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Loneliness and Psychotic Symptoms: The Mediating Role of Depression

Cognitive Therapy and Research volume 41, pages 106–116 (2017)Cite this article

Abstract

Psychotic symptoms have been shown to be associated with numerous social factors, such as migration and urban upbringing, of which one plausible common component is loneliness. This suggests a relationship between loneliness and positive psychotic symptoms. According to current cognitive models of psychosis, the relationship between loneliness and positive symptoms is likely to be explained by affective states. The current study examined the cross-sectional relationship between loneliness, depression, and positive symptoms in four separate community samples (combined N = 766) with regression based mediation analysis and network analysis. The results showed that depression completely mediated the relationship between loneliness and positive symptoms in three out of four samples. Partial mediation was found in one sample. Network analysis revealed that loneliness, depression, and positive symptoms clustered separately and that there was a unique connection between loneliness and items that assess paranoid beliefs, in the sense that loneliness was not found to be connected to other psychotic symptoms, such as hallucinations. As expected, loneliness is related to positive symptoms and depression played a strong role in explaining the association. Thus, early interventions of psychosis that target loneliness are likely to be beneficial, especially if these interventions additionally target depression. Furthermore, the specific connection of loneliness and paranoid beliefs supports the theory that specific adversity leads to specific psychotic symptoms.

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Acknowledgments

Edo S. Jaya received a research grant from the German Academic Exchange Service (Deutscher Akademischer Austausch Dienst, DAAD, 91540971). Klaus Michael Reininger was supported by a graduate scholarship of the German National Academic Foundation (Studienstiftung des deutschen Volkes).

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  1. Clinical Psychology and Psychotherapy, Institute of Psychology, University of Hamburg, Von-Melle-Park 5, D-20146, Hamburg, Germany

    Edo S. Jaya, Tobias E. Hillmann & Tania M. Lincoln

  2. Educational Psychology and Motivation, Institute of Psychology, University of Hamburg, Von-Melle-Park 5, D-20146, Hamburg, Germany

    Klaus Michael Reininger

  3. Department of Psychology, Yale University, New Haven, CT, USA

    Anton Gollwitzer

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Edo S. Jaya, Tobias E. Hillmann, Klaus Michael Reininger, Anton Gollwitzer, Tania M. Lincoln declare that they have no conflict of interest.

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Jaya, E.S., Hillmann, T.E., Reininger, K.M. et al. Loneliness and Psychotic Symptoms: The Mediating Role of Depression. Cogn Ther Res 41, 106–116 (2017). https://doi.org/10.1007/s10608-016-9799-4

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