Modeling the Interplay Between Psychological Processes and Adverse, Stressful Contexts and Experiences in Pathways to Psychosis: An Experience Sampling Study
Modeling the Interplay Between Psychological Processes and Adverse, Stressful Contexts and Experiences in Pathways to Psychosis: An Experience Sampling Study
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DOI：
10.1093/schbul/sbw185
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发表时间：
2017-03-01
影响因子：
6.6
通讯作者：
Reininghaus, Ulrich
中科院分区：
文献类型：
--
作者：
Klippel, Annelie;Myin-Germeys, Inez;Reininghaus, Ulrich
精神病的几种综合模式在精神病的发生中涉及到不利的、应激的环境和经历，以及情感和认知过程。在这些模型中，压力的影响被认为是通过情感干扰、认知偏差和异常经验等途径促进精神病经验的发展。然而，系统地测试这些途径的综合模型的尝试仍然很少。本研究采用经验抽样的方法，对51例首发精神病患者、46例有精神病危险心理状态的个体和53名对照个体进行了研究，考察了压力、增强的威胁预期和异常突显的体验如何结合起来增加精神病体验的强度。我们建立了多水平调节的中介模型来研究这些群体的间接影响。我们发现，在所有三组中，应激对精神体验的影响都是通过情感障碍的途径来调节的。应激对精神病性体验的影响在FEP个体和对照个体中通过威胁预期起中介作用，而在武装个体中不起作用。只有微弱的证据表明，通过异常突出进行了调解。然而，在所有三组中，异常的突显对精神病体验都有显著的直接影响，与压力无关。我们的发现为情感干扰和威胁预期在日常生活中压力影响早期精神病不同阶段的精神病经验形成的路径中所起的作用提供了新的见解。
Several integrated models of psychosis have implicated adverse, stressful contexts and experiences, and affective and cognitive processes in the onset of psychosis. In these models, the effects of stress are posited to contribute to the development of psychotic experiences via pathways through affective disturbance, cognitive biases, and anomalous experiences. However, attempts to systematically test comprehensive models of these pathways remain sparse. Using the Experience Sampling Method in 51 individuals with first-episode psychosis (FEP), 46 individuals with an atrisk mental state (ARMS) for psychosis, and 53 controls, we investigated how stress, enhanced threat anticipation, and experiences of aberrant salience combine to increase the intensity of psychotic experiences. We fitted multilevel moderated mediation models to investigate indirect effects across these groups. We found that the effects of stress on psychotic experiences were mediated via pathways through affective disturbance in all 3 groups. The effect of stress on psychotic experiences was mediated by threat anticipation in FEP individuals and controls but not in ARMS individuals. There was only weak evidence of mediation via aberrant salience. However, aberrant salience retained a substantial direct effect on psychotic experiences, independently of stress, in all 3 groups. Our findings provide novel insights on the role of affective disturbance and threat anticipation in pathways through which stress impacts on the formation of psychotic experiences across different stages of early psychosis in daily life.