Dr.Freeman et al
nature of the link made between affect and paranoia. It could not be determined whether the affective biases contribute to the future occurrence of paranoia, however plausible this might seem. It was also not possible to examine whether the cognitive processes are mediators of the links between negative affect and paranoia. Longitudinal study of these processes would be especially helpful. We did not alter significance levels for multiple testing, ascribing to the view that “simply describing what tests of significance have been performed, and why, is generally the best method of dealing with multiple comparisons.”46 It was shown that a bias in anticipation of events only occurred for threatening and not for positive or neutral events; it would be helpful in future studies to examine different types of threatening events (eg, social and nonsocial situations) in order to assess the generalization of threat anticipation. It would also be valuable to examine the influence of affective processes in relation to delusional subtypes.47 Other affective processes, for instance, worry,12 emotion regulation,48 and interpersonal sensitivity33 have recently been investigated in relation to paranoid thinking, and future work needs to identify those that are key to understanding and therefore important to target in treatment. Our view is that treating emotional dysfunction in patients should lead to reductions in psychotic experiences, and this requires clinical evaluation.49,50