Behavioural sensitization to daily life stress in psychosis
Behavioural sensitization to daily life stress in psychosis
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DOI：
10.1017/s0033291704004179
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发表时间：
2005-05-01
影响因子：
6.9
通讯作者：
van Os, J
中科院分区：
文献类型：
--
作者：
Myin-Germeys, I;Delespaul, P;van Os, J
背景资料。最近的神经生物学模型提供了一种可能的机制，即日常生活应激直接影响脆弱个体的精神体验强度。为了验证这一机制，在精神病发病风险(亲属)和复发风险(患者)增加的两组中，调查了日常生活应激对精神病强度的影响。以临床缓解期精神病患者(42例)、一级亲属(47例)和对照组(49例)为研究对象，采用体验式抽样方法(ESM是一种结构化的日记技术，用于评估日常生活中的当前背景和精神病理)，以评估(1)与日常活动和事件相关的主观应激，(2)日常生活中微妙的精神体验的强度。多水平回归分析显示，精神病强度的显著增加与患者主观活动和事件相关压力的增加有关。一级亲属报告称，与活动相关的压力有关的精神病强度增加，但与事件相关的压力无关。在对照受试者中未发现关联。精神错乱风险增加的受试者表现出与日常生活中的轻微压力相关的微妙精神体验强度的持续变化。因此，对环境应激的行为敏感化可能是精神分裂症的一个易损性标志，反映了多巴胺能对环境刺激的高反应。
Background. Recent neurobiological models provide a possible mechanism of daily life stress directly affecting the intensity of psychotic experiences in vulnerable individuals. In order to validate such a mechanism, the impact of daily life stress on psychosis intensity was investigated in two groups at increased risk of onset (relatives) and relapse (patients) of psychosis.Method. Patients with psychosis in a clinical state of remission (n=42), first-degree relatives (n = 47), and control subjects (n = 49) were studied with the Experiencing Sampling Method (ESM is a structured diary technique assessing current context and psychopathology in daily life) to assess (1) appraised subjective stress related to daily activities and events, and (2) intensity of subtle psychotic experiences in daily life.Results. Multilevel regression analyses revealed significant increases in psychosis intensity associated with increases in subjective activity - and event-related stress in patients. First-degree relatives reported increases in psychosis intensity in relation to activity-related stress but not event related stress. No association was found in control subjects.Conclusions. Subjects at increased risk for psychosis show continuous variation in the intensity of subtle psychotic experiences associated with minor stresses in the flow of daily life. Behavioural sensitization to environmental stress may therefore be a vulnerability marker for schizophrenia, reflecting dopaminergic hyper-responsivity in response to environmental stimuli.