Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Raymond DiGiuseppe

Second Advisor

Rafael Javier

Third Advisor

Wilson McDermut


Paranoia is strongly associated with anger. This relationship is found across the psychosis spectrum, including individuals at high risk of developing psychosis. The relationship is commonly addressed in the measurement of anger but is rarely addressed in clinical studies. This study explored the relationship between anger regulation and paranoid ideation as well as factors that mediate and moderate this relationship. Specifically, the study examined whether the influence of anger regulation cognitive-behavioral interventions on paranoid ideation changed as aspects of emotional awareness changed. It also examined whether interventions for anger regulation that target different phases of anger generation impacted paranoid ideation through different mechanisms - of either experiential avoidance or irrational beliefs about the need to habitually feel comfortable. Participants were undergraduate students and young adults in the general population. They completed the study through an online survey platform – Qualtrics, which randomly assigned participants to view one of three interventions: a Rational Emotive Behavior Therapy (REBT) a-priori intervention – that targets beliefs that occur prior to anger arousal, an Acceptance and Commitment Therapy (ACT) post-hoc intervention – that targets actions after anger is aroused, or a control condition – suggesting experiencing anger naturally. Participants completed a computerized anger-induction interview and attempted to regulate their anger using the technique they learned in the intervention video. Results showed a strong positive association between levels of state anger and conviction in paranoid ideation, both at baseline and at the end of the study, following two anger regulation attempts. Furthermore, individuals with high levels of state anger and conviction in paranoid ideation were less attentive to their emotions, had less clarity of their emotions, were more likely to be experientially avoidant, and to have irrational beliefs about having to be comfortable. Despite these strong associations, the hypothesized moderation and mediation models failed to predict the outcomes of state anger and conviction in paranoid ideation, which were predicted only by clarity of emotions. Higher levels of clarity of emotions were predictive of lower state anger and less conviction in paranoid ideation. Limitations, future research, and implications for treatment are discussed.