Is loneliness a feasible treatment target in psychosis?

Abstract

Purpose

Loneliness is a challenge for individuals with psychosis; however, interventions rarely target loneliness in this group.

Method

We developed a pilot positive psychology group intervention designed to reduce loneliness in psychosis and examined its feasibility and acceptability.

Results

Sixteen participants attended 5.38 (SD = 0.70) out of six sessions, with a dropout rate of 10%. Participants were significantly less lonely at post-treatment (p < 0.001, d = 1.51), and maintained their improvements from post-treatment to follow-up (p = 0.81, d = 0.07).

Conclusions

Loneliness may be a feasible and acceptable treatment target within psychosocial treatments.

This is a preview of subscription content, log in to check access.

Notes

  1. 1.

    18 individuals aged between 18 and 31 years old (M = 22.89, SD = 3.61; 50% women) made up the final sample.

  2. 2.

    While there is no known threshold for problematic or severe loneliness, a score of 40 and above was used to indicate above the median score across different samples [15].

  3. 3.

    As assessed by the risk section in the SCID-5 major depressive episode module; SCID-5 [17].

  4. 4.

    Those who accepted into the group program were strongly advised not to change their medication regime or take on additional therapy offered to them during their involvement in this trial. All participants included in the study reported no changes in treatment during their time of the trial at T2 and T3.

  5. 5.

    The manual was modified and adapted from Parks and Seligman’s (2017) 8-week group positive psychotherapy program.

  6. 6.

    With the exception SCID-5 which was administered at baseline only.

  7. 7.

    The coders did not code the SSPA grooming question as only audio coding was available. The research assistant conducting the assessment coded this item.

References

  1. 1.

    Peplau L, Perlman D (1982) Perspectives on loneliness. In: Peplau L, Perlman D (eds) Loneliness: a sourcebook of current theory, research and therapy. Wiley, New York, pp 1–20

    Google Scholar 

  2. 2.

    Morgan VA, Waterreus A, Jablensky A, Mackinnon A, McGrath JJ, Carr V, Bush R, Castle D, Cohen M, Harvey C, Galletly C, Stain HJ, Neil A, McGorry PD, Hocking B, Shah S, Saw S (2011) People living with psychotic illness 2010: report on the second Australian national survey. Commonwealth of Australia, Canberra, Australia

  3. 3.

    Lim MH, Gleeson JF, Alvarez-Jimenez M, Penn DL (2018) Loneliness in psychosis: a systematic review. Soc Psychiatry Psychiatr Epidemiol 53:221–238. https://doi.org/10.1007/s00127-018-1482-5

    Article  Google Scholar 

  4. 4.

    Masi CM, Chen HY, Hawkley LC, Cacioppo JT (2011) A meta-analysis of interventions to reduce loneliness. Pers Soc Psychol Rev 15:219–266. https://doi.org/10.1177/1088868310377394

    Article  PubMed  Google Scholar 

  5. 5.

    Davidson L (2010) PORT through a recovery lens. Schizophr Bull 36:107–108. https://doi.org/10.1093/schbul/sbp138

    Article  PubMed  Google Scholar 

  6. 6.

    Johnson DP, Penn DL, Fredrickson BL, Kring AM, Meyer PS, Catalino LI, Brantley M (2011) A pilot study of loving-kindness meditation for the negative symptoms of schizophrenia. Schizophr Res 129:137–140. https://doi.org/10.1016/j.schres.2011.02.015

    Article  PubMed  Google Scholar 

  7. 7.

    Meyer PS, Johnson DP, Parks A, Iwanski C, Penn DL (2012) Positive living: a pilot study of group positive psychotherapy for people with schizophrenia. J Posit Psychol 7:239–248. https://doi.org/10.1080/17439760.2012.677467

    Article  Google Scholar 

  8. 8.

    Totterdell P, Holman D, Hukin A (2008) Social networkers: measuring and examining individual differences in propensity to connect with others. Soc Netw 30:283–296. https://doi.org/10.1016/j.socnet.2008.04.003

    Article  Google Scholar 

  9. 9.

    Schrank B, Brownell T, Jakaite Z, Larkin C, Pesola F, Riches S, Tylee A, Slade M (2016) Evaluation of a positive psychotherapy group intervention for people with psychosis: pilot randomised controlled trial. Epidemiol Psychiatr Sci 25:235–246. https://doi.org/10.1017/s2045796015000141

    Article  PubMed  Google Scholar 

  10. 10.

    Lim MH, Gleeson JF (2014) Social connectedness across the psychosis spectrum: current issues and future directions for interventions in loneliness. Front Psychiatry 5:1–3. https://doi.org/10.3389/fpsyt.2014.00154

    Article  Google Scholar 

  11. 11.

    Lim MH, Gleeson JFM, Rodebaugh TL, Eres R, Long KM, Casey K, Abbott JM, Thomas N, Penn DL (2019) A pilot digital intervention targeting loneliness in young people with psychosis. Soc Psychiatry Psychiatr Epidemiol. https://doi.org/10.1007/s00127-019-01681-2

    Article  Google Scholar 

  12. 12.

    Lim MH, Rodebaugh TL, Eres R, Long KM, Penn DL, Gleeson JFM (2019) A pilot digital intervention targeting loneliness in youth mental health. Front Psychiatry Mood Anxiety Disord (In press)

  13. 13.

    Lim MH, Rodebaugh TL, Zyphur MJ, Gleeson JFM (2016) Loneliness over time: the crucial role of social anxiety. J Abnorm Psychol 125:620–630. https://doi.org/10.1037/abn0000162

    Article  PubMed  Google Scholar 

  14. 14.

    Trémeau F, Antonius D, Malaspina D, Goff DC, Javitt DC (2016) Loneliness in schizophrenia and its possible correlates. An exploratory study. Psychiatry Res 246:211–217. https://doi.org/10.1016/j.psychres.2016.09.043

    Article  PubMed  Google Scholar 

  15. 15.

    Russell D (1996) UCLA loneliness scale (Version 3): reliability, validity, and factor structure. J Pers Assess 66:20–40. https://doi.org/10.1207/s15327752jpa6601_2

    CAS  Article  Google Scholar 

  16. 16.

    Kay SR, Fiszbein A, Opler LA (1987) The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 13:261–276

    CAS  Article  Google Scholar 

  17. 17.

    First MB, Williams JBW, Karg RS, Spitzer R (2015) Structured clinical interview for DSM-5, research version. American Psychaitric Association, Arlington

    Google Scholar 

  18. 18.

    Addington D, Addington J, Schissel B (1990) A depression rating scale for schizophrenics. Schizophr Res 3:247–251

    CAS  Article  Google Scholar 

  19. 19.

    Mattick RP, Clarke JC (1998) Development and validation of measures of social phobia scrutiny fear and social interaction anxiety. Behav Res Ther 36:455–470

    CAS  Article  Google Scholar 

  20. 20.

    Rodebaugh TL, Heimberg RG, Brown PJ, Fernandez KC, Blanco C, Schneier FR, Liebowitz MR (2011) More reasons to be straightforward: findings and norms for two scales relevant to social anxiety. J Anxiety Disord 25:623–630. https://doi.org/10.1016/j.janxdis.2011.02.002

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Ryff CD, Keyes LM (1995) The structure of psychological well-being revisited. J Pers Soc Psychol 69:719–727

    CAS  Article  Google Scholar 

  22. 22.

    Patterson TL, Moscona S, McKibbin CL, Davidson K, Jeste DV (2001) Social skills performance assessment among older patients with schizophrenia. Schizophr Res 48:351–360. https://doi.org/10.1016/S0920-9964(00)00109-2

    CAS  Article  PubMed  Google Scholar 

  23. 23.

    Hughes ME, Waite LJ, Hawkley LC, Cacioppo JT (2004) A short scale for measuring loneliness in large Ssurveys: results from two population-based studies. Res Aging 26:655–672. https://doi.org/10.1177/0164027504268574

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Cacioppo JT, Cacioppo S, Cole SW, Capitanio JP, Goossens L, Boomsma DI (2015) Loneliness across phylogeny and a call for comparative studies and animal models. Perspect Psychol Sci 10:202–212. https://doi.org/10.1177/1745691614564876

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

Robert Eres, Claire Peck, Julia Cheah, and Carla McEnery are acknowledged for research assistance on the project. Special thanks to co-group facilitators, Nicole Harris, Yamiko Marama, and Christopher Jillard. Thank you to all participating young people and staff of Eastern Health.

Funding

Grant awarded to M.H. Lim from the Swinburne Development Fund.

Author information

Affiliations

Authors

Corresponding author

Correspondence to M. H. Lim.

Ethics declarations

Conflict of interests

The authors declare no conflict of interests.

Additional information

This article is part of the focused issue ‘Loneliness: contemporary insights on causes, correlates, and consequences’.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Lim, M.H., Penn, D.L., Thomas, N. et al. Is loneliness a feasible treatment target in psychosis?. Soc Psychiatry Psychiatr Epidemiol 55, 901–906 (2020). https://doi.org/10.1007/s00127-019-01731-9

Download citation

Keywords

  • Loneliness
  • Psychosis
  • Social anxiety
  • Positive psychotherapy intervention