Is Exclusion Special? A Pre-Post Test of Psychotic-Like Symptom Change

Social exclusion has been linked to increased risk for psychotic experiences; however, it remains unclear whether exclusion has a unique impact beyond general negative experiences. Across two studies run between April 2024 and May 2024, we tested whether recalling autobiographical experiences of exclusion leads to greater increases in psychotic experiences compared to recalling other negatively valenced experiences (i.e., sadness) using a within-subjects design and a novel momentary self-report measure. Participants completed the Momentary Assessment of Psychotic Experiences (MAPE) immediately before and after a five-minute recall task, during which they were randomly assigned to recall an experience of exclusion, sadness, inclusion, or a neutral event. Study 1 (N = 810) found that neither the exclusion nor sadness induction increased positive symptoms. Both conditions led to increased negative symptoms but did not differ significantly from each other. Study 2 (N = 836) replicated these findings in an independent sample. Across both studies, inclusion unexpectedly led to a reduction in negative symptoms, including amotivation and anhedonia, and social anhedonia. These findings suggest that exclusion contributes to short-term increases in psychotic experiences that reflect negative symptoms, but its effects are not distinguishable from other negatively valenced life experiences. In contrast, inclusion may have a protective effect, reducing specific negative symptoms. Together, these findings highlight the need to consider both negative and positive life experiences when evaluating social risk and protective factors for psychotic experiences.