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Title: Feeling lonely and anxious : a cross-sectional investigation of social networks and support in first episode psychosis
Author: Sündermann, Oliver
Awarding Body: King's College London (University of London)
Current Institution: King's College London (University of London)
Date of Award: 2012
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People with psychosis commonly have poorer social networks and social support than the general population. However, qualitative social network features (e.g. presence of a confidant, perceived social support) are under-researched in first episode psychosis. Also, mechanisms through which poor relationships and support make symptoms and functioning in psychosis worse are largely unknown. This study aimed to investigate social network features and perceived social support in people with first episode psychosis, and also examined if the association between loneliness and paranoia was mediated by anxiety. Thirty eight people with first episode psychosis were recruited for a cross-sectional study. The study used questionnaire and interview measures to assess symptoms, functioning and availability of and satisfaction with perceived social support. Additionally, qualitative social network features (loneliness, and presence of a confidant) were measured. A mood-induction task involved watching anxiety-inducing pictures and neutral/happy pictures on a computer screen. Visual analogue scales assessed changes in paranoia, anxiety and loneliness. A mediation analysis then tested whether anxiety mediated between loneliness and paranoia. Results indicated that poor perceived social support, loneliness and the absence of a confidant were strongly associated with psychosis and depressive symptoms. The mediation analysis revealed that anxiety may be one potential mediator between loneliness and paranoia. Exploratory regression analyses further revealed that participants without a confidant were more likely to feel lonely when triggered into anxiety than those with a confidant. Finally, participants had temporarily raised paranoia when triggered into anxiety, and those with higher current negative symptoms felt more paranoid after anxiety-induction thus providing tentative experimental evidence for recent cognitive models of psychosis. In line with previous studies, results showed that poor perceived social support, loneliness and the absence of a confidant were associated with more symptoms and poorer functioning. First episode patients appear to be more susceptible to feeling lonely when anxious. Anxiety may be one pathway through which loneliness affects paranoia. Potential clinical implications are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available