key: cord-0734638-daca9pi4
authors: Lopes, B.; Bortolon, C.; Jaspal, R.
title: Paranoia, hallucinations and compulsive buying during the early phase of the COVID-19 outbreak in the United Kingdom: a preliminary experimental study
date: 2020-09-17
journal: Psychiatry Res
DOI: 10.1016/j.psychres.2020.113455
sha: 8609dafe9ba03b7c97dd5eeeec65a8024a34d24a
doc_id: 734638
cord_uid: daca9pi4

This study examines the impact of COVID-19 (in the early phase of the outbreak) on symptoms of psychosis, namely paranoia and hallucinations. Three hundred and sixty-one people in the United Kingdom participated in a 2 (self-isolation vs. no self-isolation) x 2 (perceived COVID-19 symptomatology vs. no perceived COVID-19 symptomatology) x 2 (exposure to COVID-19 news vs. control) experiment online. Participants completed measures of political trust, social network, fear of COVID-19, current paranoid thoughts, hallucinatory experiences and compulsive buying. Kruskal-Wallis results showed that employed people and students are more prone to paranoia and hallucinatory experiences in response to COVID-19 news. A multigroup model showed a moderation effect of news conditions - in the COVID-19 news condition, fear of COVID-19 and political trust significantly predict the variance of paranoia, hallucinatory experiences and compulsive buying and these co-vary with each other but not in the control condition. In line with cognitive and social theories of paranoia, results suggest that negative affect and low political trust are linked to the presence of paranoid thoughts and hallucinatory experiences and compulsive buying amid COVID-19. Digitized and Tailored Cognitive and Behavioral Therapy are proposed to address the psychiatric impact of COVID-19.

There is increasing concern that the outbreak of COVID-19 in the United Kingdom (UK), as In a review, Freeman and colleagues (2011) found that 5 to 6% of the population in the UK 76 have delusions of persecution of mild severity, which suggests that paranoia is relatively examines the links between length of self-isolation, strength of social network and the 125 presence of paranoia, hallucinations and compulsive buying. 126 Social theories of paranoia (e.g., Kramer, 2002; Harper. 2008 

Compulsive buying is a cognitive and behavioral condition characterized by the 160 persistent, excessive, impulsive, and uncontrollable purchase of products in spite of 161 potentially harmful psychological, social, occupational, financial consequences (Müller, 162 Mitchell & de Zwaan, 2015). Health crises, such as epidemics and pandemics, can constitute 163 a key trigger for compulsive buying (also referred to as ‗panic buying'). During the early 164 phase of the COVID-19 outbreak, this occurred in the UK and elsewhere (e.g., Hall, 2020).

Compulsive buying in the context of COVID-19 may be conceptualized as a maladaptive 166 coping strategy, especially in people with a diagnosed mental health disorder, such as To sum up, social factors such as low political trust, self-isolation, reduced social 170 support are thought to be associated with fear of COVID-19, which in turn might also 171 increase paranoia and hallucinations. Compulsive buying could be a coping mechanism in 172 response to the current situation and associated social (e.g., political trust) and clinical factors A 2 x (self-isolation vs. no self-isolation) x 2 (perceiving COVID-19 symptomatology vs. not) 203 x 2 (exposure to COVID-19 news vs. control) between subjects experimental study was 204 conducted with pre-and post-manipulation measures.

Pre-manipulation questions included socio-demographic questions (e.g., age, income, 206 religion, occupation status, etc.), perceived COVID-19 symptomatology (yes vs. no), self-207 isolation (yes vs. no), and length of self-isolation (1=less than a week to 6=more than four 208 weeks), diagnosis of a mental health disorder (yes vs. no) and, if so, the specific diagnosis 209 and whether or not they were receiving treatment for it (yes vs. no). Moreover, they Participants were then randomly and evenly exposed to either British Broadcasting 220 Corporation (BBC) news broadcasted on the 18 th March 2020, lasting 1 minute focusing on 221 the increased death toll in the UK due to COVID-19 (COVID-19 news) or to news lasting 1.5 222 minutes about an environmental project (i.e. Eden reforestation project on the 23 rd January, After being exposed to the specific video, participants were asked to complete the Similarly, when exposed to COVID-19 news, employed people showed the highest levels Mann-Whitney tests showed no statistically significant differences between participants 333 who perceived COVID-19 symptomatology compared to those who did not in terms of 334 paranoia, hallucinatory experiences, compulsive buying, political trust, social network or fear 335 of COVID-19 (p > 0.050). Also, no statistically significant differences were found between 336 those participants who were in self-isolation vs. those who were not for paranoia, First, this study shows that employed people are more likely to exhibit paranoia when 384 exposed to COVID-19 news. This may be attributed to the precarious economic conditions 385 associated with the outbreak, which may in turn lead employed people to fear for their job 386 security and to develop a cognitive bias whereby they perceive others as attempting to cause outbreak, that such change has become extremely commonplace (e.g., working from home, 391 furlough, etc.) (Terry & Timmieson, 2003) . Also, it is likely that employed people exhibited 392 much more paranoia than people who were unemployed at the time of the study because they 393 believed themselves to be at risk of infection due to the potential need to work away from 394 home which was not the case for the unemployed, for instance, who conversely could stay at 395 home during the lockdown. 

Contrary to speculation about the impact of self-isolation on mental health (e.g. In contrast, in the control condition, the relationships between fear of COVID-19 and 446 paranoia, hallucinatory experiences and compulsive buying were weaker or entirely absent. It is clear that social representations of COVID-19 are pervasive and that they contributed to 448 participants' general cognition in relation to COVID-19 at the time of the study (Jaspal, 449 Lopes & Lopes, 2020ab). Yet, in the COVID-19 news condition, the relationships between 450 these variables strengthen, suggesting that COVID-19-related stimuli, and particularly news 451 which tends to focus on negative aspects of the outbreak, can further accentuate the 452 relationship between the outbreak and poor mental health outcomes. suggest, lower political trust is associated with more paranoia, which was accentuated in the context of being exposed to COVID-19 news. Lower political trust is also associated with 473 more hallucinations and compulsive buying when one is exposed to COVID-19 news only, 474 suggesting that when people with decreased political trust are exposed to this type of news 475 they are likely to engage in compulsive buying to cope with their COVID-19-related paranoia 476 and hallucinations.

There are also positive relationships between paranoia, hallucinatory experiences and related to greater paranoia, hallucinations and compulsive buying when one is exposed to 517 COVID-19 news and that paranoia, hallucinations and compulsive buying also co-vary when 518 one is exposed to such news. Overall, this suggests that clinical and social theories are useful 519 for understanding paranoia in the context of COVID-19 and that digitized CBT with 520 components of mindfulness which is tailored to address COVID-19 specific issues should be 521 provided to the UK population. The authors state that there are no conflicts of interest associated with this paper. We confirm that 535 this manuscript is not under review elsewhere, involves no conflict of interest, involves data that 536 were collected ethically and involves no prior or duplicate publication. We confirm that the 537 manuscript has been read and approved by all authors. 

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Note: Z and p-values were calculated for the non-standardized estimates