Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-26T04:55:51.011Z Has data issue: false hasContentIssue false
  • English
  • Français

Increased stress reactivity: a mechanism specifically associated with the positive symptoms of psychotic disorder

Published online by Cambridge University Press:  31 October 2012

T. Lataster ,
L. Valmaggia ,
M. Lardinois ,
J. van Os  and
I. Myin-Germeys
T. Lataster*
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, The Netherlands
L. Valmaggia
Affiliation:
Institute of Psychiatry, King's College London, UK
M. Lardinois
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, The Netherlands
J. van Os
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, The Netherlands Institute of Psychiatry, King's College London, UK
I. Myin-Germeys
Affiliation:
Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University Medical Centre, The Netherlands School of Psychological Sciences, University of Manchester, UK
*
*Address for correspondence: Dr T. Lataster, Department of Psychiatry and Psychology, Maastricht University Medical Centre, PO Box 616 (VIJV), 6200 MD Maastricht, The Netherlands. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

An increased reactivity to stress in the context of daily life is suggested to be an independent risk factor underlying the positive symptoms of psychotic disorder. The aim of this study was to investigate whether positive symptoms moderate the association between everyday stressful events and negative affect (NA), known as stress reactivity. This hypothesis was put to the test in patients with a diagnosis of psychotic disorder.

Method

The Comprehensive Assessment of Symptoms and History (CASH) and the Positive and Negative Syndrome Scale (PANSS) were used to assess positive and negative symptoms. The experience sampling method (ESM), a structured diary technique, was used to measure stress reactivity and psychotic symptoms in daily life.

Results

Higher levels of positive symptoms (CASH: B = 0.14, p = 0.005; PANSS: B = 0.05, p = 0.000; ESM: B = 0.03, p = 0.000) and lower levels of negative symptoms (PANSS: B = − 0.05, p = 0.001) significantly moderate the association between unpleasant events and NA. No significant moderating effect was found for CASH negative symptoms. Moreover, the moderating effect of lifetime and current symptoms on the stress–NA association was significantly larger for those patients with predominantly positive symptoms (CASH: B = 0.09, p = 0.000; PANSS: B = 0.08, p = 0.000; ESM: B = 0.13, p = 0.000).

Conclusions

Patients with a ‘psychotic syndrome’ with high levels of positive symptoms and low levels of negative symptoms show increased reactivity to stress in daily life, indicating that stress reactivity is a possible risk factor underlying this syndrome.

Keywords

Daily life stressmomentary assessmentnegative affectschizophreniasymptom dimensions
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 7 , July 2013 , pp. 1389 - 1400
Copyright
Copyright © Cambridge University Press 2012 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N, Flaum, M, Arndt, S (1992). The Comprehensive Assessment of Symptoms and History (CASH). An instrument for assessing diagnosis and psychopathology. Archives of General Psychiatry 49, 615–623.CrossRefGoogle ScholarPubMed
Andreasen, NC, Olsen, S (1982). Negative v positive schizophrenia. Definition and validation. Archives of General Psychiatry 39, 789–794.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association: Washington, DC.Google Scholar
Barrantes-Vidal, N, Ros-Morente, A, Kwapil, TR (2009). An examination of neuroticism as a moderating factor in the association of positive and negative schizotypy with psychopathology in a nonclinical sample. Schizophrenia Research 115, 303–309.CrossRefGoogle Scholar
Bebbington, P, Wilkins, S, Sham, P, Jones, P, van Os, J, Murray, R, Toone, B, Lewis, S (1996). Life events before psychotic episodes: do clinical and social variables affect the relationship? Social Psychiatry and Psychiatric Epidemiology 31, 122–128.CrossRefGoogle ScholarPubMed
Bebbington, PE, Bhugra, D, Brugha, T, Singleton, N, Farrell, M, Jenkins, R, Lewis, G, Meltzer, H (2004). Psychosis, victimisation and childhood disadvantage: evidence from the second British National Survey of Psychiatric Morbidity. British Journal of Psychiatry 185, 220–226.CrossRefGoogle ScholarPubMed
Bentall, RP, Corcoran, R, Howard, R, Blackwood, N, Kinderman, P (2001). Persecutory delusions: a review and theoretical integration. Clinical Psychology Review 21, 1143–1192.CrossRefGoogle ScholarPubMed
Birchwood, M, Iqbal, Z, Upthegrove, R (2005). Psychological pathways to depression in schizophrenia: studies in acute psychosis, post psychotic depression and auditory hallucinations. European Archives of Psychiatry and Clinical Neurosciences 255, 202–212.CrossRefGoogle ScholarPubMed
Blanchard, JJ, Kring, AM, Horan, WP, Gur, R (2011). Toward the next generation of negative symptom assessments: the collaboration to advance negative symptom assessment in schizophrenia. Schizophrenia Bulletin 37, 291–299.CrossRefGoogle Scholar
Broderick, JE, Schwartz, JE, Shiffman, S, Hufford, MR, Stone, AA (2003). Signaling does not adequately improve diary compliance. Annals of Behavioral Medicine 26, 139–148.CrossRefGoogle Scholar
Buchanan, RW, Carpenter, WT (1994). Domains of psychopathology: an approach to the reduction of heterogeneity in schizophrenia. Journal of Nervous and Mental Disease 182, 193–204.CrossRefGoogle Scholar
Carpenter, Jr. WT, Heinrichs, DW, Wagman, AM (1988). Deficit and nondeficit forms of schizophrenia: the concept. American Journal of Psychiatry 145, 578–583.Google ScholarPubMed
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences. Lawrence Earlbaum Associates: Hillsdale, NY.Google Scholar
Collip, D, Nicolson, NA, Lardinois, M, Lataster, T, van Os, J, Myin-Germeys, I (2011). Daily cortisol, stress reactivity and psychotic experiences in individuals at above average genetic risk for psychosis. Psychological Medicine 41, 2305–2315.CrossRefGoogle ScholarPubMed
Crow, TJ (1980). Molecular pathology of schizophrenia: more than one disease process? British Medical Journal 280, 66–68.CrossRefGoogle ScholarPubMed
Cuesta, MJ, Peralta, V (2008). Current psychopathological issues in psychosis: towards a phenome-wide scanning approach. Schizophrenia Bulletin 34, 587–590.CrossRefGoogle ScholarPubMed
Delespaul, PAEG (1995). Assessing Schizophrenia in Daily Life. The Experience Sampling Method. Maastricht University Press: Maastricht.CrossRefGoogle Scholar
Dikeos, DG, Wickham, H, McDonald, C, Walshe, M, Sigmundsson, T, Bramon, E, Grech, A, Toulopoulou, T, Murray, R, Sham, PC (2006). Distribution of symptom dimensions across Kraepelinian divisions. British Journal of Psychiatry 189, 346–353.CrossRefGoogle ScholarPubMed
Dinzeo, TJ, Cohen, AS, Nienow, TM, Docherty, NM (2004). Stress and arousability in schizophrenia. Schizophrenia Research 71, 127–135.CrossRefGoogle ScholarPubMed
Dinzeo, TJ, Cohen, AS, Nienow, TM, Docherty, NM (2008). Arousability in schizophrenia: relationship to emotional and physiological reactivity and symptom severity. Acta Psychiatrica Scandinavica 117, 432–439.CrossRefGoogle ScholarPubMed
Docherty, NM, St-Hilaire, A, Aakre, JM, Seghers, JP (2009). Life events and high-trait reactivity together predict psychotic symptom increases in schizophrenia. Schizophrenia Bulletin 35, 638–645.CrossRefGoogle ScholarPubMed
Dominguez, MD, Wichers, M, Lieb, R, Wittchen, HU, van Os, J (2011). Evidence that onset of clinical psychosis is an outcome of progressively more persistent subclinical psychotic experiences: an 8-year cohort study. Schizophrenia Bulletin 37, 84–93.CrossRefGoogle ScholarPubMed
Freeman, D (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychology Review 27, 425–457.CrossRefGoogle ScholarPubMed
Garety, PA, Bebbington, P, Fowler, D, Freeman, D, Kuipers, E (2007). Implications for neurobiological research of cognitive models of psychosis: a theoretical paper. Psychological Medicine 37, 1377–1391.CrossRefGoogle ScholarPubMed
Garety, PA, Fowler, DG, Freeman, D, Bebbington, P, Dunn, G, Kuipers, E (2008). Cognitive-behavioural therapy and family intervention for relapse prevention and symptom reduction in psychosis: randomised controlled trial. British Journal of Psychiatry 192, 412–423.CrossRefGoogle ScholarPubMed
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, PE (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189–195.CrossRefGoogle ScholarPubMed
Green, AS, Rafaeli, E, Bolger, N, Shrout, PE, Reis, HT (2006). Paper or plastic? Data equivalence in paper and electronic diaries. Psychological Methods 11, 87–105.CrossRefGoogle ScholarPubMed
Gumley, A, Karatzias, A, Power, K, Reilly, J, McNay, L, O'Grady, M (2006). Early intervention for relapse in schizophrenia: impact of cognitive behavioural therapy on negative beliefs about psychosis and self-esteem. British Journal of Clinical Psychology 45, 247–260.CrossRefGoogle ScholarPubMed
Hayes, SC, Villatte, M, Levin, M, Hildebrandt, M (2011). Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology 7, 141–168.CrossRefGoogle ScholarPubMed
Hodel, B, Brenner, HD, Merlo, MC, Teuber, JF (1998). Emotional management therapy in early psychosis. British Journal of Psychiatry. Supplement 172, 128–133.CrossRefGoogle ScholarPubMed
Horan, WP, Blanchard, JJ, Clark, LA, Green, MF (2008). Affective traits in schizophrenia and schizotypy. Schizophrenia Bulletin 34, 856–874.CrossRefGoogle ScholarPubMed
Horan, WP, Kring, AM, Blanchard, JJ (2006). Anhedonia in schizophrenia: a review of assessment strategies. Schizophrenia Bulletin 32, 259–273.CrossRefGoogle ScholarPubMed
Horan, WP, Subotnik, KL, Reise, SP, Ventura, J, Nuechterlein, KH (2005). Stability and clinical correlates of personality characteristics in recent-onset schizophrenia. Psychological Medicine 35, 995–1005.CrossRefGoogle ScholarPubMed
Howes, OD, Bose, SK, Turkheimer, F, Valli, I, Egerton, A, Valmaggia, LR, Murray, RM, McGuire, P (2011). Dopamine synthesis capacity before onset of psychosis: a prospective [18F]-DOPA PET imaging study. American Journal of Psychiatry 168, 1311–1317.CrossRefGoogle ScholarPubMed
Howes, OD, Kapur, S (2009). The dopamine hypothesis of schizophrenia: version III – the final common pathway. Schizophrenia Bulletin 35, 549–562.CrossRefGoogle ScholarPubMed
Jablensky, A (2006). Subtyping schizophrenia: implications for genetic research. Molecular Psychiatry 11, 815–836.CrossRefGoogle ScholarPubMed
Jacobs, N, Nicolson, NA, Derom, C, Delespaul, P, van Os, J, Myin-Germeys, I (2005). Electronic monitoring of salivary cortisol sampling compliance in daily life. Life Science 76, 2431–2443.CrossRefGoogle ScholarPubMed
Janssen, I, Krabbendam, L, Bak, M, Hanssen, M, Vollebergh, W, de Graaf, R, van Os, J (2004). Childhood abuse as a risk factor for psychotic experiences. Acta Psychiatrica Scandinavica 109, 38–45.CrossRefGoogle ScholarPubMed
Kapur, S (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry 160, 13–23.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, LA (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin 13, 261–276.CrossRefGoogle ScholarPubMed
Keefe, RS, Bilder, RM, Harvey, PD, Davis, SM, Palmer, BW, Gold, JM, Meltzer, HY, Green, MF, Miller, DD, Canive, JM, Adler, LW, Manschreck, TC, Swartz, M, Rosenheck, R, Perkins, DO, Walker, TM, Stroup, TS, McEvoy, JP, Lieberman, JA (2006). Baseline neurocognitive deficits in the CATIE schizophrenia trial. Neuropsychopharmacology 31, 2033–2046.CrossRefGoogle ScholarPubMed
Keller, WR, Fischer, BA, Carpenter, Jr. WT (2011). Revisiting the diagnosis of schizophrenia: where have we been and where are we going? CNS Neuroscience and Therapeutics 17, 83–88.CrossRefGoogle ScholarPubMed
Kendell, R, Jablensky, A (2003). Distinguishing between the validity and utility of psychiatric diagnoses. American Journal of Psychiatry 160, 4–12.CrossRefGoogle ScholarPubMed
Kirkpatrick, B, Buchanan, RW, McKenney, PD, Alphs, LD, Carpenter, Jr. WT (1989). The Schedule for the Deficit syndrome: an instrument for research in schizophrenia. Psychiatry Research 30, 119–123.CrossRefGoogle ScholarPubMed
Korver, N, Quee, PJ, Boos, HB, Simons, CJ, de Haan, L; GROUP investigators (2012). Genetic Risk and Outcome of Psychosis (GROUP), a multi site longitudinal cohort study focused on gene-environment interaction: objectives, sample characteristics, recruitment and assessment methods. International Journal of Methods in Psychiatric Research 21, 205–221.CrossRefGoogle Scholar
Krabbendam, L, Janssen, I, Bak, M, Bijl, RV, de Graaf, R, van Os, J (2002). Neuroticism and low self-esteem as risk factors for psychosis. Social Psychiatry and Psychiatric Epidemiology 37, 1–6.CrossRefGoogle ScholarPubMed
Laroi, F, Van der Linden, M, DeFruyt, F, van Os, J, Aleman, A (2006). Associations between delusion proneness and personality structure in non-clinical participants: comparison between young and elderly samples. Psychopathology 39, 218–226.CrossRefGoogle Scholar
Lataster, T, Collip, D, Lardinois, M, van Os, J, Myin-Germeys, I (2010). Evidence for a familial correlation between increased reactivity to stress and positive psychotic symptoms. Acta Psychiatrica Scandinavica 122, 395–404.CrossRefGoogle ScholarPubMed
Lataster, T, Shazad, A, Henquet, C, Quee, P (2012). No evidence for familial covariation of neurocognition and negative symptoms in psychotic disorders. Schizophrenia Research 139, 271–272.CrossRefGoogle ScholarPubMed
Lataster, T, van Os, J, Drukker, M, Henquet, C, Feron, F, Gunther, N, Myin-Germeys, I (2006). Childhood victimisation and developmental expression of non-clinical delusional ideation and hallucinatory experiences: victimisation and non-clinical psychotic experiences. Social Psychiatry and Psychiatric Epidemiology 41, 423–428.CrossRefGoogle ScholarPubMed
Lataster, T, Wichers, M, Jacobs, N, Mengelers, R, Derom, C, Thiery, E, van Os, J, Myin-Germeys, I (2009). Does reactivity to stress cosegregate with subclinical psychosis? A general population twin study. Acta Psychiatrica Scandinavica 119, 45–53.CrossRefGoogle ScholarPubMed
Liddle, PF (1987). The symptoms of chronic schizophrenia. A re-examination of the positive-negative dichotomy. British Journal of Psychiatry 151, 145–151.CrossRefGoogle ScholarPubMed
Lincoln, TM, Lange, J, Burau, J, Exner, C, Moritz, S (2010). The effect of state anxiety on paranoid ideation and jumping to conclusions. An experimental investigation. Schizophrenia Bulletin 36, 1140–1148.CrossRefGoogle ScholarPubMed
Lindenmayer, JP, Bernstein-Hyman, R, Grochowski, S (1994). Five-factor model of schizophrenia. Initial validation. Journal of Nervous and Mental Disease 182, 631–638.CrossRefGoogle ScholarPubMed
Lysaker, PH, Lancaster, RS, Nees, MA, Davis, LW (2003). Neuroticism and visual memory impairments as predictors of the severity of delusions in schizophrenia. Psychiatry Research 119, 287–292.CrossRefGoogle ScholarPubMed
McGrath, JA, Avramopoulos, D, Lasseter, VK, Wolyniec, PS, Fallin, MD, Liang, KY, Nestadt, G, Thornquist, MH, Luke, JR, Chen, PL, Valle, D, Pulver, AE (2009). Familiality of novel factorial dimensions of schizophrenia. Archives of General Psychiatry 66, 591–600.CrossRefGoogle ScholarPubMed
McGrath, JA, Nestadt, G, Liang, KY, Lasseter, VK, Wolyniec, PS, Fallin, MD, Thornquist, MH, Luke, JR, Pulver, AE (2004). Five latent factors underlying schizophrenia: analysis and relationship to illnesses in relatives. Schizophrenia Bulletin 30, 855–873.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Delespaul, P, van Os, J (2005). Behavioural sensitization to daily life stress in psychosis. Psychological Medicine 35, 733–741.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, Oorschot, M, Collip, D, Lataster, J, Delespaul, P, van Os, J (2009). Experience sampling research in psychopathology: opening the black box of daily life. Psychological Medicine 39, 1533–1547.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, van Os, J (2007). Stress-reactivity in psychosis: evidence for an affective pathway to psychosis. Clinical Psychology Review 27, 409–424.CrossRefGoogle ScholarPubMed
Myin-Germeys, I, van Os, J, Schwartz, JE, Stone, AA, Delespaul, PA (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry 58, 1137–1144.CrossRefGoogle ScholarPubMed
Oorschot, M, Kwapil, T, Delespaul, P, Myin-Germeys, I (2009). Momentary assessment research in psychosis. Psychological Assessment 21, 498–505.CrossRefGoogle ScholarPubMed
Pilling, S, Bebbington, P, Kuipers, E, Garety, P, Geddes, J, Orbach, G, Morgan, C (2002). Psychological treatments in schizophrenia: I. Meta-analysis of family intervention and cognitive behaviour therapy. Psychological Medicine 32, 763–782.CrossRefGoogle ScholarPubMed
Scholten, MR, van Honk, J, Aleman, A, Kahn, RS (2006). Behavioral inhibition system (BIS), behavioral activation system (BAS) and schizophrenia: relationship with psychopathology and physiology. Journal of Psychiatric Research 40, 638–645.CrossRefGoogle ScholarPubMed
Snijders, T, Bosker, R (1999). Multilevel Analysis: An Introduction to Basis and Advanced Multilevel Modeling. Sage Publications: London.Google Scholar
StataCorp (2009). STATA Statistical Software: Release 11.0. StataCorp: College Station, TX.Google Scholar
Stone, AA, Shiffman, S, Schwartz, JE, Broderick, JE, Hufford, MR (2002). Patient non-compliance with paper diaries. British Medical Journal 324, 1193–1194.CrossRefGoogle ScholarPubMed
Strauss, GP, Duke, LA, Ross, SA, Allen, DN (2011). Posttraumatic stress disorder and negative symptoms of schizophrenia. Schizophrenia Bulletin 37, 603–610.CrossRefGoogle ScholarPubMed
Strauss, JS (1994). The person with schizophrenia as a person. II: Approaches to the subjective and complex. British Journal of Psychiatry 164 (Suppl. 23), 103–107.CrossRefGoogle Scholar
Strauss, JS, Carpenter, Jr. WT, Bartko, JJ (1974). The diagnosis and understanding of schizophrenia. Part III. Speculations on the processes that underlie schizophrenic symptoms and signs. Schizophrenia Bulletin 11, 61–69.Google Scholar
Tandon, R, Carpenter, Jr. WT (2012). DSM-5 status of psychotic disorders: 1 year prepublication. Schizophrenia Bulletin 38, 369–370.CrossRefGoogle ScholarPubMed
Valmaggia, LR, van der Gaag, M, Tarrier, N, Pijnenborg, M, Slooff, CJ (2005). Cognitive-behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication. Randomised controlled trial. British Journal of Psychiatry 186, 324–330.CrossRefGoogle ScholarPubMed
van Os, J (2009). A salience dysregulation syndrome. British Journal of Psychiatry 194, 101–103.CrossRefGoogle ScholarPubMed
van Os, J, Jones, PB (2001). Neuroticism as a risk factor for schizophrenia. Psychological Medicine 31, 1129–1134.CrossRefGoogle ScholarPubMed
van Os, J, Kapur, S (2009). Schizophrenia. Lancet 374, 635–645.CrossRefGoogle ScholarPubMed
van Winkel, R, Stefanis, NC, Myin-Germeys, I (2008). Psychosocial stress and psychosis. A review of the neurobiological mechanisms and the evidence for gene-stress interaction. Schizophrenia Bulletin 34, 1095–1105.CrossRefGoogle ScholarPubMed
Varese, F, Smeets, F, Drukker, M, Lieverse, R, Lataster, T, Viechtbauer, W, Read, J, van Os, J, Bentall, RP (2012). Childhood adversities increase the risk of psychosis: a meta-analysis of patient-control, prospective- and cross-sectional cohort studies. Schizophrenia Bulletin 38, 661–671.CrossRefGoogle ScholarPubMed
Versmissen, D, Janssen, I, Johns, L, McGuire, P, Drukker, M, à Campo, J, Myin-Germeys, I, van Os, J, Krabbendam, L (2007). Verbal self-monitoring in psychosis: a non-replication. Psychological Medicine 37, 569–576.CrossRefGoogle ScholarPubMed
Villalta-Gil, V, Vilaplana, M, Ochoa, S, Dolz, M, Usall, J, Haro, JM, Almenara, J, Gonzalez, JL, Lagares, C (2006). Four symptom dimensions in outpatients with schizophrenia. Comprehensive Psychiatry 47, 384–388.CrossRefGoogle ScholarPubMed
Walker, E, Mittal, V, Tessner, K (2008). Stress and the hypothalamic pituitary adrenal axis in the developmental course of schizophrenia. Annual Review of Clinical Psychology 4, 189–216.CrossRefGoogle ScholarPubMed
Walker, EF, Brennan, PA, Esterberg, M, Brasfield, J, Pearce, B, Compton, MT (2010). Longitudinal changes in cortisol secretion and conversion to psychosis in at-risk youth. Journal of Abnormal Psychology 119, 401–408.CrossRefGoogle ScholarPubMed