Delusional ideation is associated with social imagery: Felt presence, social anxiety, empathy and loneliness

Recent research suggests that delusional ideation (DI) may have social component to its phenomenology and underlying mechanisms. This study investigated associations between delusional ideation and factors of social imagery in healthy adults using the COVID-19 pandemic as a context of increased social threat perception. 1,854 participants completed an online survey. DI was assessed using the Peters Delusional Ideation (PDI) scale, and social imagery was investigated using the Other Experiences Questionnaire (OEQ, felt presence), the Liebowitz Social Anxiety Scale (LSAS), the Interpersonal Reactivity Index (IRI, empathy), and the UCLA Loneliness Scale. All aspects of social imagery were positively associated with DI. The strongest predictor of PDI score was felt presence, followed by loneliness, LSAS social fear dimension, IRI (empathic concern and empathy for fictional characters) scales. We propose that delusions and social imagery may share common mechanisms and increased propensity for imagining others may contribute to development of delusions.