The Relevance of Emotion Regulation in Explaining Why Social Exclusion Triggers Paranoia in Individuals at Clinical High Risk of Psychosis
The Relevance of Emotion Regulation in Explaining Why Social Exclusion Triggers Paranoia in Individuals at Clinical High Risk of Psychosis
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DOI：
10.1093/schbul/sbx135
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发表时间：
2018-07-01
影响因子：
6.6
通讯作者：
Karow, Anne
中科院分区：
文献类型：
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作者：
Lincoln, Tania M.;Sundag, Johanna;Karow, Anne
背景资料。脆弱性-压力模型假设，社会压力会在脆弱的个体中触发精神病发作。然而，对所提出的因果路径的实验证据很少，对翻译机制的了解也不够。本研究采用准实验设计，考察了社会排斥对偏执信念的影响，并考察了情绪调节(ER)作为易损性指标和情绪反应作为翻译机制的作用。方法：研究方法。对符合临床高危精神病标准的受试者(CHR，n=25)、焦虑症对照组(AC，n=40)和健康对照组(HC，n=40)进行功能障碍(如沉思、灾难、责备)和功能性ER策略(如重新评估、接受、重聚焦)的评估。然后，他们在虚拟球类游戏(Cyberball)中被暴露在社会排斥中，并评估自我报告的情绪和偏执信念的变化。结果。CHR样本显示，从社会排斥之前到之后，偏执信念的增加比两个对照组都要强得多。这是由于CHR组较低的功能水平和较高的功能障碍ER水平(与HC相比)以及自我报告的负面情绪的更强增加(与AC和HC相比)。结论。结果证实了负面情绪在从社会应激源到精神症状的通路中的作用，并表明使用功能障碍的内质网策略和使用功能策略的困难都解释了为什么精神病风险人群对社会应激源的反应带有更多的偏执。
Background. Vulnerability-stress models postulate that social stress triggers psychotic episodes in vulnerable individuals. However, experimental evidence for the proposed causal pathway is scarce and the translating mechanisms are insufficiently understood. The study assessed the impact of social exclusion on paranoid beliefs in a quasi-experimental design and investigated the role of emotion regulation (ER) as a vulnerability indicator and emotional responses as a putative translating mechanism. Methods. Participants fulfilling criteria for clinical high risk of psychosis (CHR, n = 25), controls with anxiety disorders (AC, n = 40), and healthy controls (HC, n = 40) were assessed for dysfunctional (eg, rumination, catastrophizing, blaming) and functional ER-strategies (eg, reappraising, accepting, refocusing). They were then exposed to social exclusion during a virtual ball game (Cyberball) and assessed for changes in self-reported emotions and paranoid beliefs. Results. The CHR sample showed a significantly stronger increase in paranoid beliefs from before to after the social exclusion than both control groups. This was accounted for by lower levels of functional and higher levels of dysfunctional ER (compared to HC) and by a stronger increase in self-reported negative emotion in the CHR group (compared to AC and HC). Conclusions. The results confirm the role of negative emotion on the pathway from social stressors to psychotic symptoms and indicate that both the use of dysfunctional ER strategies and difficulties in employing functional strategies add to explaining why people at risk of psychosis respond to a social stressor with increased paranoia.