Loneliness and psychosocial predictors of psychosis-proneness during COVID-19: Preliminary findings from Croatia

Validation study of the Croatian version of the Three-Item Loneliness Scale and its association to social network indices

BACKGROUND

Loneliness is a prevalent and complex phenomenon influenced by various social and demographic factors. The goal of this study was to translate the Three-Item UCLA Loneliness Scale into Croatian and test its validity and reliability in practice. An additional aim was to explore the relationship between social connectedness and loneliness within the Croatian population, with respect to age and gender.

METHOD

The Three-Item Loneliness Scale was translated into Croatian and validated according to widely accepted guidelines for cross-cultural adaptation and translation of the questionnaire into different languages. Subsequently, loneliness and social connectedness were examined in 309 Croatian participants using an anonymous online survey.

RESULTS

The results indicated a significant association between social connectedness and loneliness. In particular, those with fewer individuals in their social network were associated with higher loneliness. Notably, age had a significant negative association with loneliness, indicating increased loneliness among younger individuals. Meanwhile older individuals with fewer active network domains experienced heightened loneliness compared to other age groups. No effect of gender was observed.

CONCLUSION

Our findings highlight the importance of social connectedness in relation to loneliness, particularly among younger and older age individuals. This study, through its validation of the instrument for measuring loneliness, offers important insights into the unique Croatian context, emphasizing how cultural and social factors may influence the experience of loneliness and social connectedness.

Associations between social engagement, internalizing symptoms, and delusional ideation in the general population

BACKGROUND

Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms-such as symptoms of depression, anxiety, and trauma exposure-are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically.

METHODS

Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate.

RESULTS

Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = - 0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = - 0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = - 0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement.

CONCLUSIONS

These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.

Evidence for Reduced Sensory Precision and Increased Reliance on Priors in Hallucination-Prone Individuals in a General Population Sample

BACKGROUND

There is increasing evidence that people with hallucinations overweight perceptual beliefs relative to incoming sensory evidence. Past work demonstrating prior overweighting has used simple, nonlinguistic stimuli. However, auditory hallucinations in psychosis are often complex and linguistic. There may be an interaction between the type of auditory information being processed and its perceived quality in engendering hallucinations.

STUDY DESIGN

We administered a linguistic version of the conditioned hallucinations (CH) task to an online sample of 88 general population participants. Metrics related to hallucination-proneness, hallucination severity, stimulus thresholds, and stimulus detection rates were collected. Data were used to fit parameters of a Hierarchical Gaussian Filter (HGF) model of perceptual inference to determine how latent perceptual states influenced task behavior.

STUDY RESULTS

Replicating past results, higher CH rates were observed both in those with recent hallucinatory experiences as well as participants with high hallucination-proneness; CH rates were positively correlated with increased prior weighting; and increased prior weighting was related to hallucination severity. Unlike past results, participants with recent hallucinatory experiences as well as those with higher hallucination-proneness had higher stimulus thresholds, lower sensitivity to stimuli presented at the highest threshold, and had lower response confidence, consistent with lower precision of sensory evidence.

CONCLUSIONS

We replicate the finding that increased CH rates and recent hallucinations correlate with increased prior weighting using a linguistic version of the CH task. Results support a role for reduced sensory precision in the interplay between prior weighting and hallucination-proneness.

Investigation of daily patterns for smartphone keystroke dynamics based on loneliness and social isolation

This study examined the relationship between loneliness levels and daily patterns of mobile keystroke dynamics in healthy individuals. Sixty-six young healthy Koreans participated in the experiment. Over five weeks, the participants used a custom Android keyboard. We divided the participants into four groups based on their level of loneliness (no loneliness, moderate loneliness, severe loneliness, and very severe loneliness). The very severe loneliness group demonstrated significantly higher typing counts during sleep time than the other three groups (one-way ANOVA, F = 3.75, p < 0.05). In addition, the average cosine similarity value of weekday and weekend typing patterns in the very severe loneliness group was higher than that in the no loneliness group (Welch's t-test, t = 2.27, p < 0.05). This meant that the no loneliness group's weekday and weekend typing patterns varied, whereas the very severe loneliness group's weekday and weekend typing patterns did not. Our results indicated that individuals with very high levels of loneliness tended to use mobile keyboards during late-night hours and did not significantly change their smartphone usage behavior between weekdays and weekends. These findings suggest that mobile keystroke dynamics have the potential to be used for the early detection of loneliness and the development of targeted interventions.

Racial differences in attenuated psychotic symptoms during the COVID-19 pandemic

AIM

Rates of attenuated psychotic symptoms (APS) have increased during the COVID-19 pandemic; however, it is unclear whether this is most evident among individuals from marginalized racial groups.

METHODS

The current study evaluated APS screening data across a six-year period in the state of Georgia in the United States, spanning several years prior to and during the COVID-19 pandemic to evaluate interactions between time and race. Participants included 435 clinical help-seeking individuals.

RESULTS

The rate of individuals scoring above the APS screening cut-off was higher during the pandemic compared to pre-pandemic (41% vs 23%). This pandemic-related increase in APS was significant for Black, but not White or Asian participants.

CONCLUSIONS

Findings indicate APS are increasing during the COVID-19 pandemic among clinical help-seeking populations. Black individuals may be at greater risk for developing a psychotic disorder during the pandemic, suggesting increased need for screening, mental health monitoring, and treatment.

Trajectories of Adjustment Disorder and Well-Being in Austria and Croatia during 20 Months of the COVID-19 Pandemic

The present study aimed to investigate the trajectories of adjustment disorder (AD) symptoms and well-being over 20 months of the COVID-19 pandemic in Austria and Croatia. Further objectives of this study were to examine whether sociodemographic characteristics and the symptoms of anxiety and depression could predict these trajectories. As part of the pan-European ESTSS ADJUST study, N = 1144 individuals were recruited using convenience sampling and assessed four times between June 2020 and January 2022 through an online survey. Latent growth curve modelling was applied to estimate the trajectories of AD symptoms and well-being. Over time, the prevalence of probable AD varied between 9.8% and 15.1%. The symptoms of AD tended to increase, whereas well-being tended to decrease. According to the majority of the models tested, women, participants from Austria and those with lower income had higher initial AD symptoms, whereas older participants and those from Croatia had higher initial well-being. In all models and at all timepoints, anxiety and depression significantly predicted AD and well-being scores. Overall, our study points to several predictors of AD and well-being and indicates high variability in people's reactions to the pandemic. Psychosocial support for the general population is needed during pandemics and similar crises, with a special focus on vulnerable groups.

Social connectedness and resilience post COVID-19 pandemic: Buffering against trauma, stress, and psychosis

The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia two years after the onset of the COVID-19 pandemic. Given the existing transgenerational war trauma and associated psychiatric consequences in Croatian population, a significant pandemic-related deterioration of mental health was expected. Recent studies suggest that after an initial increase in psychiatric disorders during the pandemic in Croatia, depression, stress, and anxiety rapidly declined. These findings highlight the role of social connectedness and resilience in the face of the global pandemic. We examined resilience and psychiatric disorder risk in 377 Croatian adults using an anonymous online mental health survey. Results indicate that there was an exacerbation of all mental ill health variables, including depression, anxiety, stress, and a doubled risk for psychosis outcome post-COVID pandemic. Stress decreased levels of resilience, however, those exposed to previous traumatic experience and greater social connectedness had higher resilience levels. These findings suggest that individual differences in underlying stress sensitization of Croatian population due to past trauma may continue to influence mental health consequences two years after COVID-19 pandemic. It is essential to promote the importance of social connectedness and resilience in preventing the development of variety of mental health disorders.