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. Author manuscript; available in PMC: 2023 May 1.
Published in final edited form as: Schizophr Res. 2022 Feb 26;243:24–31. doi: 10.1016/j.schres.2022.02.028

Negative schizotypy attenuates the effect of momentary stress on social dysfunction related to COVID-19 social distancing

Michael D Masucci 1,†,*, Victoria Martin 2,†, Thanh P Le 1,3, Alex S Cohen 1
PMCID: PMC9189049  NIHMSID: NIHMS1784382  PMID: 35231831

Abstract

Schizotypy is associated with a broad range of motivational and social dysfunctions. However, there is reason to suspect that negative schizotypy may limit social dysfunction in specific contexts that typically increase isolation and loneliness. We analyzed whether positive, negative and disorganized facets of schizotypy would mitigate detrimental reactions to stress in the context of a global stressor (the COVID-19 pandemic) that has widely necessitated social and physical isolation. Responses to two measures of schizotypy were compared to ecological momentary assessments of social dysfunction for 85 undergraduates using multilevel modelling techniques. Negative schizotypy moderated the relation between momentary stress and loss of social support, such that negative schizotypy limited the magnitude of social dysfunction stemming from increases in momentary stress. This pattern was not seen for other facets of schizotypy. Implications for the treatment and measurement of schizotypy symptoms are discussed.

Keywords: Schizotypy, negative symptoms, social support, loneliness, stress, ecological momentary assessment

1. Introduction

Schizotypy, the personality organization thought to predispose individuals to developing schizophrenia and psychosis-spectrum pathology (Chapman 1994), includes expression of attenuated psychotic symptoms that qualitatively parallel symptoms of schizophrenia but range from non-clinical to clinical severity in the general population (Nelson et al., 2013). The multidimensional structure of schizotypy has been empirically supported, consisting of positive (e.g., aberrant perceptual experiences and unusual beliefs), negative (e.g., diminishment of experiences such as avolition and anhedonia), and disorganized (e.g., disrupted organization and expression of thoughts/behavior) dimensions (Kwapil & Barrantes-Vidal, 2015). In addition to higher psychosis risk (Grant et al., 2018; Lenzenweger, 2006), increased schizotypy has been associated with higher stress sensitivity (Barrantes-Vidal et al., 2013; Grattan and Linscott, 2019).

Broadly, stressful experiences are associated with poor social outcomes such as loneliness (Campagne, 2019). Additionally, loneliness has been evidenced to predict poorer mental health outcomes over time among individuals with absent or low schizotypy (Richardson et al., 2017). It is unclear if the same relation holds for individuals with high levels of schizotypy. Schizotypy has been related to higher stress (Grattan and Linscott, 2019) and loneliness (Badcock et al., 2016; Le et al., 2019a). Moreover, schizotypy has been correlated with decreased perception of social support (Blanchard et al., 2011), which is thought to be a strong moderating factor of the relation between stress and loneliness (Leigh-Hunt et al., 2017; Wang et al., 2018). However, it is possible that the effects of stress on social dysfunction may be attenuated by negative schizotypy’s atypical impact on interpersonal functioning. This relation might be counter-intuitive because people with traits of negative schizotypy can display a unique interpersonal style (reflective of social dysfunction in and of itself) which can involve schizoid or socially-avoidant tendencies (Kwapil et al., 2021), asociality, and social anhedonia (Silvia and Kwapil, 2011). It is possible that individuals with high negative schizotypy show no change in social dysfunction from stress because they may have lower levels of social interest/motivation and more modest (Catalano et al., 2018) or differential (Leung et al., 2010; McCarthy et al., 2015) responses to social reward. Thus, they may not rely on social connection to allay feelings of stress in the same way the general population does (McCarthy et al., 2018). Though examination of schizotypy often focuses on associations with detrimental functional outcomes, schizotypy may mitigate detrimental effects of stress in contexts where stress can contribute to negative social outcomes.

The outbreak of the Corona Virus Disease 2019 (COVID-19) pandemic led to social distancing measures which, although implemented to combat the spread of the disease, have been related to higher stress and other detrimental mental health outcomes (Marroquín et al., 2020). Yet, there is evidence that social support mitigates the negative effect of social distancing-related stress on depressive symptoms in this context in the general population (Sommerlad et al., 2021). In a time wherein gatherings and physical contact with others are restrained in service of the maintenance of physical well-being, stress, feelings of loneliness, and social dysfunction are expected to increase (Fiorillo and Gorwood, 2020; Saltzman et al., 2020); however, research on this point has been conflicting. One study failed to find support for a significant change in loneliness relative to COVID-19 response in the general US population (Luchetti et al., 2020). Conversely, a recent UK investigation found relatively high endorsement of loneliness (prevalence of 27%) following implementation of social distancing measures (Groarke et al., 2020), and a US study found increases in loneliness for outpatient participants with psychosis-spectrum illness when compared to healthy controls, but not when compared to individuals with affective or anxiety disorders (Pinkham et al., 2021).

Individuals demonstrating high schizotypy may respond to the stress of COVID-19 social distancing measures differently and contribute to these contradictory findings. Qualitatively, this was borne out in recent literature in which individuals with schizophrenia engaging in Metacognitive Insight and Reflection Therapy became more aware of loneliness as a community effect of the pandemic and related precautions, rather than a personal idiosyncratic trait. These clients had their schizophrenia-related loneliness and isolation normalized, which led to less pathologizing of their social difficulty and fewer feelings of “otherness” (Hasson-Ohayon & Lysaker, 2021). This seemingly adaptive response to the pandemic by schizophrenia-spectrum individuals is supported by a meta-analysis of psychopathology in the wake of disasters which demonstrated that those with pre-existing mood or anxiety disorders often decompensated. Paradoxically, individuals with schizophrenia maintained higher levels of functioning after disasters (Katz et al., 2002).

The context of the pandemic represents a unique opportunity to explore the potential differential impact of social distancing measures on stress and social dysfunction between populations with high schizotypy and low or absent schizotypy . The present study evaluated the moderation effects of positive, negative, and disorganized schizotypy on stress and social dysfunction in 85 young adults. We employed Ecological Momentary Assessment (EMA) collected multiple times per day over a two-week epoch. The assessment window occurred between late March and May of 2020, when governmental and community pandemic restrictions (COVID-19 Social Distancing [CSD] restrictions) were in full effect in the United States. Individuals with high schizotypy can have differing levels of positive, negative, and disorganized symptoms, and this heterogeneity may lead to differential reactions to stress (Ruzibiza et al., 2018). In turn, positive, negative, and disorganized domains of schizotypy were separately examined. Our design made use of multiple schizotypy measures – the Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR; Cohen et al., 2010) and the Multidimensional Schizotypy Scale (MSS; Kwapil et al., 2018) – to analyze how stress-related social dysfunction differs as a function of schizotypy factors, which have been shown to differ slightly between measures and analyses (Christensen et al., 2019; Davidson et al., 2016). We hypothesized that higher schizotypy would be associated with higher stress and CSD-related social dysfunction, consistent with demonstrated effects of schizotypy on stress sensitivity. However, the aforementioned effects on stress sensitivity and social outcomes are associated with cognitive-perceptual/positive or disorganized schizotypy, rather than negative schizotypy (Grattan and Linscott, 2019; Le et al., 2019a). There is also evidence that, in the context of EMA, negative schizotypy is unrelated to loneliness (Kwapil et al., 2012). Thus, we predicted that negative schizotypy specifically would moderate the relation between stress and CSD-related social dysfunction, such that individuals with higher negative schizotypy would demonstrate less of an increase in social dysfunction in response to the stress of CSD measures. Finally, we hypothesized that positive and disorganized schizotypy, which are less related to social functioning in daily life (Kwapil et al., 2020), would diverge from negative schizotypy and not moderate the impact of stress on social dysfunction.

2. Methods

2.1. Participants

Participants included 86 undergraduates 18 years of age or older, recruited through a University Subject Pool via the online Sona system (Sona Systems Ltd., 2002). Individuals without a cell phone compatible with the application used for the ambulatory phase were not eligible to participate. Each participant provided written informed consent and received course credit for their participation. The validity of participants’ responses was assessed through three items that are rarely endorsed; one participant exhibited an elevated score on all three of these items and was excluded from analyses, producing an analytic sample of n = 85. Sample demographics and clinical characteristics are displayed in Table 1; psychiatric history was ascertained from each participant using self-report. This project was approved by LSU IRB (protocol 4339).

Table 1.

Demographic Information (n=85)

Mean (SD)
Age 20.80 (3.64)
n (%)
 n (%)
Gender Psychiatric History
Male 11 (13%) Schizophrenia/other psychotic illness 2 (2.4%)
Female 74 (87%) Anxiety 36 (42.4%)
Depression 26 (30.6%)
Race ADHD 12 (14.1%)
Caucasian 62 (73%) Mania 2 (2.4%)
African-American 11 (13%)
Asian-American 3 (3.5%) Family History
Multiracial 1 (1.2%) Schizophrenia/other psychotic illness 9 (10.6%)
American Indian 1 (1.2%) Anxiety 55 (64.7%)
Other: Not American 3 (3.5%) Depression 47 (55.3%)
Other 4 (4.7%) ADHD 35 (41.2%)
Mania 9 (10.6%)
Ethnicity
Hispanic 7 (8.4%)
Not Hispanic 78 (91.8%)
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2.2. Measures

2.2.1. Trait Schizotypy

Trait schizotypy was assessed using the Schizotypal Personality Questionnaire – Brief [SPQ-BR; (Cohen et al., 2010)] and the Multidimensional Schizotypy Scale [MSS; Kwapil et al., 2018]. These schizotypy measures were both utilized in this investigation, as they were administered for separate parent studies. The SPQ-BR is a well-validated measure of schizotypy with 32 items rated on a 5-point Likert scale from 0 = “Strongly Disagree” to 4 = “Strongly Agree.” Items were aggregated to produce three averages reflecting Cognitive-Perceptual (14 items, α = .87), Negative (6 items tapping “No Close Friends” and “Constricted Affect” subscales, α = .84), and Disorganization symptoms (8 items, α = .87). The MSS is a newer measure featuring 77 true/false items selected using item response theory. Items were aggregated to produce three conceptually-driven subscales for each participant, reflecting Positive (26 items, α = .85), Negative (26 items, α = .87), and Disorganized (25 items, α = .94) symptoms of schizotypy (Kwapil et al., 2018).

2.2.2. Momentary Stress and Impact of COVID-19 Social Distancing (CSD)

EMA was used to assess momentary Stress (“My current situation is stressful”) and momentary impact of COVID-19 social distancing (CSD) on feelings of Loneliness (“How lonely do you feel because of COVID-19 social distancing right now?”) and Perceived Loss of Social Support (“How much has COVID-19 social distancing negatively affected your feelings of support from family, friends, or any close others right now?”). Each EMA survey included these items, rated on an 8-point scale from 0 = “Not at all” to 7 = “Very Much”.

2.2.3. Response Validity

Response validity was assessed using three items derived from the Chapman Infrequency Scale (Chapman and Chapman, 1983) that are rarely endorsed. These included two binary items (i.e., “On some mornings, I didn’t get out of bed immediately when I first woke up” and “I believe that most light bulbs are powered by electricity,” rarely endorsed as “false”) and one item rated on a Likert scale from 0 = “Strongly Disagree” to 4 = “Strongly Agree” (i.e., “Driving from New York to San Francisco is generally faster than flying between these cities,” rarely endorsed as “Agree” or above). Individuals who responded “False” to both binary items and “Agree” or “Strongly Agree” to the Likert item were excluded from analysis; one participant was excluded on this basis. Two participants who responded incorrectly to one out of three items were not excluded, as individual lapses in attention or anomalous experiences associated with schizotypy may be associated with momentary aberrant responses that are not indicative of overall response invalidity. No participants responded incorrectly to two items.

2.3. Procedures

2.3.1. Initial Phase

Before enrolling in the ambulatory phase, participants completed a demographic questionnaire, the MSS, SPQ-BR, and response validity items that were embedded in each scale through the online Sona system. Other questionnaires that were not included in the present study were also completed.

2.3.2. Ambulatory Phase

After enrolling in the ambulatory phase, participants were instructed to install the PIEL survey application (Jessup et al., 2021) on their cell phones. Participants were then asked to complete seven surveys a day over fifteen days, yielding a maximum of 105 ambulatory assessments (with an average completion rate of 79). Survey items included momentary assessments of mood, stress, psychotic-like symptoms, and the impact of CSD on their feelings of loneliness and social support. Surveys were given at equally-spaced intervals between 11:00am and 11:00pm.

2.4. Analyses

All analyses were completed in RStudio ver. 1.2.5033 (RStudio Team, 2020). Schizotypy scores and EMA responses were standardized as Z-scores before analysis.

2.4.1. Imputation

On the MSS, 5 participants each omitted 1 item; values were imputed for these items using kNN imputation (Beretta and Santaniello, 2016). No SPQ-BR items were omitted in this sample. Missing values from the ambulatory phase were not imputed and were omitted from analyses.

2.4.2. Demographic Differences and Covariates

Demographic differences in within-subject averages of the momentary variables (i.e., stress and impact of COVID-19 social distancing) were explored using two-tailed t-tests for binary categorical demographic variables (i.e., gender, ethnicity, relationship status, marriage status, psychiatric history, family psychiatric history), ANOVA for categorical demographic variables with more than 2 levels (i.e., race), and bivariate Pearson correlation for continuous and ordinal demographic variables (i.e., age, number of children). Demographics found to significantly relate to the momentary outcome variables would be added as covariates to models predicting the variable of interest.

2.4.3. Multilevel Modelling of COVID-19 Social Distancing Impact & Moderation by Schizotypy

Multilevel modelling (MLM) was conducted in R using the lme4 package (Bates et al., 2021). Ambulatory data (Level 1) were nested within participants (Level 2). Models analyzed the relation between momentary stress and momentary impact of CSD on social functioning, and whether this relation is moderated by trait schizotypy. Models were hierarchical and predicted one of the two CSD social impact variables (Loneliness and Perceived Loss of Social Support). In step 1, EMA stress was added along with a fixed effect for participant. In step 2, the relevant schizotypy variables were added. Step 3 added an interaction between momentary stress and the schizotypy variable(s) to assess for moderation. Two omnibus models, one for each schizotypy measure including either all MSS or all SPQ-BR subscale scores, were generated for each CSD social impact variable, yielding 4 omnibus models reflecting the effects of each schizotypy factor over and above the others. Schizotypy variables that emerged as significant main effects or interaction terms in step 3 of the omnibus models were then run in the same stepwise manner for to assess the independent effects of each schizotypy factor relative to their contribution to the omnibus model. The independent models included only the momentary stress variable and fixed effect in step 1, added the individual schizotypy variable in step 2, and added the interaction between stress and the schizotypy variable in step 3. Improvement in model fit between steps was assessed using chi-square testing.

3. Results

3.1. Preliminary Analyses and Models

Descriptive characteristics of the schizotypy and ambulatory variables are presented in Table 2. No demographic variables were significantly related to any momentary outcome variable. A correlation matrix of schizotypy and momentary outcome variables is presented in Table 3. The MSS and SPQ-BR demonstrated good and fair convergent validity between their Positive/Cognitive-Perceptual factors (r = 0.73, p < .01) and fair convergent validity between their Negative (r = 0.60, p < .01) and Disorganized (r = 0.55, p < .01) factors. Significant, positive correlations were evidenced between positive schizotypy domains (i.e., SPQ-BR CP and MSS Positive) and EMA stress, EMA loneliness, and EMA perceived loss of social support. SPQ-BR Negative was significantly, positively correlated with EMA stress, EMA loneliness, and EMA perceived loss of social support. Though MSS Negative evidenced a positive correlation with EMA stress, no significant associations between MSS Negative and EMA loneliness or EMA loss of social support were found. Both SPQ-BR Disorganized and MSS Disorganized were significantly, positively correlated with EMA stress, EMA loneliness, and EMA loss of social support.

Table 2.

Schizotypy and EMA score descriptives (n=85)

Mean (SD)
Schizotypal Personality Questionnaire – Brief Revised (n=85)
 Cognitive-Perceptual symptoms 1.04 (0.69)
 Negative Symptoms 1.28 (0.88)
 Disorganized Symptoms 1.69 (0.89)
Multidimensional Schizotypy Scale (n=85)
 Positive Symptoms 0.15 (0.16)
 Negative Symptoms 0.16 (0.17)
 Disorganized Symptoms 0.21 (0.26)
Ecological Momentary Assessment (n=85;k=6716)
 Average k 79.01 (21.37)
 Average Momentary Stress 3.23 (1.59)
 Average Momentary Loneliness due to CSD 4.09 (1.86)
 Average Momentary Lack of Social Support due to CSD 3.62 (1.81)
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CSD = COVID-19 Social Distancing; k = number of completed momentary assessments

EMA completion rates (k) ranged from 22.9% to 98.1%.

Multidimensional Schizotypy Scale means reflect average response between 0 (“False”) and 1 (“True”) for each subscale.

Table 3.

Bivariate correlation matrix (n=85; k = 6716 for EMA variables)

1 2 3 4 5 6 7 8 9
1. SPQ-BR Cognitive-Perceptual 1
2. SPQ-BR Negative 0.48** 1
3. SPQ-BR Disorganized 0.63** 0.50** 1
4. MSS Positive 0.73** 0.31** 0.39** 1
5. MSS Negative 0.23* 0.60** 0.28* 0.211 1
6. MSS Disorganized 0.56** 0.53** 0.55** 0.55** 0.32** 1
7. EMA Stress 0.13** 0.22** 0.14** 0.11** 0.08** 0.24** 1
8. EMA CSD Loneliness 0.16** 0.12** 0.05** 0.20** 0.00 0.19** 0.36** 1
9. EMA CSD Lack of Social Support 0.12** 0.13** 0.12** 0.17** −0.02 0.24** 0.38** 0.72** 1
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CSD = COVID-19 Social Distancing

*

p < .05;

**

p < .01

3.2.1. COVID-19 Social Distancing: Impact on Loneliness

Including a step with interaction terms improved the prediction of CSD Loneliness in the SPQ-BR model (χ2 = 30.72, p < .001) but not the MSS model (χ2 = 6.17, p = .10). In the SPQ-BR model, a main effect of Stress (B[SE] = 0.11 [0.01], 95% CI = [0.09, 0.13], p < .05) and two interaction effects, between Stress and SPQ-BR Cognitive-Perceptual Schizotypy (B[SE] = 0.04 [0.01], 95% CI = [0.02, 0.06], p <.05) and between Stress and SPQ-BR Negative Schizotypy (B[SE] = −0.05 [.0.01], 95% CI = [−0.07, −0.03], p < .05), were significant. As the interaction step of the MSS model was not significant, the model coefficients are not presented here (see Supplement S1).

3.1.2. Omnibus models: COVID-19 Social Distancing: Impact on Feelings of Social Support

The interaction step significantly improved the prediction of CSD Lack of Social Support in both the SPQ-BR and MSS omnibus models (SPQ-BR: χ2 = 48.02, p < .001; MSS: χ2 = 11.78 p = .008). In the SPQ-BR model, a main effect of Stress (B[SE] = 0.11 [.01], 95% CI = [0.09, .12], p < .05) and an interaction effect between Stress and SPQ-BR Negative Schizotypy (B[SE] = −0.06 [.01], 95% CI = [−0.08, −.04], p < .05) emerged as significant. In the MSS model, main effects of Stress (B[SE] = 0.09 [.01], 95% CI = [0.08, 0.11], p < .05) and MSS Disorganization (B[SE] = 0.25 [.12], 95% CI = [0.21, 0.47], p < .05) were significant, as well as interaction effects between Stress and MSS Negative Schizotypy (B[SE] = −0.03 [0.01], 95% CI = [−0.05, −0.01], p < .05) and between Stress and MSS Disorganization (B[SE] = 0.02 [.01], 95% CI = [0.00, 0.04], p < .05). Full results for the omnibus models are presented in Supplement S1.

3.2. Individual Models

All individual models (step 3) are displayed in Table 4. Only models of schizotypy variables and interactions that were significant in the omnibus models are discussed below. A main effect of stress emerged in each model (B[SE] = 0.09 to 0.11 [.01], p < .05). Models of negative schizotypy that were significant in both the omnibus and individual models are highlighted in Figure 1.

Table 4.

Step 3 of individual models (n=85; k=6716)

Predicting: CSD Loneliness CSD Loss of Social Support
95% CI 95% CI
χ2 B (SE) LL UL χ2 B (SE) LL UL
SPQ-BR Models
 Cognitive-Perceptual 0.14 (0.1) −0.05 0.32 0.1 (0.1) −0.09 0.29
 Stress 0.96 0.1 (0.01)* 0.08 0.12 4.37* 0.09 (0.01)* 0.07 0.11
 Interaction 0.01 (0.01) −0.01 0.02 −0.02 (0.01)* −0.03 0.00
 Negative 0.14 (0.1) −0.05 0.33 0.15 (0.1) −0.05 0.34
 Stress 15.66*** 0.11 (0.01)* 0.09 0.13 45.04*** 0.1 (0.01)* 0.09 0.12
 Interaction −0.03 (0.01)* −0.05 −0.02 −0.06 (0.01)* −0.07 −0.04
 Disorganized 0.03 (0.1) −0.16 0.22 0.08 (0.1) −0.11 0.27
 Stress 3.61 0.1 (0.01)* 0.09 0.12 11.91*** 0.1 (0.01)* 0.08 0.11
 Interaction −0.02 (0.01) −0.03 0.00 −0.03 (0.01)* −0.05 −0.01
MSS Models
 Positive 0.17 (0.09) 0.00 0.35 0.15 (0.09) −0.03 0.33
 Stress 0.08 0.1 (0.01)* 0.08 0.12 0.38 0.09 (0.01)* 0.07 0.11
 Interaction 0 (0.01) −0.01 0.02 −0.01 (0.01) −0.02 0.01
 Negative −0.01 (0.1) −0.20 0.18 −0.03 (0.1) −0.22 0.15
 Stress 5.10* 0.1 (0.01)* 0.08 0.12 7.38** 0.09 (0.01)* 0.08 0.11
 Interaction −0.02 (0.01)* −0.04 0.00 −0.02 (0.01)* −0.04 −0.01
 Disorganization 0.2 (0.09) 0.01 0.38 0.23 (0.09) 0.05 0.41
 Stress 0.18 0.1 (0.01)* 0.08 0.12 0.50 0.09 (0.01)* 0.07 0.11
 Interaction 0 (0.01) −0.02 0.01 0.01 (0.01) −0.01 0.02
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*

p < .05;

**

p < .01;

***

p < .001

CSD = COVID-19 Social Distancing; SPQ-BR = Schizotypal Personality Questionnaire – Brief Revised; MSS = Multidimensional Schizotypy Scale

χ2 fit statistic reflects difference between step two (Schizotypy variable + stress) and step three (schizotypy variable + stress + interaction)

Note: Variables that did not produce significant interactions in the omnibus models (e.g., SPQ-BR Disorganized) are not discussed in the text

Figure 1. Scatterplots of significant moderation effects of negative schizotypy.

Figure 1.

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All variables are standardized; SPQ = Schizotypal Personality Questionnaire, Brief Revised; MSS = Multidimensional Schizotypy Scale

a) Negative schizotypy as measured by the SPQ-BR moderates the effect of momentary stress on loneliness. Higher values (2; dashed line) show less of an increase in loneliness as stress increases.

b) Negative schizotypy as measured by the SPQ-BR moderates the effect of momentary stress on perceived loss of social support. Higher values (2; dashed line) show less of an increase in perceived loss of social support as stress increases.

c) Negative schizotypy as measured by the MSS moderates the effect of momentary stress on perceived loss of social support. Higher values (2; dashed line) show less of an increase in perceived loss of social support as stress increases.

3.2.1. COVID-19 Social Distancing: Impact on Loneliness

Although significant in the omnibus model, the interaction between EMA Stress and SPQ-BR CP (B[SE] = 0.01 [0.01], C95% CI = [−0.01, 0.02], p > .05) was not significant when tested with only SPQ-BR CP, EMA Stress, and their interaction predicting CSD-related Loneliness. The interaction between EMA Stress and SPQ-BR Negative was significant (B[SE] = −0.03 [0.01], C95% CI = [−0.05, −0.02], p < .05).

3.2.2. COVID-19 Social Distancing: Impact on Feelings of Loss of Social Support

Consistent with the omnibus models predicting CSD-related feelings of a loss of Social Support, a main effect of MSS Disorganization (B[SE] = 0.23 [0.09], C95% CI = [0.05, 0.41], p < .05) and interaction effects between EMA Stress and SPQ-BR Negative (B[SE] = −0.06 [0.01], C95% CI = [−0.07, −0.04], p < .05) and between EMA Stress and MSS Negative (B[SE] = −0.02 [0.01], C95% CI = [−0.04, −0.01], p < .05) were significant. Unlike in the omnibus model, the interaction between EMA Stress and MSS Disorganization was not significant (B[SE] = 0.01 [0.01], C95% CI = [−0.01, 0.02], p > .05).

4. Discussion

We evaluated the impact of schizotypy on CSD-related social dysfunction and assessed how schizotypy moderated the relation between stress and these social outcomes. Momentary stress was universally related to momentary CSD social dysfunction (Loneliness and perceived Loss of Social Support). Consistent with our hypotheses, negative schizotypy significantly moderated the relation between momentary stress and momentary CSD-related loneliness (SPQ-BR only) and perceived loss of social support (both SPQ-BR and MSS) (see Fig. 1). While these findings demonstrate the deleterious impact of stress on momentary CSD-related social dysfunction, they also demonstrate that negative schizotypy can limit the magnitude of increases in this dysfunction routed in momentary stress. Moreover, we did not find main effects of negative schizotypy on either momentary social dysfunction variable; although negative schizotypy is often conceptualized as related to social dysfunction, our findings demonstrate that momentary changes in this dysfunction may be less affected by negative schizotypy. While individuals with high schizotypy have generally exhibited higher stress sensitivity (Barrantes-Vidal et al., 2013; Grattan and Linscott, 2019; Le et al., 2019b), these results add to the literature that heterogenous presentations of schizotypy (specifically, higher negative schizotypy) may limit negative reactions to stress in certain contexts.

These results are potentially counterintuitive, as schizotypy is often viewed as conferring greater risk for the presentation of psychopathology and has not been considered much in regard to its possible adaptive functions. Although most studies associate general psychopathology with lower resilience (Fritz et al., 2018) and higher stress sensitivity (Vaessen et al., 2017), there are documented precedents where psychopathology-related traits have been shown to be adaptive in certain domains. For example, depression has been related to more realistic appraisals of situations (Seidel et al., 2012), and disorders including attention-deficit/hyperactivity disorder (White and Shah, 2006) and bipolar disorder (Johnson et al., 2012) have been related to higher creativity and accomplishment. There is evidence that schizotypy can be adaptive in some ways as well – higher schizotypy can produce more creativity (Acar and Sen, 2013; Fink et al., 2014), more realistic appraisals of self-competency due to lower bias toward illusory superiority (Cohen et al., 2014), and better performance on certain cognitive tasks, such as the context-independent condition of a working memory task (Barch et al., 2004). Moreover, our framing of negative schizotypy as a buffer against stress-related social dysfunction dovetails with evidence that negative/deficit schizophrenia can buffer against stress-induced negative affect in a laboratory setting (Cohen et al., 2003).

Potential adaptive properties aside, there are compelling reasons why negative schizotypy is non-adaptive in many, perhaps most, contexts. Stress-buffering effects of negative schizotypy may only emerge in extreme contexts, such as during a pandemic that necessitates social isolation. Of particular note, the relatively small social support network associated with negative schizotypy could contribute to an attendant increase in positive symptoms through Social Deafferentation (Hoffman, 2007). According to this process, when an individual with negative symptoms becomes even more isolative, they may lose social support systems that provide counterfactual evidence or alternative explanations for that individual’s anomalous experiences (i.e., positive symptoms). Because the individual does not have access to information that would disconfirm their own beliefs about the nature of these experiences, their experiences and potentially delusional interpretations are reinforced, increasing in intensity and frequency. However, loss of social support has been proposed to have potential benefits as well; individuals with high negative symptoms show lower rates of problematic substance use when compared to those with only high positive symptoms, and some studies propose that this benefit may stem from less social interaction and therefore less opportunity to obtain substances and less exposure to substance use-related cues. What is not clear from the present study is whether negative symptoms and attendant isolation confer benefits that outweigh deleterious increases in positive symptoms. The potential adaptive properties of symptoms on reactions to stress across phases of the schizophrenia-spectrum illness (Debbane and Barrantes-Vidal, 2015) are an important area for future study.

In addition, our findings are relevant to schizotypy measurement. The MSS and SPQ-BR generally demonstrated convergent validity; their factors correlated in an expected way (i.e., SPQ-BR Cognitive-Perceptual, Negative and Disorganized factors correlated most highly with MSS Positive, Negative and Disorganized factors, respectively) and negative schizotypy moderated the relation between stress and perceived loss of social support for both measures. However, some differences emerged. MSS Disorganized yielded a main effect on feelings of loss of social support, while SPQ-BR Disorganized did not. This may stem from differences in the aspects of disorganization reflected by the measures’ factors. SPQ-BR Disorganization comprises disorganized speech and eccentric behavior, while MSS Disorganization includes items primarily relating to cognitive disorganization (e.g., “My thoughts almost always seem fuzzy and hazy”). Considering SPQ-BR Disorganization’s strong correlation (r = .63) with the SPQ-BR Cognitive-perceptual factor, it is possible that the SPQ-BR Disorganization factor taps eccentricity stemming from positive or negative schizotypy, rather than the cognitive disorganization which appears to have an effect on social outcomes. Unlike SPQ-BR Negative, MSS Negative did not moderate the effect of stress on loneliness while controlling for other factors in the omnibus model. The SPQ-BR Negative factor we used contained items tapping constricted affect and appraisals of one’s ability to connect emotionally with others, while the MSS Negative factor includes items reflecting constricted affect, social and general amotivation, and anticipatory anhedonia. Given SPQ-BR Negative’s emphasis on interpersonal competency rather than interpersonal motivation, it is possible that individuals with higher SPQ-BR Negative viewed themselves as less socially competent and thus generally more lonely, mitigating the potential impact of stress on loneliness. In light of these results, careful consideration should be taken by researchers to decide which of these measures to use, as their subfactors may relate differently to social outcomes.

4.1. Limitations and Future Directions

Some limitations of the present study are worth mentioning. This study used a non-clinical sample and clinical information was provided by self-report, so between-group analyses based on diagnosis were of limited utility. It is unclear if these findings would generalize to individuals with schizotypy or psychotic symptoms that surpass a clinical threshold. Nonetheless, the current study’s approach of viewing schizotypy as a transdiagnostic personality organization linked to clinically-relevant outcomes is well-supported by the literature (Lenzenweger, 2018). Although correlations were found between momentary stress and CSD-related social dysfunction, these variables were collected at the same timepoint, and a causal connection cannot be established from the current study. Furthermore, the social dysfunction variables were worded in the context of CSD and may not reflect more general feelings of loneliness or loss of social support. More specifically, this study’s use of EMA methodology queries momentary experiences of social dysfunction such as loneliness, which are expected to fluctuate across ambulatory surveys as a function of context such as stress or recent interactions with a specific social relationship (Culbreth et al., 2021). General or more global feelings of social dysfunction are historically measured on comprehensive lab-based questionnaires that assess trait-like tendencies toward social dysfunction like loneliness through implicit items. In contrast, EMA methods demonstrate high ecological validity (Granholm et al., 2019), and moderation analyses on momentary variables are well-established in the EMA literature, so it can be expected that the moderating relations found in the current study are valid regardless of the causal link between stress and CSD-related social dysfunction (although this relation may only be evident in specific contexts). Further research would benefit from analyzing whether these relations hold for more general social dysfunction by using wording that does not invoke CSD restrictions for social dysfunction items, and more broadly from considering how questions related to social dysfunction are assessed.

Additionally, future studies using EMA paradigms should include momentary assessments of metacognition, affect, and other variables that may mediate the relation between stress and social dysfunction or may demonstrate differences based on symptoms of schizotypy. Finally, the EMA questions used in this study focused on perception of loneliness and social support rather than tracking actual social interaction. Future studies should employ additional outcomes (such as frequency or quality of social contact) to establish a link between self-reported social dysfunction and real-world social functioning or social support.

5. Conclusion

The present study provides evidence that negative schizotypy can act as a buffer between stress and negative social outcomes including loneliness and perceived loss of social support. There are precedents in the literature for traits related to psychopathology to serve adaptive function, and this appears to extend to negative schizotypy as well. Our measures of schizotypy captured heterogeneous characteristics of negative schizotypy that produced different moderating effects of momentary stress, which point to different mechanisms by which this buffering effect can occur. More research is required to determine if these effects extend beyond high-stress contexts that contribute to social isolation (such as COVID-19 Social Distancing protocols). Effective treatment of negative schizotypy should consider that the beneficial effects of negative schizotypy may be lost as symptoms are reduced, and provide alternative coping skills to manage social dysfunction in high-stress contexts.

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Footnotes

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Conflicts of Interest: none

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