Identifying Those Most at Risk for Psychosis

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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  • Celina


    May 29th, 2012 at 3:58 PM

    Isn’t it just crazy how much of an impact that stress can have on us, in ways that we have mostly never even realized? And knowing this and being able to predict this early in people who suffer from chronic stress is sure to offer better treatment for them than it woujld be to wait until they begin having psychotic episodes that negatively effect them and their quality of life.

  • sharon


    May 29th, 2012 at 5:20 PM

    I fail to see how this could really help, though, because what could be deemed as stressful for one person may not be to another. I recognize that a traumatic event is something that can be judged fairly pretty much across the board; most of us have the same idea about what is traumatic and what isn’t. But most of us also process stress differently and what really gets to one person may not even faze another. So if that is the case, how could there ever be any kind of early intervention when you just have no real way of knowing how one two different people will recat to the same exact event later in life?

  • jason


    May 30th, 2012 at 4:09 AM

    The idea to stage therapy with both the family and the member most at risk for psychosis is an excellent idea.

    Many times it is the family unit that is the most responsible for a large part of the stress that one person can feel, but also the part of their lives which has the most opportunity to be a caliming factor as well.

    Doing therapy together and offering tools for all of the family on how to best alleviate the stress that their family dynamic can create as well as discovering new ways to avoid it altogether can be a lifesaver for someone who who feels stressful situations quite deeply and who will have the most chance to be long term damaged by it.

  • Desmond Jarvis

    Desmond Jarvis

    May 30th, 2012 at 12:33 PM

    I have never even thought about stress being a precursor to psychosis. Man, I’ve got to bring my life down a notch or two, cause at this rate, I am gonna be flipping out real soon!

  • c martins

    c martins

    May 31st, 2012 at 1:22 AM

    all this is fine to identify, but once the patient is in a facility. who identifies before that? yes the people around the person should be aware of the identifying factors too.

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