Felt Presence and Psychosis Risk in the General Population

Felt presence (FP) is the experience that another entity is present in one's proximal environment, despite no sensory evidence. Occurrence of FP is linked to psychosis risk, but qualities of FP in the context of psychosis are not well understood. We conducted an online, exploratory survey assessing qualities of FP in relation to psychosis risk in the general population.

Three hundred and seventy-six participants completed an anonymous online survey consisting of validated measures of sensed presence, psychosis risk, loneliness, trauma, resilience and general mental health. They also responded to questions about perceptual qualities of FP. We investigated the role of the presence and its qualities in predicting psychosis risk, and relationships between qualities of FP and psychosis risk. We also examined the relationships between qualities of FP and psychosocial variables with psychosis risk.

FP and anxiety significantly predicted elevated psychosis risk. FP experiences in the high-risk group were more frequent, distressing, vivid, and multisensory than in the low-risk group. Specifically, distress during FP significantly predicted psychosis-risk status over and above demographic and psychiatric covariates (including anxiety). Cumulative trauma was linked with total number of FP experiences as well as increased frequency, distress, vividness, and understandings of FP's identity. Depression, anxiety, and stress were associated with more physiological sensations and increased distress during FP, as well as knowledge of FP's identity. Resilience was associated with more frequent and vivid FPs.

These results demonstrate strong links between FP and psychosis risk in the general population and provide preliminary evidence of qualitative markers that differentiate FP from psychosocial factors in the context of psychosis risk. Assessment and clinical conceptualizations of risk for schizophrenia should consider including experiences of bodily self-disturbance, such as FP.