Psychosis, choice to be alone and loneliness. An Experience Sampling Method investigation of the association between choice to be alone and feelings of loneliness in people with non-affective psychotic disorders, their first-degree relatives and healthy controls.
Summary
People with non-affective psychotic disorder often suffer from a dangerous vicious circle of loneliness. Being stigmatized and mastering less social skills, combined with experiencing social interactions as less rewarding due to social anhedonia or as more frightening due to social anxiety, makes it more likely for people with a non-affective psychotic disorder to become socially isolated and lonely. Furthermore, they are prone to respond with more paranoid thoughts when being confronted with loneliness, which makes them even more vulnerable. While there is a partial genetic base of social behavior, first-degree relatives could have a higher risk that predisposed them to have similar problems, which has never been investigated. The present study investigates the association between the frequency of social contact, the choice of being alone and feelings of loneliness in patients with non-affective psychotic disorders, their first-degree relatives and healthy controls. Experience Sampling Method (ESM) was used to gather highly reliable results about fluctuating social behavior in daily life. Results show that patients spent the most time alone, compared to first-degree relatives and healthy controls. No group differences were found in choice of being alone. An interaction effect was found between choice of being alone and feelings of loneliness. The choice of being alone matters differently between groups. In patients, the choice of being alone had no influence on feelings of loneliness. Contrary to expectations, first-degree relatives showed similar behavior to healthy controls. In conclusion, patients showed higher social isolation and loneliness, indicating that they have a normal motivation to be with others. Further research is required to get more insight in what causes their social isolation, like anxiety issues. First-degree relatives did not seem to behave different from healthy controls in their social behavior. Yet, while an unequal gender distribution could influence these results, further research is required to investigate possible risks on social isolation.