Stress reactivity as a putative mechanism linking childhood trauma with clinical outcomes in individuals at ultra-high-risk for psychosis: Findings from the EU-GEI High Risk Study

被引：19

作者：

Paetzold, I. ^{[1
]}

Myin-Germeys, I. ^{[2
]}

Schick, A. ^{[1
]}

Nelson, B. ^{[3
,4
]}

Velthorst, E. ^{[5
]}

Schirmbeck, F. ^{[6
,7
]}

van Os, J. ^{[8
,9
,10
]}

Morgan, C. ^{[11
,12
]}

Hartmann, J. ^{[3
,4
]}

van der Gaag, M. ^{[13
,14
]}

de Haan, L. ^{[15
]}

Valmaggia, L. ^{[16
]}

McGuire, P. ^{[9
,17
]}

Kempton, M. ^{[9
,17
]}

Reininghaus, U. ^{[1
,11
,12
]}

机构：

[1] Heidelberg Univ, Med Fac Mannheim, Cent Inst Mental Hlth, Dept Publ Mental Hlth, Mannheim, Germany

[2] Katholieke Univ Leuven, Dept Neurosci, Ctr Contextual Psychiat, Leuven, Belgium

[3] Univ Melbourne, Ctr Youth Mental Hlth, Parkville, Vic, Australia

[4] Natl Ctr Excellence Youth Mental Hlth, Orygen, Melbourne, Vic, Australia

[5] Icahn Sch Med Mt Sinai, Dept Psychiat, New York, NY 10029 USA

[6] Univ Amsterdam, Locat AMC, Amsterdam UMC, Dept Psychiat, Amsterdam, North Holland, Netherlands

[7] Inst Mental Hlth, Arkin, Amsterdam, North Holland, Netherlands

[8] Maastricht Univ, Fac Hlth Med & Life Sci, Dept Psychiat & Neuropsychol, Sch Mental Hlth & Neurosci, Maastricht, Netherlands

[9] Kings Coll London, Inst Psychiat, Dept Psychosis Studies, Kings Hlth Partners, London, England

[10] Utrecht Univ Med Ctr, Brain Ctr Rudolf Magnus, Dept Psychiat, Utrecht, Netherlands

[11] Kings Coll London, ESRC Ctr Soc & Mental Hlth & Social Epidemiol Res, London, England

[12] Kings Coll London, Inst Psychiat Psychol & Neurosci, Ctr Epidemiol & Publ Hlth, Hlth Serv & Populat Res Dept, London, England

[13] Vrije Univ, Dept Clin Neuro & Dev Psychol, Amsterdam, North Holland, Netherlands

[14] Parnassia Psychiat Inst, Dept Psychosis Res, The Hague, South Holland, Netherlands

[15] Univ Amsterdam, Dept Early Psychosis, Amsterdam UMC, Locat AMC, Amsterdam, Netherlands

[16] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Psychol, London, England

[17] South London & Maudsley NHS Fdn Trust, NIHR Biomed Res Ctr, London, England

来源：

EPIDEMIOLOGY AND PSYCHIATRIC SCIENCES | 2021年 / 30卷

基金：

英国惠康基金; 英国医学研究理事会;

关键词：

at-risk mental state; childhood abuse; transition; stress sensitization; ecological momentary assessment (EMA); experience sampling method (ESM); DAILY-LIFE STRESS; ECOLOGICAL MOMENTARY INTERVENTIONS; SCHIZOPHRENIA SPECTRUM DISORDERS; EXPERIENCE SAMPLING RESEARCH; EMOTIONAL REACTIVITY; TRANSITION RATE; BLACK-BOX; METAANALYSIS; SENSITIVITY; DEPRESSION;

D O I：

10.1017/S2045796021000251

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Aims Childhood trauma is associated with an elevated risk for psychosis, but the psychological mechanisms involved remain largely unclear. This study aimed to investigate emotional and psychotic stress reactivity in daily life as a putative mechanism linking childhood trauma and clinical outcomes in individuals at ultra-high-risk (UHR) for psychosis. Methods Experience sampling methodology was used to measure momentary stress, affect and psychotic experiences in the daily life of N = 79 UHR individuals in the EU-GEI High Risk Study. The Childhood Trauma Questionnaire was used to assess self-reported childhood trauma. Clinical outcomes were assessed at baseline, 1- and 2-year follow-up. Results The association of stress with positive (beta = -0.14, p = 0.010) and negative affect (beta = 0.11, p = 0.020) was modified by transition status such that stress reactivity was greater in individuals who transitioned to psychosis. Moreover, the association of stress with negative affect (beta = 0.06, p = 0.019) and psychotic experiences (beta = 0.05, p = 0.037) was greater in individuals exposed to high v. low levels of childhood trauma. We also found evidence that decreased positive affect in response to stress was associated with reduced functioning at 1-year follow-up (B = 6.29, p = 0.034). In addition, there was evidence that the association of childhood trauma with poor functional outcomes was mediated by stress reactivity (e.g. indirect effect: B = -2.13, p = 0.026), but no evidence that stress reactivity mediated the association between childhood trauma and transition (e.g. indirect effect: B = 0.14, p = 0.506). Conclusions Emotional and psychotic stress reactivity may be potential mechanisms linking childhood trauma with clinical outcomes in UHR individuals.

引用

页数：13