrutiny and evaluation. In turn, heightened sensitivity to being observed or judged by others may increase mistrust and foster paranoid interpretations of social situations. Despite these theoretical links, the mechanisms underlying the relationship between body image and paranoia remain poorly understood. In particular, there is a lack of systematic, prospective, and interventional studies that would allow causal inferences. Moreover, no previous research has examined how fluctuations in body image relate to paranoia-like thoughts as they unfold in everyday life using ecologically valid methods such as Ecological Momentary Assessment (EMA). The primary aim of the present project is to investigate the causal relationship between body image and paranoia-like thoughts in a non-clinical population. To address the identified gaps in the literature, this project employs a novel mixed longitudinal and experimental design that combines EMA with Ecological Momentary Interventions (EMI). In the first phase, the study will examine whether natural, moment-to-moment fluctuations in perceived body image prospectively predict changes in paranoia-like thoughts over a one-week observation period. This phase will also explore potential contributing and confounding factors, including sleep quality, interoceptive awareness, negative affect, and self-esteem. In the second phase, the project will experimentally test the directionality of this relationship by implementing a CBT-based psychological intervention aimed at improving perceived body image in participants’ natural environments. Using ecologically valid, momentary tasks designed to enhance body image, the study will assess whether experimentally induced improvements in body image lead to subsequent reductions in paranoia-like thoughts. We hypothesize that positive manipulation of body image will result in measurable decreases in paranoia-like ideation. The expected outcomes of this project include a clearer understanding of the temporal and causal links between body image and paranoia-like thoughts, as well as empirical evidence supporting body image as a modifiable risk factor for paranoid thinking. By integrating real-time assessment with real-time intervention, this project will provide valuable insights into everyday psychological processes and contribute to the development of innovative, scalable preventive interventions.