SpringerLink
Log in

Associations between social engagement, internalizing symptoms, and delusional ideation in the general population

  • Research
  • Published:
Social Psychiatry and Psychiatric Epidemiology Aims and scope Submit manuscript

Abstract

Background

Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms—such as symptoms of depression, anxiety, and trauma exposure—are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically.

Methods

Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate.

Results

Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = − 0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = − 0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = − 0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement.

Conclusions

These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability

Not applicable.

References

  1. Armando M, Nelson B, Yung AR, Ross M, Birchwood M, Girardi P, Nastro PF (2010) Psychotic-like experiences and correlation with distress and depressive symptoms in a community sample of adolescents and young adults. Schizophr Res 119(1–3):258–265. https://doi.org/10.1016/J.SCHRES.2010.03.001

    Article  PubMed  Google Scholar 

  2. Barahmand U, Ahmad HS (2016) Psychotic-like experiences and psychological distress: the role of resilience. J Am Psychiatr Nurses Assoc 22(4):312–319. https://doi.org/10.1177/1078390316653802

    Article  PubMed  Google Scholar 

  3. Brett C, Heriot-Maitland C, McGuire P, Peters E (2014) Predictors of distress associated with psychotic-like anomalous experiences in clinical and non-clinical populations. Br J Clin Psychol 53(2):213–227. https://doi.org/10.1111/BJC.12036

    Article  PubMed  Google Scholar 

  4. Karcher NR, Loewy RL, Savill M, Avenevoli S, Huber RS, Makowski C, Sher KJ, Barch DM (2021) Persistent and distressing psychotic-like experiences using adolescent brain cognitive developmentSM study data. Molecular Psychiat 27(3):1490–1501. https://doi.org/10.1038/s41380-021-01373-x

    Article  Google Scholar 

  5. Saha SG, Scott J, Varghese D, McGrath J (2011) The association between general psychological distress and delusional-like experiences: a large population-based study. Schizophrenia Res 127(1–3):246–251. https://doi.org/10.1016/J.SCHRES.2010.12.012

    Article  Google Scholar 

  6. Dominguez MDG, Wichers M, Lieb R, Wittchen HU, Van Os J (2011) Evidence that onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study. Schizophr Bull 37(1):84–93. https://doi.org/10.1093/SCHBUL/SBP022

    Article  CAS  PubMed  Google Scholar 

  7. Kaymaz N, Drukker M, Lieb R, Wittchen HU, Werbeloff N, Weiser M, Lataster T, Van Os J (2012) Do subthreshold psychotic experiences predict clinical outcomes in unselected non-help-seeking population-based samples? A systematic review and meta-analysis, enriched with new results. Psychol Med 42(11):2239–2253. https://doi.org/10.1017/S0033291711002911

    Article  CAS  PubMed  Google Scholar 

  8. Linscott RJ, Van Os J (2013) An updated and conservative systematic review and meta-analysis of epidemiological evidence on psychotic experiences in children and adults: on the pathway from proneness to persistence to dimensional expression across mental disorders. Psychol Med 43(6):1133–1149. https://doi.org/10.1017/S0033291712001626

    Article  CAS  PubMed  Google Scholar 

  9. Tandon N, Montrose D, Shah J, Rajarethinam RP, Diwadkar VA, Keshavan MS (2012) Early prodromal symptoms can predict future psychosis in familial high-risk youth. J Psychiatr Res 46(1):105–110. https://doi.org/10.1016/J.JPSYCHIRES.2011.09.019

    Article  PubMed  Google Scholar 

  10. Yung AR, Lin A (2016) Psychotic experiences and their significance. World Psychiatry 15(2):130–131. https://doi.org/10.1002/WPS.20328

    Article  PubMed  PubMed Central  Google Scholar 

  11. Fusar-Poli P, Bonoldi I, Yung AR, Borgwardt S, Kempton MJ, Valmaggia L, Barale F, Caverzasi E, McGuire P (2012) Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Arch Gen Psychiatry 69(3):220–229. https://doi.org/10.1001/ARCHGENPSYCHIATRY.2011.1472

    Article  PubMed  Google Scholar 

  12. Kelleher I, Devlin N, Wigman JTW, Kehoe A, Murtagh A, Fitzpatrick C, Cannon M (2014) Psychotic experiences in a mental health clinic sample: implications for suicidality, multimorbidity and functioning. Psychol Med 44(8):1615–1624. https://doi.org/10.1017/S0033291713002122

    Article  CAS  PubMed  Google Scholar 

  13. Lin A, Wood SJ, Nelson B, Beavan A, McGorry P, Yung AR (2015) Outcomes of nontransitioned cases in a sample at ultra-high risk for psychosis. Am J Psychiatry 172(3):249–258. https://doi.org/10.1176/APPI.AJP.2014.13030418

    Article  PubMed  Google Scholar 

  14. Van Os J, Reininghaus U (2016) Psychosis as a transdiagnostic and extended phenotype in the general population. World Psychiatry 15(2):118–124. https://doi.org/10.1002/WPS.20310

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yung AR, Nelson B, Baker K, Buckby JA, Baksheev G, Cosgrave EM (2009) Psychotic-like experiences in a community sample of adolescents: Implications for the continuum model of psychosis and prediction of schizophrenia. Aust N Z J Psychiatry 43(2):118–128. https://doi.org/10.1080/00048670802607188

    Article  PubMed  Google Scholar 

  16. Yung AR, Buckby JA, Cotton SM, Cosgrave EM, Killackey EJ, Stanford C, Godfrey K, McGorry PD (2006) Psychotic-like experiences in nonpsychotic help-seekers: associations with distress, depression, and disability. Schizophr Bull 32(2):352–359. https://doi.org/10.1093/SCHBUL/SBJ018

    Article  PubMed  Google Scholar 

  17. Preti A, Bonventre E, Ledda V, Petretto DR, Masala C (2007) Hallucinatory experiences, delusional thought proneness, and psychological distress in a nonclinical population. J Nerv Mental Dis 195(6):484–491. https://doi.org/10.1097/NMD.0B013E31802F205E

    Article  Google Scholar 

  18. Fan L, Bass E, Klein H, Springfield C, Pinkham A (2022) A preliminary investigation of paranoia variability and its association with social functioning. Schizophrenia Res 29:100258. https://doi.org/10.1016/J.SCOG.2022.100258

    Article  Google Scholar 

  19. Freeman D, Startup H, Dunn G, Wingham G, Černis E, Evans N, Lister R, Pugh K, Cordwell J, Kingdon D (2014) Persecutory delusions and psychological well-being. Soc Psychiatry Psychiatr Epidemiol 49(7):1045–1050. https://doi.org/10.1007/S00127-013-0803-Y

    Article  PubMed  Google Scholar 

  20. Pinkham AE, Harvey PD, Penn DL (2016) Paranoid individuals with schizophrenia show greater social cognitive bias and worse social functioning than non-paranoid individuals with schizophrenia. Schizophrenia Res 3:33–38. https://doi.org/10.1016/J.SCOG.2015.11.002

    Article  Google Scholar 

  21. Cantor-Graae E (2007) The contribution of social factors to the development of schizophrenia: a review of recent findings. Canadian Psychiatric Associat. https://doi.org/10.1177/070674370705200502

    Article  Google Scholar 

  22. Garety PA, Bebbington P, Fowler D, Freeman D, Kuipers E (2007) Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychol Med 37(10):1377–1391. https://doi.org/10.1017/S003329170700013X

    Article  PubMed  Google Scholar 

  23. Gin K, Stewart C, Abbott C, Banerjea P, Bracegirdle K, Browning S, Byrne M, Emsley R, Ginestet C, Hirsch C, Kuipers E, Laurens KR, Onwumere J, Plant D, Valmaggia L, Jolley S (2021) Psychosocial predictors of distressing unusual experiences in adolescence: Testing the fit of an adult cognitive model of psychosis. Schizophr Res 237:1–8. https://doi.org/10.1016/J.SCHRES.2021.08.018

    Article  PubMed  Google Scholar 

  24. MacKinnon AL, Naguib M, Barr HJ, Levinsson A, Robins S, Feeley N, Hayton B, Zelkowitz P, Gold I (2017) Delusional ideation during the perinatal period in a community sample. Schizophr Res 179:17–22. https://doi.org/10.1016/J.SCHRES.2016.09.027

    Article  PubMed  Google Scholar 

  25. Ruffell T, Azis M, Hassanali N, Ames C, Browning S, Bracegirdle K, Corrigall R, Laurens KR, Hirsch C, Kuipers E, Maddox L, Jolley S (2016) Variation in psychosocial influences according to the dimensions and content of children’s unusual experiences: potential routes for the development of targeted interventions. Eur Child Adolesc Psychiatry 25(3):311–319. https://doi.org/10.1007/S00787-015-0739-8

    Article  PubMed  Google Scholar 

  26. Saha S, Scott JG, Varghese D, McGrath JJ (2013) Socio-economic disadvantage and delusional-like experiences: a nationwide population-based study. Eur Psychiatry 28(1):59–63. https://doi.org/10.1016/J.EURPSY.2011.09.004

    Article  CAS  PubMed  Google Scholar 

  27. Varese F, Smeets F, Drukker M, Lieverse R, Lataster T, Viechtbauer W, Read J, van Os J, Bentall RP (2012) Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control. Prospect Cross-Sect Cohort Stud Schizophrenia Bulletin 38(4):661–671. https://doi.org/10.1093/schbul/sbs050

    Article  Google Scholar 

  28. Haslam C, Cruwys T, Haslam SA, Jetten J (2015) Social connectedness and health. Encyclopedia Geropsychol. https://doi.org/10.1007/978-981-287-080-3_46-2

    Article  Google Scholar 

  29. Hirschfeld RMA, Montgomery SA, Keller MB, Kasper S, Schatzburg AF, Moller H, Healy D, Baldwin D, Humble M, Versiani M, Montenegro R, Bourgeois M (2000) Social functioning in depression: a review. J Clin Psychiatry 61(4):268–275

    Article  CAS  PubMed  Google Scholar 

  30. Dell NA, Pelham M, Murphy AM (2019) Loneliness and depressive symptoms in middle aged and older adults experiencing serious mental Illness. Psychiatr Rehabil J 42(2):113–120. https://doi.org/10.1037/PRJ0000347

    Article  PubMed  Google Scholar 

  31. Lasgaard M, Goossens L, Bramsen RH, Trillingsgaard T, Elklit A (2011) Different sources of loneliness are associated with different forms of psychopathology in adolescence. J Res Pers 45(2):233–237. https://doi.org/10.1016/J.JRP.2010.12.005

    Article  Google Scholar 

  32. Perese EF, Wolf M (2009) Combating loneliness among persons with severe mental illness: social network interventions’ characteristics, effectiveness, and applicability. Issues Ment Health Nurs 26(6):591–609. https://doi.org/10.1080/01612840590959425

    Article  Google Scholar 

  33. Chrostek A, Grygiel P, Anczewska M, Wciórka J, Świtaj P (2016) The intensity and correlates of the feelings of loneliness in people with psychosis. Compr Psychiatry 70:190–199. https://doi.org/10.1016/J.COMPPSYCH.2016.07.015

    Article  CAS  PubMed  Google Scholar 

  34. Chau AKC, Zhu C, So SHW (2019) Loneliness and the psychosis continuum: a meta-analysis on positive psychotic experiences and a meta-analysis on negative psychotic experiences. Int Rev Psychiatry 31(5–6):471–490. https://doi.org/10.1080/09540261.2019.1636005

    Article  PubMed  Google Scholar 

  35. Badcock JC, Adery LH, Park S (2020) Loneliness in psychosis: A practical review and critique for clinicians. Clin Psychol Practice 27(4):e12345. https://doi.org/10.1111/CPSP.12345

    Article  Google Scholar 

  36. Butter S, Murphy J, Shevlin M, Houston J (2017) Social isolation and psychosis-like experiences: a UK general population analysis. Psychosis 9(4):291–300. https://doi.org/10.1080/17522439.2017.1349829

    Article  Google Scholar 

  37. Collip D, Wigman JTW, Lin A, Nelson B, Oorschot M, Vollebergh WAM, Ryan J, Baksheev G, Wichers M, Van Os J, Myin-Germeys I, Yung AR (2013) Dynamic association between interpersonal functioning and positive symptom dimensions of psychosis over time: a longitudinal study of healthy adolescents. Schizophr Bull 39(1):179–185. https://doi.org/10.1093/SCHBUL/SBR115

    Article  PubMed  Google Scholar 

  38. Combs DR, Finn JA, Wohlfahrt W, Penn DL, Basso MR (2013) Social cognition and social functioning in nonclinical paranoia. Cogn Neuropsychiatry 18(6):531–548. https://doi.org/10.1080/13546805.2013.766595

    Article  PubMed  Google Scholar 

  39. Heins M, Achterhof R, Collip D, Viechtbauer W, Kirtley OJ, Gunther N, van Os J, Feron F, Myin-Germeys I (2019) Social functioning and subclinical psychosis in adolescence: a longitudinal general adolescent population study. Acta Psychiatr Scand 140(3):275–282. https://doi.org/10.1111/ACPS.13069

    Article  CAS  PubMed  Google Scholar 

  40. Korenic SA, Ered A, Pierce KM, Calvo EM, Olino TM, Murty VP, Ellman LM (2021) Examining self-reported social functioning, sleep quality, and psychotic-like experiences in college students. J Psychiatr Res 143:54–59. https://doi.org/10.1016/J.JPSYCHIRES.2021.08.023

    Article  PubMed  PubMed Central  Google Scholar 

  41. Le TP, Cowan T, Schwartz EK, Elvevåg B, Holmlund TB, Foltz PW, Barkus E, Cohen AS (2019) The importance of loneliness in psychotic-like symptoms: data from three studies. Psychiatry Res 282:112625. https://doi.org/10.1016/J.PSYCHRES.2019.112625

    Article  PubMed  Google Scholar 

  42. Narita Z, Stickley A, DeVylder J (2020) Loneliness and psychotic experiences in a general population sample. Schizophr Res 218:146–150. https://doi.org/10.1016/J.SCHRES.2020.01.018

    Article  PubMed  Google Scholar 

  43. Oshima N, Nishida A, Fukushima M, Shimodera S, Kasai K, Okazaki Y, Sasaki T (2010) Psychotic-like experiences (PLEs) and mental health status in twin and singleton Japanese high school students. Early Interv Psychiatry 4(3):206–213. https://doi.org/10.1111/J.1751-7893.2010.00186.X

    Article  PubMed  Google Scholar 

  44. Saha S, Scott J, Varghese D, McGrath J (2012) Social support and delusional-like experiences: a nationwide population-based study. Epidemiol Psychiatric Sci 21(2):203–212. https://doi.org/10.1017/S2045796011000862

    Article  CAS  Google Scholar 

  45. Unterrassner L, Wyss TA, Wotruba D, Haker H, Rössler W (2017) The intricate relationship between psychotic-like experiences and associated subclinical symptoms in healthy individuals. Front Psychol 8(SEP):1537. https://doi.org/10.3389/FPSYG.2017.01537

    Article  PubMed  PubMed Central  Google Scholar 

  46. Horan WP, Subotnik KL, Snyder KS, Nuechterlein KH (2006) Do recent-onset schizophrenia patients experience a “social network crisis”? Psychiatry 69(2):115–129. https://doi.org/10.1521/PSYC.2006.69.2.115

    Article  PubMed  Google Scholar 

  47. Berry C, Greenwood K (2018) Direct and indirect associations between dysfunctional attitudes, self-stigma, hopefulness and social inclusion in young people experiencing psychosis. Schizophr Res 193:197–203. https://doi.org/10.1016/J.SCHRES.2017.06.037

    Article  PubMed  Google Scholar 

  48. Springfield CR, Ackerman RA, Pinkham AE (2021) The dyadic effects of subclinical paranoia on relationship satisfaction in roommate relationships and college adjustment. J Abnorm Psychol 130(7):797–805. https://doi.org/10.1037/ABN0000689

    Article  PubMed  Google Scholar 

  49. Fett AKJ, Hanssen E, Eemers M, Peters E, Shergill SS (2022) Social isolation and psychosis: an investigation of social interactions and paranoia in daily life. Eur Arch Psychiatry Clin Neurosci 272(1):119–127. https://doi.org/10.1007/S00406-021-01278-4

    Article  PubMed  Google Scholar 

  50. Boyda D, McFeeters D (2015) Childhood maltreatment and social functioning in adults with sub-clinical psychosis. Psychiatry Res 226(1):376–382. https://doi.org/10.1016/J.PSYCHRES.2015.01.023

    Article  PubMed  Google Scholar 

  51. Gutteridge TP, Kelly AB, Laurens KR (2023) Increased likelihood of distressing and functionally impairing psychotic-like experiences among children with co-occurring internalising and externalising problems. Schizophr Res 252:225–230. https://doi.org/10.1016/J.SCHRES.2023.01.017

    Article  PubMed  Google Scholar 

  52. Isaksson J, Vadlin S, Olofsdotter S, Åslund C, Nilsson KW (2020) Psychotic-like experiences during early adolescence predict symptoms of depression, anxiety, and conduct problems three years later: a community-based study. Schizophr Res 215:190–196. https://doi.org/10.1016/J.SCHRES.2019.10.033

    Article  PubMed  Google Scholar 

  53. Johns LC, Cannon M, Singleton N, Murray RM, Farrell M, Brugha T, Bebbington P, Jenkins R, Meltzer H (2004) Prevalence and correlates of self-reported psychotic symptoms in the British population. Br J Psychiatry 185(4):298–305. https://doi.org/10.1192/BJP.185.4.298

    Article  PubMed  Google Scholar 

  54. Lancefield KS, Raudino A, Downs JM, Laurens KR (2016) Trajectories of childhood internalizing and externalizing psychopathology and psychotic-like experiences in adolescence: A prospective population-based cohort study. Dev Psychopathol 28(2):527–536. https://doi.org/10.1017/S0954579415001108

    Article  PubMed  PubMed Central  Google Scholar 

  55. McGrath JJ, Saha S, Lim CCW, Aguilar-Gaxiola S, Alonso J, Andrade LH, Bromet EJ, Bruffaerts R, De Almeida JMC, Cardoso G, De Girolamo G, Fayyad J, Florescu S, Gureje O, Haro JM, Kawakami N, Koenen KC, Kovess-Masfety V, Lee S, Wojtyniak B (2017) Trauma and psychotic experiences: transnational data from the World Mental Health Survey. British J Psychiat 211(6):373–380. https://doi.org/10.1192/BJP.BP.117.205955

    Article  Google Scholar 

  56. Saha S, Varghese D, Slade T, Degenhardt L, Mills K, McGrath J, Scott J (2011) The association between trauma and delusional-like experiences. Psychiatry Res 189(2):259–264. https://doi.org/10.1016/J.PSYCHRES.2011.03.019

    Article  PubMed  Google Scholar 

  57. Scott J, Chant D, Andrews G, Martin G, McGrath J (2007) Association between trauma exposure and delusional experiences in a large community-based sample. Br J Psychiatry 190(4):339–343. https://doi.org/10.1192/BJP.BP.106.026708

    Article  PubMed  Google Scholar 

  58. van Os J, Hanssen M, Bijl RV, Ravelli A (2000) Strauss (1969) revisited: a psychosis continuum in the general population? Schizop Res 45(1–2):11–20. https://doi.org/10.1016/S0920-9964(99)00224-8

    Article  Google Scholar 

  59. Wigman JTW, Van Nierop M, Vollebergh WAM, Lieb R, Beesdo-Baum K, Wittchen HU, Van Os J (2012) Evidence that psychotic symptoms are prevalent in disorders of anxiety and depression, impacting on illness onset, risk, and severity—implications for diagnosis and ultra-high risk research. Schizophr Bull 38(2):247–257. https://doi.org/10.1093/SCHBUL/SBR196

    Article  PubMed  PubMed Central  Google Scholar 

  60. Wong KKY, Francesconi M, Flouri E (2021) Internalizing and externalizing problems across childhood and psychotic-like experiences in young-adulthood: the role of developmental period. Schizophr Res 231:108–114. https://doi.org/10.1016/J.SCHRES.2021.03.016

    Article  PubMed  Google Scholar 

  61. Yamasaki S, Usami S, Sasaki R, Koike S, Ando S, Kitagawa Y, Matamura M, Fukushima M, Yonehara H, Foo JC, Nishida A, Sasaki T (2018) The association between changes in depression/anxiety and trajectories of psychotic-like experiences over a year in adolescence. Schizophr Res 195:149–153. https://doi.org/10.1016/J.SCHRES.2017.10.019

    Article  PubMed  Google Scholar 

  62. Byrne GJ, Steele SJ, Pachana NA, Oude Voshaar RC (2015) Delusion-like experiences in older people with anxiety disorders. Int Psychogeriatr 27(7):1191–1196. https://doi.org/10.1017/S1041610215000113

    Article  PubMed  Google Scholar 

  63. Hartley S, Barrowclough C, Haddock G (2013) Anxiety and depression in psychosis: a systematic review of associations with positive psychotic symptoms. Acta Psychiatr Scand 128(5):327–346. https://doi.org/10.1111/ACPS.12080

    Article  CAS  PubMed  Google Scholar 

  64. Saha S, Scott J, Varghese D, McGrath J (2012) Anxiety and depressive disorders are associated with delusional-like experiences: a replication study based on a National Survey of Mental Health and Wellbeing. BMJ Open 2(3):e001001. https://doi.org/10.1136/BMJOPEN-2012-001001

    Article  PubMed  PubMed Central  Google Scholar 

  65. Abramson LY, Metalsky GI, Alloy LB (1989) Hopelessness depression: a theory-based subtype of depression. Psychol Rev 96(2):358–372. https://doi.org/10.1037/0033-295X.96.2.358

    Article  Google Scholar 

  66. Panzarella C, Alloy LB, Whitehouse WG (2006) Expanded hopelessness theory of depression: On the mechanisms by which social support protects against depression. Cogn Ther Res 30(3):307–333. https://doi.org/10.1007/S10608-006-9048-3

    Article  Google Scholar 

  67. Weittenhiller LP, Mikhail ME, Mote J, Campellone TR, Kring AM (2021) What gets in the way of social engagement in schizophrenia? World J Psychiat 11(1):13. https://doi.org/10.5498/WJP.V11.I1.13

    Article  Google Scholar 

  68. Asher L, Zammit S, Sullivan S, Dorrington S, Heron J, Lewis G (2013) The relationship between psychotic symptoms and social functioning in a non-clinical population of 12 year olds. Schizophr Res 150(2–3):404–409. https://doi.org/10.1016/J.SCHRES.2013.08.031

    Article  PubMed  Google Scholar 

  69. Deng WY, Grove T, Deldin P (2020) Anxiety mediates the relationship between psychotic-like experiences and social functioning in the general population. Psychopathology 53(2):95–102. https://doi.org/10.1159/000507869

    Article  PubMed  Google Scholar 

  70. Jaya ES, Hillmann TE, Reininger KM, Gollwitzer A, Lincoln TM (2017) Loneliness and psychotic symptoms: the mediating role of depression. Cogn Ther Res 41(1):106–116. https://doi.org/10.1007/S10608-016-9799-4

    Article  Google Scholar 

  71. Sündermann O, Onwumere J, Kane F, Morgan C, Kuipers E (2014) Social networks and support in first-episode psychosis: Exploring the role of loneliness and anxiety. Soc Psychiatry Psychiatr Epidemiol 49(3):359–366. https://doi.org/10.1007/S00127-013-0754-3

    Article  PubMed  Google Scholar 

  72. Nooner KB, Colcombe SJ, Tobe RH, Mennes M, Benedict MM, Moreno AL, Panek LJ, Brown S, Zavitz ST, Li Q, Sikka S, Gutman D, Bangaru S, Schlachter RT, Kamiel SM, Anwar AR, Hinz CM, Kaplan MS, Rachlin AB, Milham MP (2012) The NKI-rockland sample: a model for accelerating the pace of discovery science in psychiatry. Front Neurosci. https://doi.org/10.3389/FNINS.2012.00152

    Article  PubMed  PubMed Central  Google Scholar 

  73. Peters E, Joseph S, Day S, Garety P (2004) Measuring delusional ideation: the 21-item Peters et al. delusions inventory (PDI). Schizophr Bull 30(4):1005–1022. https://doi.org/10.1093/oxfordjournals.schbul.a007116

    Article  PubMed  Google Scholar 

  74. Sheffield JM, Brinen AP, Freeman D (2021) Paranoia and grandiosity in the general population: differential associations with putative causal factors. Front Psych 12:559. https://doi.org/10.3389/FPSYT.2021.668152

    Article  Google Scholar 

  75. Beck A, Steer R, Brown G (1996) Beck depression inventory- II. Psychological Assessment

  76. Spielberger CD (1970) Manual for the state-trait anxietry, inventory. Consulting Psychologist

  77. Elliott DM, Briere J (1992) Sexual abuse trauma among professional women: validating the trauma symptom checklist-40 (TSC-40). Child Abuse Negl 16(3):391–398. https://doi.org/10.1016/0145-2134(92)90048-V

    Article  CAS  PubMed  Google Scholar 

  78. Holtzman RE, Rebok GW, Saczynski JS, Kouzis AC, Doyle KW, Eaton WW (2004) Social network characteristics and cognition in middle-aged and older adults. J Gerontol 59(6):P278–P284. https://doi.org/10.1093/GERONB/59.6.P278

    Article  Google Scholar 

  79. Hayes AF (2021) Introduction to Mediation, Moderation, and Conditional Process Analysis (TD Little Ed; Third Edition). Guildford Press, UK

  80. Gizdic A, Baxter T, Barrantes-Vidal N, Park S (2022) Loneliness and psychosocial predictors of psychosis-proneness during COVID-19: Preliminary findings from Croatia. Psychiatry Res 317:114900. https://doi.org/10.1016/J.PSYCHRES.2022.114900

    Article  PubMed  PubMed Central  Google Scholar 

  81. Domènech-Abella J, Mundó J, Haro JM, Rubio-Valera M (2019) Anxiety, depression, loneliness and social network in the elderly: Longitudinal associations from the Irish longitudinal study on ageing (TILDA). J Affect Disord 246:82–88. https://doi.org/10.1016/J.JAD.2018.12.043

    Article  PubMed  Google Scholar 

  82. Wang J, Mann F, Lloyd-Evans B, Ma R, Johnson S (2018) Associations between loneliness and perceived social support and outcomes of mental health problems: a systematic review. BMC Psychiatry 18(1):1–16. https://doi.org/10.1186/S12888-018-1736-5

    Article  Google Scholar 

  83. Hawkley LC, Cacioppo JT (2010) Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med 40(2):218–227. https://doi.org/10.1007/S12160-010-9210-8

    Article  PubMed  Google Scholar 

  84. Hawkley LC, Burleson MH, Berntson GG, Cacioppo JT (2003) Loneliness in everyday life: cardiovascular activity, psychosocial context, and health behaviors. J Pers Soc Psychol 85(1):105–120. https://doi.org/10.1037/0022-3514.85.1.105

    Article  PubMed  Google Scholar 

  85. MacDonald EM, Pica S, McDonald S, Hayes RL, Baglioni AJ (1998) Stress and co** in early psychosis: role of symptoms, self-efficacy, and social support in co** with stress. Br J Psychiatry 172(S33):122–127. https://doi.org/10.1192/S0007125000297778

    Article  CAS  Google Scholar 

  86. Norman RMG, Malla AK, Manchanda R, Harricharan R, Takhar J, Northcott S (2005) Social support and three-year symptom and admission outcomes for first episode psychosis. Schizophr Res 80(2–3):227–234. https://doi.org/10.1016/J.SCHRES.2005.05.006

    Article  PubMed  Google Scholar 

  87. LeMoult J, Gotlib IH (2019) Depression: a cognitive perspective. Clin Psychol Rev 69:51–66. https://doi.org/10.1016/J.CPR.2018.06.008

    Article  PubMed  Google Scholar 

  88. de Jong Gierveld J, Van Tilburg T, Dykstra PA (2006) Loneliness and social isolation Cambridge handbook of personal relationships. Cambridge University Press, pp 485–500

    Book  Google Scholar 

  89. Christiansen J, Qualter P, Friis K, Pedersen SS, Lund R, Andersen CM, Bekker-Jeppesen M, Lasgaard M (2021) Associations of loneliness and social isolation with physical and mental health among adolescents and young adults. Colorectal Dis 141(4):226–236. https://doi.org/10.1177/17579139211016077

    Article  CAS  Google Scholar 

  90. Menec VH, Newall NE, MacKenzie CS, Shooshtari S, Nowicki S (2020) Examining social isolation and loneliness in combination in relation to social support and psychological distress using Canadian Longitudinal Study of Aging (CLSA) data. PLoS ONE 15(3):e0230673. https://doi.org/10.1371/JOURNAL.PONE.0230673

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  91. Spithoven AWM, Bijttebier P, Goossens L (2017) It is all in their mind: A review on information processing bias in lonely individuals. Clin Psychol Rev 58:97–114. https://doi.org/10.1016/J.CPR.2017.10.003

    Article  PubMed  Google Scholar 

  92. Moritz S, Veckenstedt R, Hottenrott B, Woodward TS, Randjbar S, Lincoln TM (2010) Different sides of the same coin? Intercorrelat Cognit Biases Schizophrenia 15(4):406–421. https://doi.org/10.1080/13546800903399993

    Article  Google Scholar 

  93. Ludwig KA, Nye LN, Simmons GL, Jarskog LF, Pinkham AE, Harvey PD, Penn DL (2020) Correlates of loneliness among persons with psychotic disorders. Soc Psychiatry Psychiatr Epidemiol 55(5):549–559. https://doi.org/10.1007/S00127-019-01789-5

    Article  PubMed  Google Scholar 

  94. Stain HJ, Galletly CA, Clark S, Wilson J, Killen EA, Anthes L, Campbell LE, Hanlon M-C, Harvey C (2012) Understanding the social costs of psychosis: the experience of adults affected by psychosis identified within the second Australian national survey of psychosis. Aust N Z J Psychiatry 46(9):879–889. https://doi.org/10.1177/0004867412449060

    Article  PubMed  Google Scholar 

  95. Lim MH, Gleeson JF (2014) Social connectedness across the psychosis spectrum: current issues and future directions for interventions in loneliness. Front Psychiatry 5:154. https://doi.org/10.3389/FPSYT.2014.00154

    Article  PubMed  PubMed Central  Google Scholar 

  96. Michalska Da Rocha B, Rhodes S, Vasilopoulou E, Hutton P (2018) Loneliness in psychosis: a meta-analytical review. Schizophr Bull 44(1):114–125. https://doi.org/10.1093/SCHBUL/SBX036

    Article  PubMed  Google Scholar 

  97. Serra-Arumí C, Vila-Badia R, Del Cacho N, Butjosa A, Abella M, Colomer-Salvans A, Cunill R, Tena MC, Véliz DI, Bustos-Cardona T, Dolz M, Usall J, Abella M, Aguilar S, Alba L, Alcalde R, Álvarez M, Bañuelos M, Vives L, PROFEP Group (2023) Association of perceived social support with sociodemographic, clinical, and psychosocial variables in patients with first-episode psychosis. J Psychiat Res 162:30–36. https://doi.org/10.1016/J.JPSYCHIRES.2023.04.008

    Article  PubMed  Google Scholar 

  98. Lipton FR, Cohen CI, Fischer E, Katz SE (1981) Schizophrenia: a network crisis. Schizophr Bull 7(1):144–151. https://doi.org/10.1093/SCHBUL/7.1.144

    Article  CAS  PubMed  Google Scholar 

  99. Häfner H, Löffler W, Maurer K, Hambrecht M, An Der Heiden W (1999) Depression, negative symptoms, social stagnation and social decline in the early course of schizophrenia. Acta Psychiatr Scand 100(2):105–118. https://doi.org/10.1111/J.1600-0447.1999.TB10831.X

    Article  PubMed  Google Scholar 

  100. Addington J, Penn D, Woods SW, Addington D, Perkins DO (2008) Social functioning in individuals at clinical high risk for psychosis. Schizophr Res 99(1–3):119–124. https://doi.org/10.1016/J.SCHRES.2007.10.001

    Article  PubMed  Google Scholar 

  101. Chudleigh C, Naismith SL, Blaszczynski A, Hermens DF, Hodge MAR, Hickie IB (2011) How does social functioning in the early stages of psychosis relate to depression and social anxiety? Early Interv Psychiatry 5(3):224–232. https://doi.org/10.1111/J.1751-7893.2011.00280.X

    Article  PubMed  Google Scholar 

  102. Gayer-Anderson C, Morgan C (2013) Social networks, support and early psychosis: a systematic review. Epidemiol Psychiat Sci 22(2):131–146. https://doi.org/10.1017/S2045796012000406

    Article  CAS  Google Scholar 

  103. Ryan PC, Damme KSF, Kuhney FS, Mittal VA (2023) Social network size in adolescents at clinical high risk for psychosis. Early Interv Psychiatry 17(5):462–469. https://doi.org/10.1111/eip.13341

    Article  PubMed  Google Scholar 

  104. Addington J, Addington D (2005) Patterns of premorbid functioning in first episode psychosis: relationship to 2-year outcome. Acta Psychiatr Scand 112(1):40–46. https://doi.org/10.1111/J.1600-0447.2005.00511.X

    Article  CAS  PubMed  Google Scholar 

  105. Freeman D, Garety PA, Kuipers E, Fowler D, Bebbington PE (2002) A cognitive model of persecutory delusions. Br J Clin Psychol 41(4):331–347. https://doi.org/10.1348/014466502760387461

    Article  PubMed  Google Scholar 

  106. Green AF, Rebok G, Lyketsos CG (2008) Influence of social network characteristics on cognition and functional status with aging. Int J Geriatr Psychiatry 23(9):972–978. https://doi.org/10.1002/GPS.2023

    Article  PubMed  PubMed Central  Google Scholar 

  107. Krueger KR, Wilson RS, Kamenetsky JM, Barnes LL, Bienias JL, Bennett DA (2009) Social engagement and cognitive function in old age. Exp Aging Res 35(1):45–60. https://doi.org/10.1080/03610730802545028

    Article  PubMed  PubMed Central  Google Scholar 

  108. Nicholson NR (2012) A review of social isolation: An important but underassessed condition in older adults. J Primary Prevent 33(2–3):137–152. https://doi.org/10.1007/S10935-012-0271-2

    Article  Google Scholar 

  109. Pinquart M, Sörensen S (2010) Influences on loneliness in older adults: a meta-analysis. Basic Appl Soc Psychol 23(4):245–266. https://doi.org/10.1207/S15324834BASP2304_2

    Article  Google Scholar 

  110. Victor CR, Yang K (2011) The prevalence of loneliness among adults: a case study of the United Kingdom. J Psychol 146(1–2):85–104. https://doi.org/10.1080/00223980.2011.613875

    Article  Google Scholar 

  111. Kessler RC, Foster C, Webster PS, House JS (1992) The relationship between age and depressive symptoms in two national surveys. Psychol Aging 7(1):119–126. https://doi.org/10.1037/0882-7974.7.1.119

    Article  CAS  PubMed  Google Scholar 

  112. Peters ER, Joseph SA, Garety PA (1995) The measurement of delusional ideation in the normal population-introducing the PDI (Peters et al delusions inventory). Schizophrenia Res 15(1–2):19. https://doi.org/10.1016/0920-9964(95)95071-g

    Article  Google Scholar 

  113. Verdoux H, van Os J, Maurice-Tison S, Gay B, Salamon R, Bourgeois M (1998) Is early adulthood a critical developmental stage for psychosis proneness? A survey of delusional ideation in normal subjects. Schizophr Res 29(1–2):24. https://doi.org/10.1016/s0920-9964(97)88351-x

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by a K23-MH126313 (JMS). We want to thank Dr. Neil Woodward for procurement and organization of the Rockland dataset.

Funding

This work was supported by a K23-MH126313 (JMS).

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 1601 23rd Ave S, Suite 3057K, Nashville, TN, 37212, USA

    Lauren M. Hall, Alexandra B. Moussa-Tooks & Julia M. Sheffield

Authors
  1. Lauren M. Hall
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexandra B. Moussa-Tooks
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julia M. Sheffield
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LMH and JMS conceptualized the project. LMH acquired the data and conducted the analyses. LMH, ABM, and JMS supported the interpretation of the data and analyses. LMH drafted the initial manuscript, and JMS and ABM commented on previous versions of the manuscript, contributed to the writing, and made critical revisions. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lauren M. Hall.

Ethics declarations

Conflict of interest

The authors have no relevant financial, non-financial, or competing interests to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Participant gave their informed consent before their inclusion in the study.

Consent to publish

Not applicable.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hall, L.M., Moussa-Tooks, A.B. & Sheffield, J.M. Associations between social engagement, internalizing symptoms, and delusional ideation in the general population. Soc Psychiatry Psychiatr Epidemiol 59, 989–1002 (2024). https://doi.org/10.1007/s00127-023-02540-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00127-023-02540-x

Keywords

Search

Navigation