Young People at Risk of Psychosis: a User-led Exploration of Interpersonal Relationships and Communication of Psychological Difficulties

Aim: The aim of the present study was to qualitatively explore experiences and perceptions of interpersonal relationships and interpersonal communication among young people at risk of psychosis.

Method: Semi-structured interviews were conducted using a qualitative grounded theory approach. Participants had entered into a service providing psychological interventions for young people assessed to be at a high risk of developing psychosis (Northwest UK). Our sample comprised one female and seven male participants (n = 8), ranging in age from 16 to 28 years, with a mean age of 22.4 years.

Results: Analyses identified three central themes: difficulty with interpersonal relationships and reduced opportunities for helpful communication, difficulty talking to others about psychological problems, and experiences of talking to others about psychological problems.

Conclusions: Individuals at risk of psychosis may have experienced significant difficulties with interpersonal relationships. Such difficulties may contribute directly to the development of unusual psychological experiences, and to an inability or reluctance to communicate these to others. In addition, commonly held stigmatizing ideas associated with unusual psychological experiences may contribute to a fear among at-risk individuals that they are 'going mad', and this may lead to concealment of their difficulties, and to delayed help-seeking. For at-risk individuals, helpful communication of psychological distress offers significant benefits, including improved psychological and emotional well-being and reduced risk of psychosis. Thus, while concealment of distress may directly impact on the development of unusual psychological difficulties, communication of such difficulties may be central to recovery.