The impact of the COVID-19 pandemic on perceptions of social relationships, negative affect, and paranoid ideation

The COVID-19 pandemic contributed to worsening mental health across the globe. The pandemic may have been especially impactful on those experiencing heightened psychosis spectrum symptomatology given greater pre-pandemic social isolation and increased vulnerability to stress. Yet, few studies exploring the impact of the COVID-19 pandemic on perceptions of social relationships and mental health have sampled individuals high in psychosis spectrum symptomatology, including those with psychosis spectrum disorders. Utilizing a mixed transdiagnostic community sample enriched for psychotic spectrum disorders, this longitudinal study investigated whether perceptions of social relationships and psychiatric symptoms changed during the COVID-19 pandemic, whether pandemic-related impacts were associated with social perceptions and symptomatology, and whether paranoid ideation was related to perceptions of the government response to the COVID-19 pandemic. Pandemic impacts were not uniform, with participants reporting a range of adverse impacts including poorer health-related behaviors, difficulties fulfilling basic needs, and medical related challenges. Results indicated that compared to pre-pandemic assessments, perceived rejection and hostility increased during the COVID-19 pandemic. Participants who experienced more pandemic-related impacts reported less social support, more social distress, greater negative affect, and greater paranoid ideation. Paranoid ideation was related to more negative perceptions of the government’s response to the pandemic. These findings demonstrate the importance of assessing individual differences in pandemic-related impacts and the clinical consequences of such impacts. Results also suggest that those high in paranoid ideation may be reluctant to engage in government recommended protective health behaviors to limit the spread of COVID-19.