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Torrecilla P, Barrantes-Vidal N. The moderating role of hair cortisol in the association of early and recent stress with stress-related phenotypes. Front Psychol 2023; 14:1150142. [PMID: 37416538 PMCID: PMC10320289 DOI: 10.3389/fpsyg.2023.1150142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023] Open
Abstract
BackgroundIncreased hair cortisol concentrations (HCC) have been found in clinical samples of schizophrenia, first episode psychosis and clinical risk for psychosis, but evidence of such is scarce in schizotypy. High HCC are supposed to reflect elevated chronic stress. However, HCC were not directly associated with adversity measures and stress-related phenotypes in previous research. This study tested whether HCC moderated the association between a comprehensive range of psychosocial stressors with several stress-related phenotypes in a sample of nonclinical young adults. It was expected that stressors, either distal (i.e., early-life) or recent, would be associated with subclinical features, particularly for those with elevated HCC, reflecting the effects of a potential biological sensitization to stress.MethodsThe sample comprised 132 nonclinical young adults belonging to the Barcelona Longitudinal Investigation of Schizotypy Study (BLISS). Participants completed a questionnaire of childhood adversity and two complementary measures of recent life events, tapping threatening vs. more general life events. Both the frequency and subjective impact (positive vs. negative) of general life events were also assessed. Psychotic (i.e., schizotypy, suspiciousness) and non-psychotic (i.e., depression, anxiety) subclinical features as well as appraisals of perceived stress were examined. Hierarchical linear regressions and simple slope analyses were computed.ResultsHCC moderated the effects of both early and recent stress on suspiciousness as well as the effects of recent life events on perceived stress, such that those with higher HCC presented increased suspiciousness and perceived stress at higher levels of stress exposure. Positive, but not negative, recent life events were associated with decreased perceived stress and depression, and these associations were moderated by low HCC, indicating a buffering effect for those with a non-impaired HPA axis.ConclusionIn line with the neural diathesis-stress model, results highlight the role of the interplay between the HPA axis and exposure to stressful experiences in exacerbating psychosis features and extend evidence to the nonclinical expression of the psychosis continuum. In addition, findings support the protective effect of positive experiences in decreasing stress appraisals and affective disturbances, which is consistent with emerging research about the relevance of positive factors in reducing the likelihood of psychopathological outcomes.
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Affiliation(s)
- Pilar Torrecilla
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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2
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Georgiades A, Almuqrin A, Rubinic P, Mouhitzadeh K, Tognin S, Mechelli A. Psychosocial stress, interpersonal sensitivity, and social withdrawal in clinical high risk for psychosis: a systematic review. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:38. [PMID: 37330526 DOI: 10.1038/s41537-023-00362-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/28/2023] [Indexed: 06/19/2023]
Abstract
Stress has repeatedly been implicated in the onset and exacerbation of positive symptoms of psychosis. Increasing interest is growing for the role of psychosocial stress in the development of psychosis symptoms in individuals at Clinical High Risk (CHR) for psychosis. A systematic review was therefore conducted to summarize the existing evidence base regarding psychosocial stress, interpersonal sensitivity, and social withdrawal in individuals at CHR for psychosis. An electronic search of Ovid (PsychINFO, EMBASE, MEDLINE, and GLOBAL HEALTH) was conducted until February 2022. Studies that examined psychosocial stress in CHR were included. Twenty-nine studies were eligible for inclusion. Psychosocial stress, interpersonal sensitivity, and social withdrawal were higher in CHR individuals compared to healthy controls and there was some evidence of their association with positive symptoms of psychosis. Two types of psychosocial stressors were found to occur more frequently with CHR status, namely daily stressors, and early and recent trauma, while significant life events did not appear to be significant. Greater exposure to psychosocial stress, emotional abuse, and perceived discrimination significantly increased risk of transition to psychosis in CHR. No studies examined the role of interpersonal sensitivity on transition to psychosis in CHR. This systematic review provides evidence for the association of trauma, daily stressors, social withdrawal, and interpersonal sensitivity with CHR status. Further studies investigating the impact of psychosocial stress on psychosis symptom expression in individuals at CHR and its effects on transition to psychosis are therefore warranted.
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Affiliation(s)
- A Georgiades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK.
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, 27-29 Fairlight Avenue, London, NW10 8AL, UK.
| | - A Almuqrin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - P Rubinic
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - K Mouhitzadeh
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - S Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - A Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
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4
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Pignon B, Lajnef M, Kirkbride JB, Peyre H, Ferchiou A, Richard JR, Baudin G, Tosato S, Jongsma H, de Haan L, Tarricone I, Bernardo M, Velthorst E, Braca M, Arango C, Arrojo M, Bobes J, Del-Ben CM, Di Forti M, Gayer-Anderson C, Jones PB, La Cascia C, Lasalvia A, Menezes PR, Quattrone D, Sanjuán J, Selten JP, Tortelli A, Llorca PM, van Os J, Rutten BPF, Murray RM, Morgan C, Leboyer M, Szöke A, Schürhoff F. The Independent Effects of Psychosocial Stressors on Subclinical Psychosis: Findings From the Multinational EU-GEI Study. Schizophr Bull 2021; 47:1674-1684. [PMID: 34009318 PMCID: PMC8562561 DOI: 10.1093/schbul/sbab060] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The influence of psychosocial stressors on psychosis risk has usually been studied in isolation and after the onset of the disorder, potentially ignoring important confounding relationships or the fact that some stressors that may be the consequence of the disorder rather than preexisting. The study of subclinical psychosis could help to address some of these issues. In this study, we investigated whether there was (i) an association between dimensions of subclinical psychosis and several psychosocial stressors including: childhood trauma, self-reported discrimination experiences, low social capital, and stressful life experiences, and (ii) any evidence of environment-environment (ExE) interactions between these factors. Data were drawn from the EUGEI study, in which healthy controls (N = 1497) and siblings of subjects with a psychotic disorder (N = 265) were included in six countries. The association between psychosocial stressors and subclinical psychosis dimensions (positive, negative and depressive dimension as measured by the Community Assessment of Psychic Experiences (CAPE) scale) and possible ExE interactions were assessed using linear regression models. After adjusting for sex, age, ethnicity, country, and control/sibling status, childhood trauma (β for positive dimension: 0.13, negative: 0.49, depressive: 0.26) and stressful life events (positive: 0.08, negative: 0.16, depressive: 0.17) were associated with the three dimensions. Lower social capital was associated with the negative and depression dimensions (negative: 0.26, depressive: 0.13), and self-reported discrimination experiences with the positive dimension (0.06). Our findings are in favor of independent, cumulative and non-specific influences of social adversities in subclinical psychosis in non-clinical populations, without arguments for E × E interactions.
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Affiliation(s)
- Baptiste Pignon
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France,To whom correspondence should be addressed; Hôpital Albert
Chenevier, Groupe hospitalier Henri-Mondor, CHU de Créteil, Assistance
Publique-Hôpitaux de Paris (AP-HP), 40 rue de Mesly, 94 000 Créteil,
France; tel: 33-1-49-81-31-31, fax:
+33-1-49-81-30-59, e-mail:
| | - Mohamed Lajnef
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | | | - Hugo Peyre
- AP-HP, Hôpital universitaire Robert Debré,
Service de pédopsychiatrie, Paris,
France
| | - Aziz Ferchiou
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Jean-Romain Richard
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Grégoire Baudin
- Université de Paris, Laboratoire de Psychopathologie
et Processus de Santé, Boulogne
Billancourt, France
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience,
Biomedicine and Movement Sciences, University of Verona,
Verona, Italy
| | - Hannah Jongsma
- Centre for Transcultural Psychiatry
“Veldzicht.” Balkbrug, the Netherlands; VR Mental Health Group,
University Center for Psychiatry, Univerisity Medical Centre
Groningen, Groningen, The Netherlands,Centre for Longitudinal Studies, UCL,
London, UK
| | - Lieuwe de Haan
- Amsterdam UMC,
Amsterdam, The
Netherlands,Arkin, Amsterdam,
The Netherlands
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna
University, Bologna, Italy
| | - Miguel Bernardo
- Barcelona Clínic Schizophrenia Unit, Hospital
Clínic of Barcelona, Institute of Neuroscience, University of Barcelona;
Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS),
Barcelona; Centro de Investigación Biomédica en Red de Salud Mental
(CIBERSAM), Spain
| | - Eva Velthorst
- Department of Psychiatry, Icahn School of Medicine at
Mount Sinai, New York, NY
| | - Mauro Braca
- Department of Mental Health and Pathological Addictions,
Local Health Authority, Bologna, Italy
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute
of Psychiatry and Mental Health, Hospital General.Universitario Gregorio
Marañón, Gregorio Marañón, (IiGSM), School of Medicine,
Universidad Complutense de Madrid; CIBERSAM,
Madrid, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group,
Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo
Hospitalario Universitario de Santiago de Compostela, Spain
| | - Julio Bobes
- Faculty of Medicine and Health Sciences - Psychiatry,
Universidad de Oviedo; ISPA, INEUROPA CIBERSAM,
Oviedo, Spain
| | - Cristina Marta Del-Ben
- Department of Neuroscience and Behaviour, Ribeirão
Preto Medical School, University of São Paulo,
São Paulo, Brazil
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK,South London and Maudsley NHS Mental Health Foundation
Trust, London, UK
| | - Charlotte Gayer-Anderson
- Department of Health Service and Population Research,
Institute of Psychiatry, King’s College London, De Crespigny
Park, Denmark Hill, London, UK
| | - Peter B Jones
- Department of Psychiatry, University of
Cambridge, Cambridge, UK,CAMEO, Cambridgeshire & Peterborough NHS Foundation
Trust, Cambridge, UK
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced
Diagnostics, School of Medicine, University of Palermo,
Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience,
Biomedicine and Movement Sciences, University of Verona,
Verona, Italy
| | - Paulo Rossi Menezes
- Department of Preventive Medicine, Faculdade de Medicina,
Universidade of São Paulo, São
Paulo, Brazil
| | - Diego Quattrone
- Social, Genetic, and Developmental Psychiatry Centre,
Institute of Psychiatry, Psychology and Neuroscience, King’s College
London, London, UK
| | - Julio Sanjuán
- Biomedical Research Networking Centre in Mental Health
(CIBERSAM), Madrid, Spain,Department of Psychiatry, Hospital Clínico
Universitario de Valencia, School of Medicine, Universidad de
Valencia, Valencia, Spain,Biomedical Research Institute INCLIVA,
Valencia, Spain
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health,
Leiden, The
Netherlands,Maastricht University Medical Center, Departmentof
Psychiatry & Neuropsychology, School for Mental Health and
Neuroscience, Maastricht, The Netherlands
| | - Andrea Tortelli
- French National Institute of Health and Medical Research
(INSERM), Créteil, France,EPS Maison Blanche,
Paris, France
| | - Pierre-Michel Llorca
- CHU Clermont-Ferrand, Psychiatrie B,
Clermont-Ferrand, France,Université Clermont Auvergne,
Clermont-Ferrand, France
| | - Jim van Os
- Department of Psychiatry and Neuropsychology, School for
Mental Health and Neuroscience, Maastricht University Medical
Centre, Maastricht, The Netherlands,Department of Psychiatry, UMC Utrecht Brain Centre,
University Medical Centre Utrecht, Utrecht University,
Utrecht, The
Netherlands,Department of Psychosis Studies, Institute of Psychiatry,
Psychology & Neuroscience, King’s College London,
London, UK
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for
Mental Health and Neuroscience, Maastricht University Medical
Centre, Maastricht, The Netherlands
| | - Robin M Murray
- The Institute of Psychiatry, Psychology and Neuroscience,
King’s College London, London,
UK
| | - Craig Morgan
- Department of Health Service and Population Research,
Institute of Psychiatry, King’s College London, De Crespigny
Park, Denmark Hill, London, UK
| | - Marion Leboyer
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
| | - Franck Schürhoff
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux
Universitaires « H. Mondor», DMU IMPACT, Fondation
FondaMental, Créteil, France
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7
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Armando M, Sandini C, Chambaz M, Schaer M, Schneider M, Eliez S. Coping Strategies Mediate the Effect of Stressful Life Events on Schizotypal Traits and Psychotic Symptoms in 22q11.2 Deletion Syndrome. Schizophr Bull 2018; 44:S525-S535. [PMID: 29548017 PMCID: PMC6188528 DOI: 10.1093/schbul/sby025] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Converging evidence suggests that psychosis emerges from the complex interaction of genetic and environmental factors. Stressful life events (SLEs) play a prominent role in combination with coping strategies and with a dysfunctional hypothalamus-pituitary-adrenal axis (HPAA). It has been proposed that the framework of schizotypy might help disentangle the interaction between genetic and environmental factors in the pathogenesis of psychosis. Similarly, 22q11.2 deletion syndrome (22q11DS) is considered as a genetic model of psychosis vulnerability. However, SLE and coping strategies remain largely unexplored in 22q11DS. Moreover, the HPAA has not been systematically investigated in this population. Here, we explored the correlation between SLE, emotional coping strategies, schizotypal personality traits, subthreshold psychotic symptoms in a sample of 43 healthy controls (HCs) compared with 59 individuals with 22q11DS. In the latter, we also explored the correlation with pituitary volume as estimated from structural magnetic resonance imaging. We found that SLE and negative coping strategies were correlated with schizotypal personality traits in both HCs and 22q11DS, and with psychotic symptoms in the 22q11DS group only, whereas reduced pituitary volume correlated with general psychopathology. Moreover, dysfunctional coping mediated the effect of SLE on schizotypal personality traits and psychotic symptoms in 22q11DS. Our findings recapitulate evidence in nonsyndromic patients and confirm the central role of stress and coping in the pathogenesis of psychosis. More broadly, they highlight the importance of environmental factors in the pathway to psychosis in 22q11DS, suggesting a strong rationale for the implementation of stress and particularly coping-oriented interventions in this population.
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Affiliation(s)
- Marco Armando
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Corrado Sandini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Maelle Chambaz
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Marie Schaer
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
| | - Maude Schneider
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, School of Medicine, University of Geneva, David Dufour, Geneva, Switzerland
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9
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Cohen AS, Mohr C, Ettinger U, Chan RCK, Park S. Schizotypy as an organizing framework for social and affective sciences. Schizophr Bull 2015; 41 Suppl 2:S427-35. [PMID: 25810057 PMCID: PMC4373637 DOI: 10.1093/schbul/sbu195] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Schizotypy, defined in terms of commonly occurring personality traits related to the schizophrenia spectrum, has been an important construct for understanding the neurodevelopment and stress-diathesis of schizophrenia. However, as schizotypy nears its sixth decade of application, it is important to acknowledge its impressively rich literature accumulating outside of schizophrenia research. In this article, we make the case that schizotypy has considerable potential as a conceptual framework for understanding individual differences in affective and social functions beyond those directly involved in schizophrenia spectrum pathology. This case is predicated on (a) a burgeoning literature noting anomalies in a wide range of social functioning, affiliative, positive and negative emotional, expressive, and social cognitive systems, (b) practical and methodological features associated with schizotypy research that help facilitate empirical investigation, and (c) close ties to theoretical constructs of central importance to affective and social science (eg, stress diathesis, neural compensation). We highlight recent schizotypy research, ie providing insight into the nature of affective and social systems more generally. This includes current efforts to clarify the neurodevelopmental, neurobiological, and psychological underpinnings of affiliative drives, hedonic capacity, social cognition, and stress responsivity systems. Additionally, we discuss neural compensatory and resilience factors that may mitigate the expression of stress-diathesis and functional outcome, and highlight schizotypy's potential role for understanding cultural determinants of social and affective functions.
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Affiliation(s)
- Alex S. Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA;,*To whom correspondence should be addressed; Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70808, US; tel: 225-578-7017, fax: 225-578-4125, e-mail:
| | - Christine Mohr
- Institute of Psychology, University of Lausanne, Switzerland
| | | | - Raymond C. K. Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Sohee Park
- Department of Psychology, Vanderbilt University, Nashville, TN
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