SRINAGAR: A study of 498 young adults in Kashmir has identified three distinct patterns of delusion-like experiences. Nearly one in four participants fell into the strong-endorsement group, marked by higher levels of distress, preoccupation and conviction. The researchers, however, caution that these findings do not indicate psychosis or clinical delusions.
The study, published in BMC Psychology in 2026, found that 45.6 per cent of participants belonged to the moderate-endorsement group, 29.7 per cent to the weak-endorsement group and 24.7 per cent to the strong-endorsement group. The researchers said the pattern supports the view that psychotic-like experiences can occur along a continuum of severity, rather than existing simply as either present or absent.
The paper, Latent profile analysis of delusion-like experiences among emerging adults of Kashmir, was authored by Amir Sultan of the Department of Psychology, University of Kashmir, and Sadiya Sajad of the PG Psychology programme at the Indira Gandhi National Open University (IGNOU), Srinagar Centre. It was published by Springer Nature in BMC Psychology (volume 14).
The researchers examined DLEs among young adults using the 21-item Peters Delusion Inventory (PDI-21). The study was conducted between March and October 2024 among students aged 18 to 30 enrolled in colleges and universities across Kashmir. Initially, 503 people participated, but five were excluded following examination of statistical outliers, leaving 498 participants for the final analysis.
The final sample had a mean age of 23.01 years. Women accounted for 55.2 per cent of participants and men 44.8 per cent. Of the participants, 47.8 per cent were undergraduates and 52.2 per cent postgraduates. About two-thirds came from nuclear families, while 32.9 per cent belonged to joint families. Rural residents accounted for 47 per cent and urban residents 53 per cent. In terms of socioeconomic status, 36.9 per cent were from below-poverty-line households and 63.1 per cent from above-poverty-line households.
What the researchers measured
DLEs refer to unusual beliefs or experiences that can resemble aspects of delusional thinking but do not necessarily amount to a psychiatric disorder. The researchers note that such experiences can occur in the general population and may include ideas of reference, suspiciousness and magical thinking.
The paper stresses that the mere presence of such experiences does not make them pathological. Their significance depends partly on accompanying factors such as distress, preoccupation and conviction—in other words, how troubling the experience is, how much attention it occupies and how strongly the individual believes it.
The PDI-21 asks participants to indicate whether they endorse particular unusual beliefs and, where they do, to rate their levels of distress, preoccupation and conviction. Higher scores indicate greater severity. The researchers reported high internal consistency for the overall scale in their sample, with a Cronbach’s alpha of 0.90.
Three distinct groups
Using latent profile analysis, a statistical technique used to identify unobserved subgroups within a population, the researchers found that a three-profile model best fitted their data.
The first group, classified as Weak Endorsement, consisted of 148 participants, or 29.7 per cent of the sample. Their scores were lowest across all four measures.
The second, Moderate Endorsement, was the largest group, comprising 227 participants or 45.6 per cent. Their scores fell between the other two groups.
The third, Strong Endorsement, consisted of 123 participants, or 24.7 per cent. This group recorded substantially higher scores for unusual beliefs as well as distress, preoccupation and conviction.
The difference between the three groups was statistically significant across every measure. The researchers reported very large effect sizes, with partial eta squared values ranging from 0.83 to 0.85 for the four indicators.
The scores demonstrate the gradient particularly clearly. The Weak Endorsement group had an average total PDI score of 5.79, compared with 10.7 for the Moderate Endorsement group and 15.8 for the Strong Endorsement group. For distress, the corresponding scores were 13.8, 30.2 and 52.2; for preoccupation, 15.3, 32.9 and 54.7; and for conviction, 18.2, 37.6 and 58.1.
The authors write that the profiles “form a clear gradient from low to high endorsement of DLEs.”
No significant difference by gender, education or residence
One of the study’s notable findings was that membership of the three groups was not significantly associated with gender, education, family type, rural or urban residence, or socioeconomic status.
The statistical tests found no significant association for gender, education, family structure, domicile or socioeconomic status, with all p-values above 0.05.
The authors nevertheless caution against interpreting this finding as proof that demographic and social factors are irrelevant. They point out that the study involved a relatively homogeneous age group and student population, which may have restricted demographic variation. They also note that factors such as stress, trauma and social adversity were not measured and could operate indirectly.
Cultural context matters
The researchers devote particular attention to the cultural context of Kashmir and South Asia.
They say that religious and supernatural beliefs can function as socially shared symbolic frameworks through which people interpret ambiguous or unusual experiences. Consequently, endorsing some items on the PDI does not necessarily mean that a person is experiencing pathological delusional ideation.
The paper says moderate endorsement may represent a “heterogeneous mixture of benign, culturally tangible experiences rather than a coherent subclinical state.”
This is important because the study does not treat unusual beliefs in isolation. The researchers argue that the intensity of distress, preoccupation and conviction provides important information about where an experience lies on the broader spectrum.
No psychosis
Despite the substantially higher scores recorded by the Strong Endorsement group, the researchers explicitly warn against equating the group with people suffering from psychosis.
They note that high levels of distress and conviction have been associated in previous research with later functional impairment and help-seeking. But the present research was cross-sectional, rather than longitudinal, and did not involve clinical diagnoses.
“Without longitudinal or diagnostic data, the Strong Endorsement profile should not be interpreted as a proxy for psychosis or clinical delusions,” the authors state.
The researchers also point out that elevated PDI scores can be associated with temporary emotional and psychological states, including anxiety, sleep disturbance and academic stress. They therefore describe the clinical significance of the Strong Endorsement group as provisional rather than definitive.
Implications for universities
The authors say the findings could nevertheless have implications for mental-health screening in university settings.
They argue that identifying students experiencing unusual beliefs alongside elevated distress could provide an opportunity for early support. They specifically stress that such screening should not be used to label students as psychotic, but rather as a means of identifying people experiencing significant distress who may benefit from appropriate psychological support.
The study also contributes to a wider debate in psychiatry and psychology over whether psychotic experiences should be understood categorically or dimensionally.
The three groups displayed a progressive increase across all four PDI measures rather than fundamentally different configurations of symptoms. The authors say this supports dimensional models of psychotic experiences, while the statistically distinct Strong Endorsement group also lends some support to hybrid models that recognise thresholds of greater psychological vulnerability along a continuous spectrum.
Study limitations
The researchers emphasise several limitations.
First, the participants were recruited through convenience sampling from colleges and universities, which limits how far the findings can be generalised to Kashmir’s wider population. The results should therefore not be treated as a prevalence estimate for all young people in the Valley.
Second, the study did not include formal clinical assessments. As a result, the researchers say it cannot establish whether participants with strong DLE scores have an increased risk of developing a psychiatric disorder.
Third, the research was cross-sectional, meaning it captured participants at one point in time and cannot establish how these experiences develop or change over time.
The authors conclude that longitudinal, clinical and cross-cultural research will be needed to clarify how DLEs relate to broader models of psychosis and mental health.
The study was approved by the IGNOU Institutional Ethical Committee, which approved the research protocol under approval number IGNOU-IEC-266 dated August 9, 2023. Participants provided informed consent and confidentiality was maintained. The authors reported no competing interests and said the research received no funding.
Taken together, the findings do not suggest that a quarter of Kashmir’s young adults are experiencing psychosis. Rather, they show that unusual or delusion-like experiences exist at varying intensities within this student sample, with a smaller group reporting substantially greater distress, preoccupation and conviction. The central finding, according to the authors, is therefore not the existence of a clinical disorder but the variation in intensity of such experiences within a non-clinical population—a pattern they say strengthens the case for understanding psychotic experiences as existing on a continuum rather than as a simple clinical/non-clinical divide.
