The temporal association between social isolation, distress, and psychotic experiences in individuals at clinical high-risk for psychosis

• Published in: Psychological medicine Vol. 54; no. 8; pp. 1684 - 1692
• Main Authors: Akcaoglu, Zeynep, Vaessen, Thomas, Velthorst, Eva, Lafit, Ginette, Achterhof, Robin, Nelson, Barnaby, McGorry, Patrick, Schirmbeck, Frederike, Morgan, Craig, Hartmann, Jessica, van der Gaag, Mark, de Haan, Lieuwe, Valmaggia, Lucia, McGuire, Philip, Kempton, Matthew, Steinhart, Henrietta, Klippel, Annelie, Viechtbauer, Wolfgang, Batink, Tim, van Winkel, Ruud, van Amelsvoort, Thérèse, Marcelis, Machteld, van Aubel, Evelyne, Reininghaus, Ulrich, Myin-Germeys, Inez
• Format: Journal Article
• Language: English
• Published: England Cambridge University Press 01.06.2024
• Subjects: Adolescent; Adult; Affect (Psychology); Ecological Momentary Assessment; Emotional behavior; Female; High risk; Humans; Hypotheses; Male; Psychological Distress; Psychosis; Psychotic Disorders - psychology; Risk Factors; Social interaction; Social interactions; Social isolation; Social Isolation - psychology; Social networks; Stress; Stress, Psychological - psychology; Withdrawal; Young Adult; distress; solitary stress; social isolation; clinical high-risk; experience sampling methodology; psychotic experiences; negative affect
• ISSN: 0033-2917; 1469-8978
• DOI: 10.1017/S0033291723003598

Psychotic experiences (PEs) and social isolation (SI) seem related during early stages of psychosis, but the temporal dynamics between the two are not clear. Literature so far suggests a self-perpetuating cycle wherein momentary increases in PEs lead to social withdrawal, which, subsequently, triggers PEs at a next point in time, especially when SI is associated with increased distress. The current study investigated the daily-life temporal associations between SI and PEs, as well as the role of SI-related and general affective distress in individuals at clinical high risk (CHR) for psychosis. We used experience sampling methodology in a sample of 137 CHR participants. We analyzed the association between SI, PEs, and distress using time-lagged linear mixed-effects models. SI did not predict next-moment fluctuations in PEs, or . Furthermore, although SI-related distress was not predictive of subsequent PEs, general affective distress during SI was a robust predictor of next-moment PEs. Our results suggest that SI and PEs are not directly related on a moment-to-moment level, but a negative emotional state when alone does contribute to the risk of PEs. These findings highlight the role of affective wellbeing during early-stage psychosis development.