Loneliness in early psychosis: a mixed-methods study
Niharika Jhingan (Psychosis Research Lab, RISE Program, Cambridge Health Alliance)
Lynn DeLisi (Psychosis Research Lab, RISE Program, Cambridge Health Alliance)
Daniel Fulford (Department of Psychological & Brain Sciences, Boston University)
Background: Loneliness, the subjective experience of social disconnection, is prevalent across the psychosis spectrum, with negative consequences for physical health, symptom trajectory, and overall wellbeing. Loneliness is particularly salient for youth at the earliest stages of illness, given unique contributions of developmental (e.g., identity formation), social (e.g., stigma), and illness related factors (e.g., psychosis symptomatology). Despite its relevance for early intervention, little is known about correlates of loneliness in the daily lives of youth recovering from early psychosis, and few studies have explored the lived experience of loneliness in this population.
Methods: Data were drawn from the Pathways to Loneliness in Early Psychosis study at Cambridge Health Alliance’s Recovery in Shared Experiences (RISE) Program [F31MH140381]. Analyses include ecological momentary assessment (EMA) data in 30 participants over two weeks. EMA questions captured experiences of social connection, disconnection, and related phenomena (e.g., stigma, belongingness). Participants also provided real-time qualitative reflections on loneliness and a subset completed full qualitative interviews following the EMA period.
Results: Descriptive analyses reflected heterogeneity of loneliness in daily life. For some participants, momentary loneliness fluctuated substantially across the two-week period, while others reported more persistent disconnection. We will also present follow-up analyses of our intensive longitudinal data using multilevel modeling to elucidate between- and within- participant differences in loneliness across the study duration. Preliminary qualitative reflections illuminated proximal contributors to loneliness, including stigma, social rejection, and unmet needs for belonging, as well as structural challenges.
Conclusions: The current project is the first to explore loneliness through a dynamic, mixed-methods, intensive longitudinal approach in youth with early psychosis. We suggest structural, developmental, social, and symptom-related factors interact to contribute to the subjective experience of disconnection in youth with psychosis spectrum diagnoses. We discuss avenues for addressing loneliness and it correlates in the context of early intervention.