I'm personally not in the field of medicine or psychology, but I have a Bachelors in Arts in Creative Writing and a Bachelors in Science in Film. So, I know only about story telling and the visual medium. And I know that when it comes to Larry Fessenden (the man who co-written this game and played as the Flamethrower Guy), he often deals with not just the horror of the situation, but the psychology of the characters in the situation. In his film "Habit", one could argue if Anna was a vampire or not, as there's enough evidence on both sides to make the argument either way. But Fessenden stated, "The important detail is that Sam believes it to be true, and I always wanted to tell a story where the mind turns on itself."
So, I do believe your theory is correct, as Fessenden has also dealt with stories involving the lead characters and their relationships breaking down (in 'Habit', it's Sam and the distancing of his friendships, as well as his ongoing issues with his ex-girlfriend, all in the middle of his inability to grieve for the passing of his father. In "Wendigo", it's about the kid trying to cope with the world around him and during the final act, dealing with the loss of his father. In "The Last Winter", we see a group of people who are close friends slowly fracturing due to the situation they are in, even possibly losing their minds as well). So, in regards to the psychological aspect of the story when it comes to Josh, his alienation of his friends and his guilt of losing his sisters, I believe you're on the mark because of how Fessenden deals with such themes previously.
But this one's eating my popcorn!
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