Experiences of Social Adversity and Functioning Preceding Psychosis: A Qualitative Phenomenological Study
Grace Kiernan, Anneke Sools, Tim Alber, Lena Liedtke, Mar Rus-Calafell
Study at a glance
AI-extracted from the abstract| Characteristics | Qualitative study |
|---|---|
| Sample size | 14 |
| Population | Individuals with early psychosis |
| Key findings | Four themes captured experiences of social adversity and functioning across life periods: always feeling different; early losses and relational instability ("Bottling everything up"); hiding the self out of shame; and demands becoming overwhelming, with shutting down under pressure. Social withdrawal and not speaking about distress spanned all themes. The authors argue that social withdrawal before psychosis is a heterogeneous, meaningful response to social adversity rather than merely an indicator of functional decline. |
Abstract
Objective: This study explores experiences of social adversity and changes in social functioning from the perspectives of individuals with early psychosis.Method: Interviews were conducted with N=14 individuals with early psychosis and analysed using Interpretative Phenomenological Analysis.Results: Four overarching themes reflecting varying experiences of social adversity and functioning were identified: 1. Always feeling different, 2. Early losses and relational instability: “Bottling everything up”, 3. Hiding the self out of shame, and 4. Demands becoming overwhelming: shutting down under pressure. These themes spanned different life periods, from early childhood to adulthood. Social withdrawal, along with not speaking about distress, was identified as an overarching experience across the four themes.Conclusions: The findings highlight that social withdrawal prior to psychosis is a heterogeneous and meaningful response to social adversity, rather than merely an indicator of functional decline. Attending to the subjective meanings and developmental pathways underlying these experiences may improve early identification and support more personalised intervention strategies in clinical high-risk populations.