The impact of being with friends vs. strangers on paranoia in psychosis: An Experience Sampling Method (ESM) study on the relationship between nature of company and experiences of momentary paranoia in people with non-affective psychotic disorders, their healthy relatives and controls

Abstract

People with non-affective psychosis experience major problems in social life. Both paranoid delusions and low social engagement are associated with low quality of life. There is no empirical consensus on the connections between social surroundings and delusions of paranoia. Knowledge of risk and protective factors in daily social life could lead to new clinical strategies to diminish the occurrence of paranoia, and thereby increase the quality of life of people with non-affective psychosis. This study therefore investigated the relationship between nature of social company and experiences of momentary paranoia in people with non-affective psychosis. Psychotic patients, their healthy relatives, and healthy controls took part in the research. The experience sampling method (ESM) was used, which allows examining the moment to moment changes in social interactions and momentary paranoia in the real context of daily life. 72 participants took part in the study. Participants filled in questionnaires on an electronic device, ten times a day, for one week. The data was analyzed using mixed multilevel analyses. It was found that patients experienced more momentary paranoia than relatives, and relatives experienced more momentary paranoia than healthy controls. In contrast to the expectation, patients experienced more momentary paranoia when they were in the company of a stranger compared to when they were accompanied by a close relation, as did relatives and controls. Furthermore, patients experienced less momentary paranoia when they were in the company of others (both strangers and close relations) than when they were alone. Social withdrawal thus seems dysfunctional in terms of the occurrence of paranoia. Yet, patients were alone more often than relatives and healthy controls. Company of other people, even unfamiliar others, might be a protective factor for the experience of paranoia in psychotic patients and should therefore be stimulated in treatment and other interventions.