Better safe than sorry? Exploratory associations between fear-learning processes and later paranoia in threat-exposed adolescents in standardized Virtual Reality environments

Abstract Background Childhood threat exposure (CTE) has been linked to altered fear-learning, yet its prospective role in adolescent paranoia remains unclear. This study examined whether threat–safety discrimination (TSD) and fear generalisation (FG) predict Virtual Reality (VR)-assessed state paranoia 18 months later, and whether CTE and gender moderate these associations. Methods 120 adolescents (aged 12–16) participated at Wave 1, completing a classical conditioning and FG task and reporting CTE. At Wave 2, 97 participants completed a VR social environment assessing state paranoia. Linear regression models tested TSD and FG main effects, followed by moderation by CTE, and the FG × CTE × gender interactions. Results Neither TSD (β = 0.14, p = .198) nor FG (β = −0.07, p = .530) predicted Wave 2 paranoia at group level. However, CTE significantly moderated the association between TSD and later paranoia (β = 0.21, p = .035), whereby adolescents with higher CTE and better discrimination showed higher paranoia. A significant FG × CTE × gender interaction (β = 0.53, p = .044) revealed divergent pathways: in boys, higher FG predicted lower paranoia (F(1, 84) = 7.34, p = .008), particularly with higher CTE, which was absent in girls. Conclusion Exploratory interactions, partly opposite to our hypotheses, suggested that better TSD and reduced FG were associated with higher paranoia in threat-exposed youth, particularly boys. This pattern may reflect a “better safe than sorry” strategy involving fine-grained appraisal of threat and safety cues, potentially adaptive in unpredictable and threatening environments but at the cost of greater distrust.