Stressful life events have been shown to influence the risk of psychosis in certain individuals. How people respond to life stressors can be predictive of their vulnerability for later mental health issues, including schizophrenia. Certain individuals may be more sensitive to stress reactivity and experience deleterious consequences, such as delusions or hallucinations, which can precede psychotic episodes. Understanding how people at ultra-high risk (UHR) for psychosis respond to stress compared to individuals with psychosis could help clinicians identify those most at risk for future psychological difficulties. To measure these differences, Jasper E. Palmier-Claus of the Manchester Academic Health Sciences Centre and the School of Community Based Medicine at the University of Manchester in the UK led a study that compared 27 nonpsychotic non-at-risk participants with 27 UHR individuals and 27 individuals with a history of psychosis. The participants were required to enter daily reports about their stress levels and emotions at various times over a 6-day period.
Palmier-Claus discovered that compared with the nonpsychotic nonrisk group, the UHR participants had higher levels of negative responses to stressors. Surprisingly, the UHR group also had more negative responses than the clinical group with a history of psychosis. This suggests that the stress-response dynamic may be more a predictive factor of psychosis than a maintenance factor in individuals already diagnosed with psychosis. This finding is critical as it could provide evidence of early psychosis in certain individuals and therefore allow clinicians to treat and manage the illness in its infancy. “Clinically, it may be useful to identify reoccurring stressors in UHR individuals’ lives in order to improve their mood and symptoms,” said Palmier-Claus.
Interventions could focus on improving family relations to minimize tension and stress in daily lives. Strategies that teach individuals how to cope with stress in adaptive ways, such as mindfulness therapy, could further help prevent and weaken the symptoms of psychosis. Other approaches that are aimed at reducing stress in people with anxiety and panic may also be beneficial to UHR individuals. Overall, the findings from this study provide opportunities to identify and treat individuals most at risk for psychosis before the onset of symptoms.
Palmier-Claus, J. E. (2012). Emotional and symptomatic reactivity to stress in individuals at ultra-high risk of developing psychosis. Psychological Medicine, 42.5, 1003-1012.
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