Social skills, paranoid thinking, and social outcomes among young adults

Interpersonal consequences of paranoid ideation, negative symptoms and sleep problems in a transdiagnostic sample of individuals with psychosis

Paranoid ideation is a transdiagnostic construct that is associated with social impairment and often occurs in psychotic spectrum disorders. Little research has examined how paranoid ideation is related to social behaviors that underlie social impairment and may ultimately lead to social rejection. It is important to consider that negative symptoms and sleep problems also contribute to social impairment. No research has assessed the unique and combined influence of paranoid ideation, negative symptoms, and sleep problems on social impairment. Therefore, the current study examined how paranoid ideation, negative symptoms, and sleep problems contribute to poorer social skills and social rejection in a transdiagnostic sample of persons with psychosis and community members (N = 112). Assessments included diagnostic and symptom interviews, questionnaires, behavioral ratings of social skill and facial displays of affect, and naive observer reactions utilizing thin-slice methodology. Greater paranoid ideation, negative symptoms, and sleep problems were each related to poorer social skill and more negative reactions from observers. When considered in path analyses, negative symptoms were associated with observer reports of less willingness to interact with participants through poorer social skill. These findings demonstrate the symptom correlates of social rejection and how interpersonal behavior may contribute to social exclusion.

The relationship between family functioning and psychotic-like experiences of college students: Chain multiple mediating effects

AIM

To explore the mechanism of the relationship between college students' family functioning and psychotic-like experiences, a chain multi-intermediary model is constructed to investigate the multiple mediating effects of interpersonal adaptation, sleep quality and loneliness on college students' family functioning and psychotic-like experiences.

METHODS

Seven hundred seven college students in China were surveyed by using the Family Care Index Questionnaire, Loneliness Scale, Pittsburgh Sleep Quality Index Questionnaire, College Students' Interpersonal Adaptability Subscale and Community Assessment of Psychiatric Experiences.

RESULTS

(a) The detection rate of psychotic-like experiences among college students is 72.14%, of which 6.93% reported frequent psychotic-like experiences; (b) There is a significant correlation between family functioning, sleep quality, loneliness, interpersonal adaptation and psychotic-like experiences of college students; (c) Interpersonal adaptation, loneliness and sleep quality of college students have chain multiple mediating effect in the relationship between family functioning and psychotic-like experiences.

CONCLUSION

The results reveal the mechanism of the relationship between family functioning and psychotic-like experiences, which helps us to better understand how family functioning affects the occurrence and development of college students' psychotic-like experiences.

Loneliness, positive, negative and disorganised Schizotypy before and during the COVID-19 pandemic

Loneliness is common in psychosis and occurs along a continuum. Here we investigate inter-relationships between loneliness, three-dimensional schizotypy, and depressive symptoms before and during the COVID-19 pandemic.

The sample included 507 university students (48.3% participated before and 51.7% during the COVID-19 pandemic) who completed the Multidimensional Schizotypy Scale-Brief, the Counseling Center Assessment of Psychological Symptoms depression scale and the University of California, Los Angeles Loneliness Scale. Schizotypy and depression scores were regressed onto loneliness individually and in multiple regressions.

The cohorts did not differ in any of the schizotypy domains (all p > .29). Depressive symptoms (p = .05) and loneliness (p = .006) were higher during the pandemic than before. Across cohorts, loneliness was significantly associated with positive (β = 0.23, p < .001), negative (β = 0.44, p < .001), and disorganised schizotypy (β = 0.44, p < .001), and with depression (β = 0.72, p < .001). Schizotypy together explained a significant amount of variance in loneliness (R² = 0.26), with significant associations with positive (β = −0.09, p = .047), negative (β = 0.31, p < .001) and disorganised schizotypy (β = 0.34, p < .001). When depression was included (β = 0.69, p < .001), only positive (β = −0.09, p = .008) and negative schizotypy (β = 0.22, p < .001) significantly predicted loneliness.

When all schizotypy dimensions and depression were considered together, only negative schizotypy and depression significantly predicted loneliness. Loneliness and depressive symptoms were higher during the pandemic, but this did not relate to cohort differences in schizotypy.

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Loneliness is uniquely associated with negative schizotypy and depression, but not disorganised schizotypy.

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Certain aspects of positive schizotypy may protect against loneliness.

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Loneliness and depressive symptoms were higher in students during the COVID-19 pandemic than before.

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Cohorts of students assessed before and during the pandemic showed similar levels of schizotypy.

Domains of Vulnerability, Resilience, Health Habits, and Mental and Physical Health for Health Disparities Research

Health disparities associated with severe mental illness (SMI) have become a major public health concern. The disparities are not directly due to the SMI. They involve the same leading causes of premature death as in the general population. The causes of the disparities are therefore suspected to reflect differences in health-related behavior and resilience. As with other problems associated with SMI, studying non-clinical populations at risk for future onset provides important clues about pathways, from vulnerability to unhealthy behavior and compromised resilience, to poor health and reduced quality of life. The purpose of this study was to identify possible pathways in a sample of public university students. Four domains of biosystemic functioning with a priori relevance to SMI-related vulnerability and health disparities were identified. Measures reflecting various well-studied constructs within each domain were factor-analyzed to identify common sources of variance within the domains. Relationships between factors in adjacent domains were identified with linear multiple regression. The results reveal strong relationships between common factors across domains that are consistent with pathways from vulnerability to health disparities, to reduced quality of life. Although the results do not provide dispositive evidence of causal pathways, they serve as a guide for further, larger-scale, longitudinal studies to identify causal processes and the pathways they follow to health consequences.

Loneliness and psychotic experiences among US university students: Findings from the Healthy Minds Study 2020

Loneliness and psychotic experiences (PEs) are common in university students. Despite this, little information is available on the association between loneliness and PEs in this population. In the present study, we studied 30,529 individuals from the Fall semester cohort of the 2020 Healthy Minds Study, a cross-sectional, web-based survey examining mental health and related factors in undergraduate and graduate students aged 18 years or older. Multivariable logistic regression analyses were used to evaluate associations between loneliness (exposure) and PEs (outcome). Loneliness was significantly associated with increased odds of any PEs (odds ratio, 1.32; 95% CI, 1.29-1.36), adjusting for age, gender identity, race/ethnicity, sexual orientation, and international student status. This relationship was consistent across the subtypes of PEs, i.e., delusions (odds ratio, 1.32; 95% CI, 1.29-1.36) and hallucinations (odds ratio, 1.27; 95% CI, 1.21-1.34), adjusting for the same covariates. We found that loneliness is consistently associated with PEs across different subtypes in a university population sample. Future studies may consider testing whether interventions to reduce loneliness among young adults and university students can have an impact on PEs.

The cross-lagged relationship between loneliness, social support, and psychotic-like experiences in young adults

BACKGROUND

Individuals with psychotic disorders often report feelings of loneliness, fewer social contacts and less satisfaction with their social support prior to diagnosis. However, temporal relationships between these variables remain unclear. The primary aim of this study was to examine whether subjective and objective social factors predict, or are predicted by, psychotic-like experiences (PLEs) in healthy young adults.

METHODS

196 undergraduates completed baseline and 3-month follow-up assessments for PLEs, loneliness, social support size, and satisfaction. Cross-lagged panel models were conducted to investigate the temporal relationships between these variables.

RESULTS

Higher loneliness scores, fewer social contacts, and being less satisfied with social support at both time points were significantly associated with higher endorsement of PLEs. Furthermore, after controlling for baseline levels, cross-lagged analyses revealed that individuals who reported feeling more lonely and having less social support at baseline, predicted higher PLEs three months later but not vice versa. No cross-lagged effect was found between the satisfaction of social support and PLEs.

CONCLUSION

The study highlights the significant relationships between loneliness, social support and PLEs. Higher levels of loneliness and smaller social support networks predicted future PLEs. These findings need to be given full consideration in future clinical practice and intervention for young adults with PLEs.

Bidirectional pathways between psychosocial risk factors and paranoid ideation in a general nonclinical population

We investigated (a) whether psychosocial factors (experienced stress, anticipatory worry, social detachment, sleeping disturbances, alcohol use) predict the course of paranoid ideation between the ages of 24 to 50 years and (b) whether the predictive relationships are more likely to proceed from the psychosocial factors to paranoid ideation, or vice versa. The participants (N = 1534-1553) came from the population-based Young Finns study. Paranoid ideation and psychosocial factors were assessed by reliable self-report questionnaires in 2001, 2007, and 2011/2012. The data were analyzed using growth curve and structural equation models. High experienced stress, anticipatory worry, social detachment, frequent sleeping disturbances, and frequent alcohol use predicted more paranoid ideation. More risk factors predicted increasing paranoid ideation. There were bidirectional predictive relationships of paranoid ideation with experienced stress, anticipatory worry, social detachment, and sleeping disturbances. The link between alcohol use and paranoid ideation was only correlative. In conclusion, paranoid ideation increases by reciprocal interactions with stress, worry, social detachment, and sleeping disturbances. The findings support the threat-anticipation model of paranoid ideation, providing important implications for treatment of paranoia.

Loneliness and psychotic experiences in a general population sample

Increased loneliness has been associated with common mental disorders including psychotic disorders. However, as yet, little information is available on the association between loneliness and the occurrence of psychotic experiences (PEs), especially when adjusted for confounding factors. To address this deficit, the current study examined the relationship between PEs and loneliness in a general population sample in the United States (N = 974). We fitted three regression models to examine the associations between loneliness and PEs, using hierarchical adjustments for sociodemographic factors, adverse childhood experiences, and common mental disorders. Even at the highest level of adjustment, loneliness was significantly associated with increased odds for any PEs (OR = 1.25, 95% CI = 1.13-1.39). The same applied to the association between loneliness and delusional mood (OR = 1.29, 95% CI = 1.15-1.44). For delusion of reference and persecution, delusions of control, and hallucinations, there were no significant associations when adjusted for sociodemographic factors, adverse childhood experiences, and common mental disorders. These results suggest that increased loneliness is associated with PEs, particularly delusional mood. Future studies should employ longitudinal data and biological measures to examine potential causal relationships and underlying mechanisms.

The mediating effect of Internet gaming disorder's symptoms on loneliness and aggression among undergraduate students and working adults in Malaysia

Insufficient attention has been given to the integration of the mediating effect of Internet gaming disorder (IGD) symptoms on loneliness and four components of aggression-physical aggression, verbal aggression, anger, and hostility-in the Malaysian context. In the present study, 410 participants with (a) at least 1 year of Internet gaming experience and (b) between ages 20- to 39 years were recruited using the probability proportional to size sampling method. Participants were undergraduate students and working adults. Self-reported questionnaires (the Internet Gaming Disorder Scale, University of California, Los Angeles Loneliness Scale, and the Buss-Perry Aggression Questionnaire) were used. The present study found that loneliness positively predicted four components of aggression (i.e., anger, hostility, physical aggression, and verbal aggression) and symptoms of IGD. Relationships between loneliness and the four components of aggression were partially mediated by IGD symptoms. The present study enriches and consolidates existing empirical evidence, particularly in the Malaysian context. If the mediating effect is not emphasized, it may lead to spurious conclusions that can significantly diminish the effectiveness of interventions that are meant to manage aggression.

Loneliness and the psychosis continuum: a meta-analysis on positive psychotic experiences and a meta-analysis on negative psychotic experiences

There is an increase in interest in the relationships between loneliness and psychosis. The notion of psychosis continuum implies that psychotic experiences extend from clinical populations with psychotic disorders to non-clinical populations. This meta-analytic review aimed to examine the respective associations of loneliness with positive and negative psychotic experiences along the psychosis continuum. A systematic database search was conducted and a total of 30 studies were included in the first meta-analysis and 15 studies were included in the second meta-analysis. There was a medium association between loneliness and positive psychotic experiences (r = 0.302, p < 0.001). In particular, the association between loneliness and paranoia was robust (r = 0.448, p < 0.001). The second meta-analysis revealed a medium association between loneliness and negative psychotic experiences (r = 0.347, p < 0.001). The associations between loneliness and both positive and negative psychotic experiences were found to be smaller among clinical than non-clinical samples. The above findings provided evidence for the associations between loneliness and the two core dimensions of psychotic experiences along the phenomenological continuum. Future research should examine the dynamics of these relationships in both clinical and non-clinical samples, preferably using a single-symptom approach.

Loneliness as a mediator for college students' social skills and experiences of depression and anxiety

INTRODUCTION

Rates of anxiety and depression are increasing among college undergraduates. Existing research has demonstrated a link between social skills and mental health outcomes. This study explores the relationship between verbal social skills (encoding and decoding) and anxiety and depression by measuring the extent to which loneliness mediates these relationships.

METHODS

Baseline data from a cross-sequential study exploring college student mental health was used to analyze social skills, loneliness, as well as, depression and anxiety. A diverse group of students (n = 2,054; M = 19.95; SD = 1.26) participated from two residential colleges in the United States.

RESULTS

Six mediation models were estimated, separately testing whether loneliness mediated the relationship between anxiety and depression and social expressiveness, sensitivity, and control. All six found that (a) anxiety and depression were separately predicted by the verbal encoding skills of social expressivity and social control and the decoding skill of social sensitivity, and (b) all of those relationships were mediated by loneliness. These models accounted for 37-38% of the variability in scores of depression and 17-20% of the variability in scores of anxiety.

CONCLUSIONS

The results of this study indicate verbal social skills play an important role in students experience of loneliness as well as depression and anxiety. Improving the social skills of students should be considered by colleges seeking to reduce the mental health burdens experienced by their students.

Loneliness in Psychosis: A Meta-analytical Review

Loneliness may be related to psychotic symptoms but a comprehensive synthesis of the literature in this area is lacking. The primary aim of the current study is to provide a systematic review and meta-analysis of the association between loneliness and psychotic symptoms in people with psychosis. A search of electronic databases was conducted (PsychINFO, MEDLINE, EMBASE, and Web of Science). A random effects meta-analysis was used to compute a pooled estimate of the correlation between loneliness and psychotic symptoms. Study and outcome quality were assessed using adapted versions of the Agency for Healthcare Research and Quality (AHRQ) tool and GRADE approach, respectively. Thirteen studies were included, providing data from 15 647 participants. A moderate association between psychosis and loneliness was observed (k = 13, N = 15 647, r = .32, 95% CI 0.20, 0.44; I2 = 97.56%; moderate quality evidence). Whether loneliness was assessed by a single-item or a more comprehensive measure had no moderating effect on the estimate. Results indicate that there is a significant positive relationship between loneliness and psychosis. Further studies are needed to determine the causal status of this relationship, but this robust finding should be considered in clinical practice and treatment provision for those with psychotic disorders.

The lonely road to paranoia. A path-analytic investigation of loneliness and paranoia

Loneliness and paranoia are related, but the mechanisms that link them to each other remain unclear. Systematic reviews on loneliness propose a social-cognitive model in which loneliness leads to negative evaluations of other persons and a lack of interpersonal trust. However, the data discussed in these reviews are based on healthy individuals. Building on this model, the present study investigated 1) whether negative interpersonal schemata mediate the association between loneliness and paranoia and 2) whether a low level of perceived social support and less frequent social contact are related to loneliness. Using a cross-sectional design, sixty-five participants with a diagnosis of schizophrenia were recruited online and completed questionnaire-based measures of loneliness, paranoia, negative interpersonal schemata, perceived social support and frequency of social contact. Data were analyzed taking a path-analytic approach. The association between loneliness and paranoia was significantly and fully mediated by negative schemata of others. Moreover, a low level of perceived social support was significantly associated with loneliness, whereas self-reported frequency of social contact was not. The present results highlight the potential role of interpersonal negative schemata in the formation and maintenance of paranoia and elucidate the crucial role of loneliness in the way individuals construe themselves within a social environment.

The impact of loneliness on paranoia: An experimental approach

BACKGROUND AND OBJECTIVES

Loneliness is a common problem in patients with schizophrenia, and may be particularly linked with persecutory ideation. Nevertheless, its role as a potential risk factor in the formation and maintenance of persecutory delusions is largely unexplored.

METHODS

Loneliness was experimentally manipulated using a false-feedback paradigm in a non-clinical sample (n = 60). Change in state paranoia was compared between the induction of increased loneliness, the induction of reduced loneliness and a control condition. Distinct associations between pre-post scores of loneliness and state paranoia were examined at three (medium/high/low) levels of proneness to psychosis across the experimental conditions.

RESULTS

Reduction of loneliness was associated with a significant reduction of present paranoid beliefs, while induction of loneliness lead to more pronounced paranoia on trend significance level. Moreover, proneness to psychosis significantly moderated the impact of loneliness on paranoia. Persons with a pronounced level of proneness to psychosis showed a stronger reduction of paranoid beliefs as a consequence of a decrease in loneliness, than less prone individuals.

LIMITATIONS

A limitation is the small size of our sample, which may have limited the power to detect significant within-group changes in state paranoia in the high-loneliness condition and changes in loneliness in the low-loneliness condition.

CONCLUSIONS

The findings support the feasibility of the experimental design to manipulate loneliness and suggest that loneliness could be a cause of paranoia. However, the findings need to be confirmed in high risk samples to draw conclusions about the role of loneliness in the genesis of clinically relevant levels of paranoia and derive implications for cognitive behaviour therapy.