Socially Distanced: An Exploratory Study of the Relationships Between Delusional Ideation and Social Imagery Under the Lens of the COVID-19 Pandemic

Abstract

Purpose: Delusional ideation, defined as false beliefs and altered thinking, has long been attributed to anomalous/bizarre perceptual experiences and reasoning deficits. Recent studies, however, have challenged this view, suggesting instead that delusional ideation may have more of a social component to its phenomenology and underlying mechanisms. This study investigated associations between delusional ideation and factors of social imagery (felt presence, empathy, loneliness, and social anxiety) in healthy adults, using the COVID-19 pandemic as a natural social experiment rich in perceived threat and social isolation. Methods: 2,200 participants completed the online “How are you coping? COVID-19 survey,” designed to measure the psychological, social, and financial impacts of the pandemic. Delusional ideation was assessed using the Peters Delusional Ideation (PDI) scale and felt presence experiences were assessed by the Other Experiences Questionnaire (OEQ). Other measures of social imagery included the Liebowitz Social Anxiety Scale (LSAS), the Interpersonal Reactivity Index (IRI) (empathy), and the UCLA Loneliness Scale. Results: All aspects of social imagery were positively associated with delusional ideation. The strongest predictor of PDI score was felt presence (ß=.298, p<.001), followed by loneliness (ß=.222, p<.001), LSAS (social fear dimension) (ß=.135, p=.001), IRI (empathic concern scale) (ß=.101, p<.001), and IRI (empathizing with fictitious characters scale) (ß=.088, p<.001). Conclusion: Results support the hypothesis that delusional ideation is sensitive to alterations in sociality, and delusions may involve social cognition for representing social agents. We propose that delusions and social imagery may share common mechanisms and increased propensity for imagining others may contribute to development of delusions.