Hostname: page-component-586b7cd67f-dlnhk Total loading time: 0 Render date: 2024-11-22T07:00:07.604Z Has data issue: false hasContentIssue false
  • English
  • Français

Temporal association of stress sensitivity and symptoms in individuals at clinical high risk for psychosis

Published online by Cambridge University Press:  01 June 2012

J. E. DeVylder ,
S. Ben-David ,
S. A. Schobel ,
D. Kimhy ,
D. Malaspina  and
C. M. Corcoran
J. E. DeVylder
Affiliation:
Columbia University School of Social Work, New York, NY, USA
S. Ben-David
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
S. A. Schobel
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
D. Kimhy
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
D. Malaspina
Affiliation:
Department of Psychiatry, New York University, New York, NY, USA
C. M. Corcoran*
Affiliation:
Department of Psychiatry, Columbia University, New York, NY, USA
*
*Address for correspondence: C. M. Corcoran, M.D., New York State Psychiatric Institute at Columbia University, Unit 55, 1051 Riverside Drive, New York, NY 10032, USA. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Increased sensitivity and exposure to stress are associated with psychotic symptoms in schizophrenia and its risk states, but little is known about the co-evolution of stress sensitivity and exposure with positive and other symptoms in a clinical high-risk (CHR) cohort.

Method

A combined cross-sectional and longitudinal design was used to examine the associations over time of stress sensitivity and exposure (i.e. life events) with ‘prodromal’ symptoms in a cohort of 65 CHR patients assessed quarterly for up to 4 years, and at baseline in 24 healthy controls similar in age and gender.

Results

Impaired stress tolerance was greater in patients, in whom it was associated over time with positive and negative symptoms, in addition to depression, anxiety and poor function. By contrast, life events were comparable in patients and controls, and bore no association with symptoms. In this treated cohort, there was a trajectory of improvement in stress tolerance, symptoms and function over time.

Conclusions

Impaired stress tolerance was associated with a wide range of ‘prodromal’ symptoms, consistent with it being a core feature of the psychosis risk state. Self-reported life events were not relevant as a correlate of clinical status. As in other treated CHR cohorts, most patients improved over time across symptom domains.

Keywords

Hassleshigh risklife eventsprodromalschizophreniastress
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 2 , February 2013 , pp. 259 - 268
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

Beck, AT, Brown, G, Epstein, N, Steer, RA (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893–897.CrossRefGoogle ScholarPubMed
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Cannon, TD, Huttunen, MO, Dahlstrom, M, Larmo, I, Rasanen, P, Juriloo, A (2002). Antipsychotic drug treatment in the prodromal phase of schizophrenia. American Journal of Psychiatry 159, 1230–1232.CrossRefGoogle ScholarPubMed
Coddington, RD (1972). The significance of life events as etiological factors in the diseases of children. II. A study of a normal population. Journal of Psychosomatic Research 16, 205–213.CrossRefGoogle Scholar
Cohen, S, Kamarck, T, Mermelstein, R (1983). A global measure of perceived stress. Journal of Health and Social Behavior 24, 386–396.CrossRefGoogle ScholarPubMed
Collip, D, Nicolson, NA, Lardinois, M, Lataster, T, van Os, J, Myin-Germeys, I; G.R.O.U.P. (2011). Daily cortisol, stress reactivity and psychotic experiences in individuals at above average genetic risk for psychosis. Psychological Medicine 41, 2305–2315.CrossRefGoogle ScholarPubMed
Corcoran, CM, Kimhy, D, Stanford, A, Khan, S, Walsh, J, Thompson, J, Schobel, S, Harkavy-Friedman, J, Goetz, R, Colibazzi, T, Cressman, V, Malaspina, D (2008). Temporal association of cannabis use with symptoms in individuals at clinical high risk for psychosis. Schizophrenia Research 106, 286–293.CrossRefGoogle ScholarPubMed
Corcoran, C, Smith, C, McLaughlin, D, Auther, AM, Malaspina, D, Cornblatt, BA (2012). HPA axis function and symptoms in adolescents at clinical high risk for schizophrenia. Schizophrenia Research 135, 170–174.CrossRefGoogle ScholarPubMed
Corcoran, C, Walker, E, Huot, R, Mittal, V, Tessner, K, Kestler, L, Malaspina, D (2003). The stress cascade and schizophrenia: etiology and onset. Schizophrenia Bulletin 29, 671–692.CrossRefGoogle ScholarPubMed
Cornblatt, BA, Lencz, T, Smith, CW, Olsen, R, Auther, AM, Nakayama, E, Lesser, ML, Tai, JY, Shah, MR, Foley, CA, Kane, JM, Correll, CU (2007). Can antidepressants be used to treat the schizophrenia prodrome? Results of a prospective, naturalistic treatment study of adolescents. Journal of Clinical Psychiatry 68, 546–547.CrossRefGoogle ScholarPubMed
Dohrenwend, BP (2006). Inventorying stressful life events as risk factors for psychopathology: toward resolution of the problem of intracategory variability. Psychological Bulletin 132, 477–495.CrossRefGoogle ScholarPubMed
Goldstone, E, Farhall, J, Ong, B (2011). Life hassles, experiential avoidance and distressing delusional experiences. Behaviour Research and Therapy 49, 260–266.CrossRefGoogle ScholarPubMed
Grace, AA (2012). Dopamine system dysregulation by the hippocampus: implications for the pathophysiology and treatment of schizophrenia. Neuropharmacology 62, 1342–1348.CrossRefGoogle ScholarPubMed
Hawkins, KA, McGlashan, TH, Quinlan, D, Miller, TJ, Perkins, DO, Zipursky, RB, Addington, J, Woods, SW (2004). Factorial structure of the scale of prodromal symptoms. Schizophrenia Research 68, 339–347.CrossRefGoogle ScholarPubMed
Khalili-Mahani, N, Dedovic, K, Engert, V, Pruessner, M, Pruessner, JC (2010). Hippocampal activation during a cognitive task is associated with subsequent neuroendocrine and cognitive responses to psychological stress. Hippocampus 20, 323–334.CrossRefGoogle ScholarPubMed
Kimhy, D, Corcoran, C (2008). Use of Palm computer as an adjunct to cognitive-behavioural therapy with an ultra-high-risk patient: a case report. Early Intervention in Psychiatry 2, 234–241.CrossRefGoogle ScholarPubMed
Lee, H, Schepp, K (2009). The relationship between symptoms and stress in adolescents with schizophrenia. Issues in Mental Health Nursing 30, 736–744.CrossRefGoogle ScholarPubMed
Liang, KY, Zeger, SL (1986). Longitudinal data analysis using generalized linear models. Biometrika 73, 13–22.CrossRefGoogle Scholar
Malla, RM, Norman, RM (1992). Relationship of major life events and daily stressors to symptomatology in schizophrenia. Journal of Nervous and Mental Disease 180, 664–667.Google ScholarPubMed
Mason, O, Startup, M, Halpin, S, Schall, U, Conrad, A, Carr, V (2004). Risk factors for transition to first episode psychosis among individuals with ‘at-risk mental states’. Schizophrenia Research 71, 227–237.CrossRefGoogle ScholarPubMed
McGorry, PD, Yung, AF, Phillips, LJ, Yuen, HP, Francey, S, Cosgrave, EM, Germano, D, Bravin, J, McDonald, T, Blair, A, Adlard, S, Jackson, H (2002). Randomized controlled trial of interventions designed to reduce the risk of progression to first-episode psychosis in a clinical sample with subthreshold symptoms. Archives of General Psychiatry 59, 921–928.CrossRefGoogle Scholar
Miller, TJ, McGlashan, TH, Rosen, JL, Cadenhead, K, Ventura, J, McFarlane, W, Perkins, DO, Pearlson, GD, Woods, SW (2003). Prodromal assessment with the structured interview for prodromal syndromes and the scale of prodromal symptoms: predictive validity, interrater reliability, and training to reliability. Schizophrenia Bulletin 29, 703–715.CrossRefGoogle ScholarPubMed
Moghaddam, B (2002). Stress activation of glutamate neurotransmission in the prefrontal cortex: implications for dopamine-associated psychiatric disorders. Biological Psychiatry 51, 775–787.CrossRefGoogle ScholarPubMed
Monroe, SM (2008). Modern approaches to conceptualizing and measuring human life stress. Annual Review of Clinical Psychology 4, 33–52.CrossRefGoogle ScholarPubMed
Morrison, AP, French, P, Walford, L, Lewis, SW, Kilcommons, A, Green, J, Parker, S, Bentall, RP (2004). Cognitive therapy for the prevention of psychosis in people at ultra-high risk: randomised controlled trial. British Journal of Psychiatry 185, 291–297.CrossRefGoogle ScholarPubMed
Norman, RM, Malla, AK (1993). Stressful life events and schizophrenia. I: A review of the research. British Journal of Psychiatry 162, 161–166.CrossRefGoogle Scholar
Norman, RM, Malla, AK (1994). A prospective study of daily stressors and symptomatology in schizophrenic patients. Social Psychiatry and Psychiatric Epidemiology 29, 244–249.CrossRefGoogle ScholarPubMed
Nuechterlein, KH, Dawson, ME (1984). A heuristic vulnerability/stress model of schizophrenia. Schizophrenia Bulletin 10, 300–312.CrossRefGoogle Scholar
Pruessner, M, Iyer, SN, Faridi, K, Joober, R, Malla, AK (2011). Stress and protective factors in individuals at ultra-high risk for psychosis, first episode psychosis and healthy controls. Schizophrenia Research 129, 29–35.CrossRefGoogle ScholarPubMed
Raune, D, Bebbington, P, Dunn, G, Kuipers, E (2006). Event attributes and the content of psychotic experiences in first-episode psychosis. Psychological Medicine 36, 221–230.CrossRefGoogle ScholarPubMed
Schlosser, DA, Jacobson, S, Chen, Q, Sugar, CA, Niendam, TA, Li, G, Bearden, CE, Cannon, TD (2011). Recovery from an at-risk state: clinical and functional outcomes of putatively prodromal youth who do not develop psychosis. Schizophrenia Bulletin. Published online: 8 August 2011. doi:10.1093/schbul/sbr098.Google Scholar
Schobel, SA, Lewandowski, NM, Corcoran, CM, Moore, H, Brown, T, Malaspina, D, Small, SA (2009). Differential targeting of the CA1 subfield of the hippocampal formation by schizophrenia and related psychotic disorders. Archives of General Psychiatry 66, 938–946.CrossRefGoogle ScholarPubMed
Steele, GP, Henderson, S, Duncan-Jones, P (1980). The reliability of reporting adverse experiences. Psychological Medicine 10, 301–306.CrossRefGoogle ScholarPubMed
Tessner, KD, Mittal, V, Walker, EF (2011). Longitudinal study of stressful life events and daily stressors among adolescents at high risk for psychotic disorders. Schizophrenia Bulletin 37, 432–441.CrossRefGoogle ScholarPubMed
Thompson, KN, Phillips, LJ, Komesaroff, P, Yuen, HP, Wood, SJ, Pantelis, C, Velakoulis, D, Yung, AR, McGorry, PD (2007). Stress and HPA-axis functioning in young people at ultra high risk for psychosis. Journal of Psychiatric Research 41, 561–569.CrossRefGoogle ScholarPubMed
Tso, IF, Grove, TB, Taylor, SF (2012). Self-assessment of psychological stress in schizophrenia: preliminary evidence of reliability and validity. Psychiatry Research 195, 39–44.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
Walker, EF, Cornblatt, BA, Addington, J, Cadenhead, KS, Cannon, TD, McGlashan, TH, Perkins, PO, Seidman, LJ, Tsuang, MT, Woods, SW, Heinssen, R (2009). The relation of antipsychotic and antidepressant medication with baseline symptoms and symptom progression: a naturalistic study of the North American Prodrome Longitudinal Sample. Schizophrenia Research 115, 50–57.CrossRefGoogle ScholarPubMed
Walker, EF, Diforio, D (1997). Schizophrenia: a neural diathesis-stress model. Psychological Review 104, 667–685.CrossRefGoogle ScholarPubMed
Webster, MJ, Knable, MB, O'Grady, J, Orthmann, J, Weickert, CS (2002). Regional specificity of brain glucocorticoid receptor mRNA alterations in subjects with schizophrenia and mood disorders. Molecular Psychiatry 7, 985–994.CrossRefGoogle ScholarPubMed
Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'Olio, M, Francey, SM, Cosgrave, EM, Kilackey, E, Stanford, C, Godfrey, K, Buckby, J (2005). Mapping the onset of psychosis: the comprehensive assessment of at-risk mental states. Australian and New Zealand Journal of Psychiatry 39, 964–971.CrossRefGoogle ScholarPubMed