Covid-19, trust, paranoia and compulsive buying

The Covid-19 outbreak in the UK is a major stress-inducing event that has been leading to an increase in common mental health problems, such as depression (see Kanter & Manbeck, 2020; Shevlin et al., 2020; and this recent longitudinal review led by psychologists at the University of Glasgow). However, most research has overlooked the relationships between COVID-19 and the onset of less common psychiatric conditions symptomatic of psychosis, such as paranoia and hallucinations.

Paranoia is a symptom of psychosis that is characterised by the belief that other people are intentionally and maliciously causing one harm (e.g., beliefs of a conspiracy). Hallucinations are also a symptom of psychosis and are anomalous experiences e.g., seeing and hearing things that are not there. 

They are commonly associated with paranoia and both are prompted by stress-inducing experiences such as fear that one might have been infected with coronavirus (Lincoln et al., 2008). Although having paranoia and hallucinations per se does not lead to a diagnosis of a psychotic disorder, it is well known that in time and when exposed to continuous stress, vulnerable individuals can go on to develop psychotic disorders (see Freeman et al., 2011). 

Is self-isolation always a problem for mental health?

In our studies (Jaspal, Lopes & Lopes, 2020a, 2020b; Lopes, Bortolon & Jaspal, 2020), we have found out that contrary to the major expectation that self-isolation imposed by social distancing/quarantine measures is detrimental to mental health in the UK, self-isolation per se does not appear to lead to poor mental health outcomes, especially if self-isolation occurs for a relatively short period of time and when it is possible to maintain a social network and support during lockdown. What we have found is that believing that you have symptoms of COVID-19 and being exposed to threatening stimuli related to COVID-19, such as news, do seem to be more associated with depression. 

Moreover, when analysing the presence of paranoia and of hallucinations in response to COVID-19 in the UK, it seems that when people are exposed to news which focuses on the negative aspects of COVID-19 (e.g. increased death rate) in contrast to a control, there are strong relationships between having fear of Covid-19 and of low political trust and current paranoia, hallucinations and compulsive buying. In other words, when people in the UK are exposed to COVID-19 news in comparison to a control, their fear of COVID-19 may lead to more paranoia, hallucinations and associated compulsive buying whereas their low political trust in the UK government also increases their Covid-19-related paranoia, hallucinations and compulsive buying (see Lopes, Bortolon & Jaspal, 2020). 

Buying to cope

Especially during the early phase of the pandemic, we saw a lot of compulsive buying behaviour in the UK and elsewhere. This behaviour may actually be a maladaptive coping response to COVID-19 psychological stress, fear and paranoia and hallucinations.

It seems that when people experience fear of Covid-19 and have low political trust, they are likely to experience paranoia and hallucinations i.e. personally threatening feelings and thoughts (e.g. 'others are plotting against me') in response to Covid-19. These feelings are then related to compulsive buying as a mechanism to prevent, and cope with, COVID-19 threats (e.g., food and medicine shortages, disease).

Not surprisingly, there has been an increase in conspiracy theories in relation to the COVID-19 outbreak, such as the idea that the virus was created in a lab (Pew Research Centre, 2020). In support of social theories of paranoia (see Aupers, 2012), disenchantment with the current authorities and governments, and increased mistrust and suspicion of authorities, media and science may be associated with an increase in paranoia in the face of Covid-19.

Who is especially vulnerable to poor mental health?

Results of our studies also showed that certain groups in the UK population are more vulnerable to poor mental health (including paranoia and hallucinations) in response to Covid-19. In light of past literature suggesting the links between social disadvantage, stress and inequality and minority status (e.g. Madiha et al., 2016), our research suggests that religious minorities (such as Muslims) may be more prone to developing paranoia in response to Covid-19 in relation to the White majority in the UK. This might be due to the threatening social representations of the Muslim community in the UK that can be exarcebated in the context of Covid-19 (Lopes & Jaspal, 2015). 

Moreover, employed people in the UK are more likely to develop both paranoia and hallucinations than unemployed and people in other occupations in response to Covid-19. This might be due to two major issues: on the one hand, major changes in the workplace due to COVID-19 (layoffs, health and safety strict measures) may have led employed people to misconstrue the workplace environment as potentially threatening to them and as such they may perceive those changes as being harmful (see Lopes, Kamau & Jaspal, 2018). On the other hand, employed people in contrast to people who were already unemployed before COVID-19 might have to be working outside the home and might need to deal with the fear of contagion in workplaces. 

Indeed, our studies suggest that people of low income are more likely to have been working outside of the home during quarantine and thus be more susceptible to mental health issues as well (Jaspal, Lopes & Lopes, 2020). This suggests that people who are exposed to COVID-19 stressors in the workplace might need help to cope with this stress. Moreover, in support of past literature, students also are vulnerable to developing COVID-19-related paranoia and hallucinations and this might be due to developmental challenges and lack of social support which are well-known concomitants of paranoia in the literature (Harper & Timmons, 2019). 

Where next?

In the face of a devastating mental health crisis allied to economic and health crises due to Covid-19, we propose that already available resources like digitised cognitive behavioural therapy (CBT) that is provided in the NHS should be used. The digitised CBT should include components of mindfulness and emotion regulation and coping skills tailored to address Covid-19 related stressors and issues for the UK population (Lopes & Jaspal, 2020). 

This is vital to prevent and ameliorate the potential negative impact of Covid-19 not only in relation to an increase in common mental health problems such as depression but also less common psychiatric conditions such as paranoia and hallucinations that are symptomatic of psychosis. This support will be especially vital for those communities that are especially vulnerable to poor mental health during the pandemic.

- Professor Rusi Jaspal

Nottingham Trent University, UK

[email protected]

- Barbara Lopes, University of Coimbra, Portugal

References

Aupers, S. (2012) "Trust no one": Modernization, paranoia and a conspiracy culture. European Journal of Communication, 27(1) 22-34. https://doi.org/10.1177/0267323111433566    

Freeman, D., McManus, S., Brugha, T., Meltzer, H., Jenkins, R., & Bebbington, P. (2011). Concomitants of paranoia in the general population. Psychological Medicine, 41, 923-936.

Harper, D. & Timmons, C. (2019) How is paranoia experienced in a student population? A qualitative study of students scoring highly on a paranoia measure. Psychology & Psychotherapy: Theory, Research & Practice, 1-18 https://doi.org/10.1111/papt.12250  

Jaspal, R. Lopes, B., & Lopes, P. (2020a). Fear, social isolation and compulsive buying in response to COVID-19 in a religiously diverse sample in the UK. Mental Health, Religion and Culture, 31(5), 427-442. https://doi.org/10.1080/13674676.2020.1784119

Jaspal, R., Lopes, B. & Lopes, P. (2020b) Predicting social distancing and compulsive buying behaviours in response to Covid-19 in a United Kingdom sample. Cogent Psychology, 7(1), 1-14. https://doi.org/10.1080/23311908.2020.1800924 

Kanter, J. & Manbeck, C. (2020) Covid-19 could lead to an epidemic of clinical depression, and the health care system is not ready for that either. 

Lincoln, T., Peter, N., Schäfer, M. & Moritz, S. (2008) Impact of stress on paranoia: an experimental investigation of moderators and mediators. Psychological Medicine, 39 (7) 1129-1139. https://10.1017/S0033291708004613

Lopes, B., Bortolon, C. & Jaspal, R. (2020) Paranoia, hallucinations and compulsive buying during the early phase of COVID-19 in the United Kingdom: a preliminary experimental study. Psychiatry Research.https://doi.org/10.1016/j.psychres.2020.113455

Lopes B., & Jaspal R. (2015) Paranoia predicts out-group prejudice: preliminary experimental data. Mental Health, Religion & Culture, 18(5), 380–95. https://10.1080/13674676.2015.1065475   

Lopes, B., & Jaspal, R. (2020). Understanding the mental health burden of COVID-19 in the United Kingdom. Psychological Trauma: Theory, Research, Practice and Policy, 12(5), 465–467. https://10.1037/tra0000632 

Lopes, B., Kamau, C. & Jaspal, R. (2018) Coping with perceived abusive supervision in the workplace: the role of paranoia. Journal of Leadership & Organizational Studies, 26(2), 237-255. https://doi.org/10.1177/1548051818795821  

Madiha, S., Ellett, L., Dutt, A., Day, F., Laing, J., Kroll, J., Petrella, S., McGuire, P. & Valmaggia, L. (2016) Perceived ethnic discrimination and persecutory paranoia in individuals at ultra-risk for psychosis. Psychiatry Research, 241, 309-3014. https://doi.org/10.1016/j.psychres.2016.05.006

Pew Research Center (2020) Nearly three-in-ten Americans believe COVID-19 was made in a lab.

Shevlin, M., McBride, O., Murphy, J., Miller-Gibson, J., Hartman, T., Levita, L., Mason, L., Martinez, A., McKay, R., Stocks, T., Bennett, K., Hyland, P., Karatzias, T. & Bentall, R. (2020) Anxiety, Depression, Traumatic Stress, and COVID-19 related Anxiety in the UK General Population During the COVID-19 Pandemic.https://doi.org/10.31234/osf.io/hb6nq