Perception of peer group rank of individuals with early psychosis

Objectives. Social rank theory has been applied to psychosis, in particular the relationship between an individual and their voices. However, perceived peer group rank has not been empirically tested in an early psychosis group. The purpose of the study was to test the prediction that individuals with early psychosis will have lower perceived social status, engage in submissive behaviours more frequently, and will feel more entrapped by external events compared to a healthy control group. Design. The study employed a cross-sectional design, comparing individuals with early psychosis and healthy controls. Methods. A total of 24 participants with early psychosis and 24 matched controls completed self-report measures of social rank, including social comparison, submissive behaviours and entrapment, measures of depression, anxiety and psychotic symptoms, and measures of peer network size and peer relationship quality. Results. Individuals with early psychosis viewed themselves as being of lower social rank and inferior in relation to matched controls, and also reported engaging in submissive behaviours more frequently and felt more entrapped by external events. Conclusions. Perception of lower social rank and inferiority amongst individuals with early psychosis may impact on engagement in peer relationships and impact on the social decline in early psychosis, which could have significant implications for interventions and recovery. Practitioner Points center dot Individuals with early psychosis felt less satisfied with, and more excluded by, their peer group than matched controls. center dot Low rank in relation to peers might be a mechanism whereby individuals with early psychosis avoid their friends and lose friendships. center dot It may be appropriate to assess perceived social rank in relation to peers amongst individuals with early psychosis in clinical settings. center dot Cross-sectional design means that no conclusions regarding causality can be made. center dot Peer network was assessed using self-report and at a single time point; future longitudinal studies are therefore needed.