Do loneliness and social exclusion breed paranoia? An experience sampling investigation across the psychosis continuum.

Journal article


Bell, Victoria, Velthorst, Eva, Almansa, Jorge, Myin-Germeys, Inez, Shergill, Sukhi and Fett, Anne-Kathrin 2023. Do loneliness and social exclusion breed paranoia? An experience sampling investigation across the psychosis continuum. Schizophrenia Research: Cognition. 33, p. 100282. https://doi.org/10.1016/j.scog.2023.100282
AuthorsBell, Victoria, Velthorst, Eva, Almansa, Jorge, Myin-Germeys, Inez, Shergill, Sukhi and Fett, Anne-Kathrin
AbstractThe role of loneliness and social exclusion in the development of paranoia is largely unexplored. Negative affect may mediate potential associations between these factors. We investigated the temporal relationships of daily-life loneliness, felt social exclusion, negative affect, and paranoia across the psychosis continuum. Seventy-five participants, including 29 individuals with a diagnosis of non-affective psychosis, 20 first-degree relatives, and 26 controls used an Experience Sampling Method (ESM) app to capture the fluctuations in loneliness, feelings of social exclusion, paranoia, and negative affect across a 1-week period. Data were analysed with multilevel regression analyses. In all groups, loneliness and feelings of social exclusion were independent predictors of paranoia over time (b = 0.05,  < .001 and b = 0.04,  < .05, respectively). Negative affect predicted paranoia (b = 0.17,  < .001) and partially mediated the associations between loneliness, social exclusion, and paranoia. It also predicted loneliness (b = 0.15,  < .0001), but not social exclusion (b = 0.04,  = .21) over time. Paranoia predicted social exclusion over time, with more pronounced effects in controls (b = 0.43) than patients (b = 0.19; relatives: b = 0.17); but not loneliness (b = 0.08,  = .16). Paranoia and negative affect worsen in all groups following feelings of loneliness and social exclusion. This highlights the importance of a sense of belonging and being included for mental well-being. Loneliness, feeling socially excluded, and negative affect were independent predictors of paranoid thinking, suggesting they represent useful targets in its treatment. [Abstract copyright: © 2023 The Author(s).]
KeywordsExperience sampling; Social exclusion; Negative affect; Paranoia; Loneliness
Year2023
JournalSchizophrenia Research: Cognition
Journal citation33, p. 100282
PublisherElsevier
ISSN2215-0013
Digital Object Identifier (DOI)https://doi.org/10.1016/j.scog.2023.100282
https://doi.org/S2215-0013(23)00005-7
Official URLhttps://www.sciencedirect.com/science/article/pii/S2215001323000057?via%3Dihub
Publication dates
Online24 Mar 2023
Publication process dates
Accepted17 Mar 2023
Deposited17 Apr 2023
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