Stress exposure and sensitivity in the clinical high-risk syndrome: Initial findings from the North American Prodrome Longitudinal Study (NAPLS)

SCHIZOPHRENIA RESEARCH

卷:160

Article

Trotman, Hanan D.¹  Holtzman, Carrie W.¹  Walker, Elaine F.¹  Addington, Jean M.²  Bearden, Carrie E.^3,4  Cadenhead, Kristin S.⁵  Cannon, Tyrone D.⁶  Cornblatt, Barbara A.⁷  Heinssen, Robert K.⁸  Mathalon, Daniel H.⁹  Tsuang, Ming T.¹⁰  Perkins, Diana O.¹¹  Seidman, Larry J.¹²  Woods, Scott W.¹³  McGlashan, Thomas H.¹³ 

[1] Emory Univ, Dept Psychol, Atlanta, GA 30322 USA

[2] Univ Calgary, Dept Psychiat, Calgary, AB, Canada

[3] Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Los Angeles, CA 90024 USA

[4] Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA

[5] Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA

[6] Yale Univ, Dept Psychol, New Haven, CT 06520 USA

[7] Zucker Hillside Hosp, Dept Psychiat, New York, NY USA

[8] NIMH, Bethesda, MD 20892 USA

[9] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA USA

[10] Univ Calif Irvine, Dept Psychiat, Irvine, CA 92717 USA

[11] Univ N Carolina, Dept Psychiat, Chapel Hill, NC USA

[12] Harvard Univ, Dept Psychol, Boston, MA 02115 USA

[13] Yale Univ, Dept Psychiat, New Haven, CT 06520 USA

关键词: Clinical high risk;    Prodrome;    Stress;    PERI Life Events Scale;    Daily Stress Inventory;    Daily hassles;   

DOI  :  10.1016/j.schres.2014.09.017

来源: Elsevier

【 摘 要 】

There is inconsistent evidence for increased stress exposure among individuals at clinical high risk (CHR) for psychosis. Yet similar to patients with a diagnosed psychotic illness, the preponderance of evidence suggests that CHR individuals tend to experience stressful life events (LE) and daily hassles (DH) as more subjectively stressful than healthy individuals. The present study utilizes data from the North American Prodrome Longitudinal Study Phase 2 (NAPLS-2) to test the hypotheses that (1) CHR individuals manifest higher self-reported stress in response to both LE and DH when compared to healthy controls (HC), (2) group differences in self-reported stress increase with age, (3) baseline self-reported stress is associated with follow-up clinical status, and (4) there is a sensitization effect of LE on the response to DH. In contrast to some previous research, the present findings indicate that the CHR group (N = 314) reported exposure to more LE when compared to the HC group (N= 162). As predicted, CHR participants rated events as more stressful, and those who progressed to psychosis reported a greater frequency of LE and greater stress from events compared to those whose prodromal symptoms remitted. There was also some evidence of stress-sensitization; those who experienced more stress from LE rated current DH as more stressful. The results indicate that the prodromal phase is a period of heightened stress and stress sensitivity, and elevated cumulative lifetime exposure to stressful events may increase reactions to current stressors. (C) 2014 Elsevier B.V. All rights reserved.

【 授权许可】

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