Schizophrenia: Reaction to Positive Life Events

Dynamic interplay between life events and course of psychotic disorders: 10-year longitudinal study following first admission

BACKGROUND

Life events (LEs) are a risk factor for first onset and relapse of psychotic disorders. However, the impact of LEs on specific symptoms - namely reality distortion, disorganization, negative symptoms, depression, and mania - remains unclear. Moreover, the differential effects of negative v. positive LEs are poorly understood.

METHODS

The present study utilizes an epidemiologic cohort of patients (N = 428) ascertained at first-admission for psychosis and followed for a decade thereafter. Symptoms were assessed at 6-, 24-, 48-, and 120-month follow-ups.

RESULTS

We examined symptom change within-person and found that negative events in the previous 6 months predicted an increase in reality distortion (β = 0.07), disorganized (β = 0.07), manic (β = 0.08), and depressive symptoms (β = 0.06), and a decrease in negative symptoms (β = -0.08). Conversely, positive LEs predicted fewer reality distortion (β = -0.04), disorganized (β = -0.04), and negative (β = -0.13) symptoms, and were unrelated to mood symptoms. A between-person approach to the same hypotheses confirmed that negative LEs predicted change in all symptoms, while positive LEs predicted change only in negative symptoms. In contrast, symptoms rarely predicted future LEs.

CONCLUSIONS

These findings confirm that LEs have an effect on symptoms, and thus contribute to the burden of psychotic disorders. That LEs increase positive symptoms and decrease negative symptoms suggest at least two different mechanisms underlying the relationship between LEs and symptoms. Our findings underscore the need for increased symptom monitoring following negative LEs, as symptoms may worsen during that time.

Negative and positive life events and their relation to substance and behavioral addictions

BACKGROUND

Research has shown that negative life events (LEs) may be connected to the development and maintenance of addictions. However, few studies have examined the potential relationship between positive events and addictive disorders, and even fewer studies evaluated the subjective perception of LEs that may underlie these relationships. Importantly, addictive disorders include both substance-related and behavioral addictions, but the relative relationship of each type of addiction with LEs remains unclear.

METHODS

The present study compared 212 participants suffering from an addiction (drugs, alcohol, gambling, and sex) and 79 controls on self-report measures of negative and positive LEs.

RESULTS

Compared with controls, individuals with an addiction reported experiencing a larger number of both negative and positive LEs and also tended to be more influenced by negative LEs. Findings also demonstrated differential patterns across addiction types, such that participants with compulsive sexual behavior (CSB) reported experiencing less negative events than those with drug use disorders (DUD) and were less influenced by these events than participants with alcohol use disorder (AUD). Finally, analyses within each group further revealed differences in the way each group experienced negative compared to positive events. Controls and participants with CSB reported experiencing a similar number of positive and negative events, whereas participants with DUD, AUD, and gambling disorder reported more negative events in their lives.

CONCLUSIONS

These findings suggest a unique profile among different types of addictions, which should be taken into account when planning personalized prevention and intervention approaches.