Social-Cognitive Frameworks for Understanding the Connection Between Social Isolation and Psychosis Risk

Increasing evidence demonstrates an association between social isolation and psychosis risk. In this perspective, we attempt to account for why that is. Drawing from work in social psychology, social neuroscience, and clinical psychological science, we present two frameworks for understanding the association between social isolation and psychosis risk: the “social-needs” framework and the “social-processing” framework. Social needs states that because of people’s inherent social needs, isolation produces increased social attention, perception, and thought to fill the social void, resulting in the perception of anomalous social information and social meaning. Social processing states that the lack of exposure to social stimuli during isolation diminishes social processing (i.e., social thought, social perceptions) and may lead isolated individuals to turn their attention inward, blurring internal and external worlds and intensifying self-focus in a way that creates reality-monitoring disturbances and anomalous self-experiences. Conveniently, these frameworks can be empirically arbitrated. We review the literature connecting social isolation to psychosis, describe the frameworks, their empirical support, and the predictions they make, and discuss clinical implications. Ultimately, a better accounting of isolation’s pro-psychotic effects might lead to better efforts at psychosis prevention.