Perceived stress mediates the relationship between social adaptation and quality of life in individuals at ultra high risk of psychosis

Polygenic risk for schizophrenia, social dispositions, and pace of epigenetic aging: Results from the Young Finns Study

Schizophrenia is often regarded as a disorder of premature aging. We investigated (a) whether polygenic risk for schizophrenia (PRSsch ) relates to pace of epigenetic aging and (b) whether personal dispositions toward active and emotionally close relationships protect against accelerated epigenetic aging in individuals with high PRSsch . The sample came from the population-based Young Finns Study (n = 1348). Epigenetic aging was measured with DNA methylation aging algorithms such as AgeAccelHannum , EEAAHannum , IEAAHannum , IEAAHorvath , AgeAccelHorvath , AgeAccelPheno , AgeAccelGrim , and DunedinPACE. A PRSsch was calculated using summary statistics from the most comprehensive genome-wide association study of schizophrenia to date. Social dispositions were assessed in terms of extraversion, sociability, reward dependence, cooperativeness, and attachment security. We found that PRSsch did not have a statistically significant effect on any studied indicator of epigenetic aging. Instead, PRSsch had a significant interaction with reward dependence (p = 0.001-0.004), cooperation (p = 0.009-0.020), extraversion (p = 0.019-0.041), sociability (p = 0.003-0.016), and attachment security (p = 0.007-0.014) in predicting AgeAccelHannum , EEAAHannum , or IEAAHannum . Specifically, participants with high PRSsch appeared to display accelerated epigenetic aging at higher (vs. lower) levels of extraversion, sociability, attachment security, reward dependence, and cooperativeness. A rather opposite pattern was evident for those with low PRSsch . No such interactions were evident when predicting the other indicators of epigenetic aging. In conclusion, against our hypothesis, frequent social interactions may relate to accelerated epigenetic aging in individuals at risk for psychosis. We speculate that this may be explained by social-cognitive impairments (perceiving social situations as overwhelming or excessively arousing) or ending up in less supportive or deviant social groups.

Quality of life and its predictors in first-episode schizophrenia and individuals at clinical high-risk for psychosis

BACKGROUND

This is a cross-sectional study comparing the degree of subjective quality of life (QOL) impairment and its predictive factors in first-episode schizophrenia (FES) and individuals at clinical high-risk (CHR) for psychosis.

METHODS

Seventy-seven FES, 59 CHR, and 64 healthy controls (HC) were included. The QOL of all participants was assessed using the World Health Organization Quality of Life (WHOQOL)-Brief Form (BREF). Psychiatric symptoms of individuals with FES were assessed with the Positive and Negative Syndrome Scale (PANSS), five factors were further identified through factor analysis; for individuals with CHR and HC, the Scale of Prodromal Symptoms (SOPS) was used.

RESULTS

The total and four sub-domain scores of the WHOQOL-BREF in the FES and CHR groups were lower than those of the HC group. The overall and psychological health scores in the CHR group were lowest. In the FES group, after applying Bonferroni's correction, there is a negative correlation between the total QOL scores and anxiety/depressive symptom scores (r = -0.34, P = 0.003). The stepwise multiple regression analysis showed that the QOL of both FES and CHR group were negatively affected by anxiety/depressive symptoms and unemployment (P < 0.05).

CONCLUSIONS

Compared with FES, CHR individuals are more dissatisfied with their QOL. Although diagnostic assessment of FES and CHR relies heavily on positive symptoms, the QOL is more affected by anxiety/depressive symptoms and social functioning.

Perceived stress and life satisfaction during COVID-19 pandemic: the mediating role of social adaptation and the moderating role of emotional resilience

The present study mainly focused on college students during the COVID-19 outbreak and aimed to develop and examine a moderated mediation model between perceived stress and life satisfaction, with social adaptation during COVID-19 as a mediator, and emotional resilience as a moderator. A sample of 1032 college students participated in this study and completed questionnaires regarding perceived stress, social adaptation during COVID-19, emotional resilience, and life satisfaction. Findings indicated that 1) social adaptation during COVID-19 partially mediated the association between perceived stress and life satisfaction; and 2) emotional resilience moderated the relationship between perceived stress and social adaptation during COVID-19 as well as perceived stress and life satisfaction. These two relationships became stronger for college students with lower levels of emotional resilience. The results were discussed to illuminate the mechanism in relation to theoretical and practical implication for improving college students' life satisfaction during the period of the COVID-19 outbreak.

Patient-Reported Outcome Measures in Clinical High Risk for Psychosis: A Systematic Review

A key issue in both research and clinical work with youth at clinical high risk (CHR) of psychosis is that there are clearly heterogenous clinical outcomes in addition to the development of psychosis. Thus, it is important to capture the psychopathologic outcomes of the CHR group and develop a core outcomes assessment set that may help in dissecting the heterogeneity and aid progress toward new treatments. In assessing psychopathology and often poor social and role functioning, we may be missing the important perspectives of the CHR individuals themselves. It is important to consider the perspectives of youth at CHR by using patient-reported outcome measures (PROMs). This systematic review of PROMs in CHR was conducted based on a comprehensive search of several databases and followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Sixty-four publications were included in the review examining PROMs for symptoms, functioning, quality of life, self-perceptions, stress, and resilience. Typically, PROMs were not the primary focus of the studies reviewed. The PROMs summarized here fit with results published elsewhere in the literature based on interviewer measures. However, very few of the measures used were validated for CHR or for youth. There are several recommendations for determining a core set of PROMs for use with CHR.

Association among resilience, post-traumatic stress disorder, and somatization in frontline healthcare workers in COVID-19: The mediating role of perceived stress

BACKGROUND

Frontline healthcare workers were at a high risk of infection and developing mental health problems during the outbreak of coronavirus disease 2019 (COVID-19). It is important to monitor the symptoms of post-traumatic stress disorder (PTSD) and somatization among frontline healthcare workers in China.

AIM

This study aimed to investigate PTSD, somatization, resilience, and perceived stress among frontline healthcare workers fighting against COVID-19 and examine the mediating effects of perceived stress on resilience in both PTSD and somatization.

METHODS

The study was conducted from December 2021 to February 2022 through an online survey of frontline healthcare workers fighting against COVID-19. The survey included questions regarding socio-demographic information, resilience (10-item Conner-Davidson Resilience Scale, CD-RISC-10), perceived stress (14-item Perceived Stress Scale, PSS), PTSD (Checklist-Civilian Version, PCL-C), and somatization (Symptom Checklist-90). The PROCESS macro for SPSS was used to examine the mediating effects of perceived stress.

RESULTS

Approximately 14.9% of healthcare workers had possible PTSD (PCL-C score of ≥ 44), and 41.04% of the workers had low resilience (CD-RISC-10 score of ≤ 25.5). Approximately 54.05% of healthcare workers were symptomatic, and 14.7% had a moderate or higher degree of somatization with sleep-related problems as the most common symptom. Perceived stress was negatively correlated with resilience (r = -0.527, p < 0.001) and positively correlated with PTSD (r = 0.505, p < 0.001) and somatization (r = 0.361, p < 0.001). In addition, perceived stress mediated the relationship between resilience and PTSD [indirect b = -0.382; bootstrapped confidence interval (CI), -0.454, -0.319] and somatization (indirect effect b = -0.159; bootstrapped CI, -0.199, -0.123).

CONCLUSION

The prevalence of PTSD and somatic symptoms indicates that the mental health of frontline healthcare workers deserves more attention. Resilience is negatively associated with PTSD and somatization, and the relationship among resilience, PTSD, and somatization is mediated by perceived stress. Strategies for reducing perceived stress and increasing resilience may help to prevent and alleviate PTSD and somatization.

Perceived stress, social functioning and quality of life in first-episode psychosis: A 1-year follow-up study

AIM

Quality of life (QoL) has been widely studied in people with schizophrenia. In the early phases of psychosis, it remains often impaired even after the remission of psychotic symptoms. The aim of this study was to explore QoL and social functioning during the first year after a first-episode psychosis (FEP), and to study potential moderating effects of stress measures.

METHODS

Here, 61 FEP subjects and 55 healthy controls (HCs) were included. Sociodemographic data and clinical variables were collected through a semi-structured interview. Stress measures, social functioning and QoL were assessed with the Holmes-Rahe Social Readjustment Rating Scale, the Perceived Stress Scale, the Social Adaptation Self-Scale and the Euro-QoL-5D, respectively. Analysis of variance was employed with repeated measures and a mediation analysis at baseline and at 1-year follow-up was carried out.

RESULTS

Patients reported lower QoL, poorer social functioning and more stress than HC. FEP patients significantly improved in QoL and stress measures over time, but not in social functioning. Perceived stress mediated the association between poorer social functioning and lower QoL.

CONCLUSIONS

Social functioning at baseline may determine QoL over a 1-year follow-up period. Despite the improvement in most measures, patients do not achieve the level of well-being as the healthy group.

Perceived stress, quality of life, and coping skills among patients with schizophrenia in symptomatic remission

Background

Schizophrenia is one of the worst diseases with its ubiquitous challenges due to its unique psychopathology and life events. Patients with schizophrenia use various coping strategies to overcome distress. The aim of the study was to evaluate the association between perceived stress, quality of life, and coping skills in patients with schizophrenia in remission. A total of 48 consecutive patients of schizophrenia, in remission, attending outpatient department of psychiatry at Academic hospital, South India, who satisfied the inclusion and exclusion criteria were recruited for the present study. The participants were assessed on Positive and Negative Symptoms Scale, Ways of Coping Checklist – Revised and Perceived Stress Scale and WHO Quality of Life. Results were analyzed using appropriate statistical package software v 16.0.

Result

Highest medial was found in self-controlling and positive reappraisal coping skills. Distancing is associated with high physical domain of quality of life whereas patients with good social support score more in social and physical domain of quality of life.

Conclusion

Patients with history of schizophrenia even though in remission dwell a stressful life. They often need different kind of social support or cognitive aids. In that view, studying their stress level, ability to cope with it, and quality of life will help us to manage them in better way.

Social Adaptation in Context: The Differential Role of Religiosity and Self-Esteem in Vulnerable vs. Non-vulnerable Populations - A Registered Report Study

There is evidence that religiosity and self-esteem are positively related, while self-esteem and religiosity in turn predict successful social adaptation. Moreover, self-esteem has been shown to be directly related to social adaptation in vulnerable contexts. In this registered report study, we tested the hypothesis that religiosity has a positive influence on social adaptation for people living in vulnerable contexts and that self-esteem is a mediator of this relationship. Evidence from this study indicates that neither there is any effect of religiosity on social adaptation nor on self-esteem, independent of whether people live in vulnerable contexts or not.

Relationship between childhood trauma and social adaptation in a sample of young people attending an early intervention service for psychosis

INTRODUCTION

Childhood trauma has been associated with an increased risk of psychosis, a greater severity of psychopathological symptoms, and a worse functional prognosis in patients with psychotic disorders. The current study aims to explore the relationship between childhood trauma, psychopathology and social adaptation in a sample of young people with first episode psychosis (FEP) or at-risk mental states (ARMS).

MATERIAL AND METHODS

The sample included 114 young people (18-35 years old, 81 FEP and 33 ARMS) who were attending an Early Intervention Service for Psychosis. Positive, negative and depressive symptoms were assessed with the PANSS and the Calgary Depression Scale; history of childhood trauma was assessed with the Childhood Trauma Questionnaire; social adaptation was assessed with the Social Adaptation Self-evaluation Scale (SASS). Structural equation modeling (SEM) was used to explore the relationship between childhood trauma, psychopathology and SASS dimensions in the global sample (including FEP and ARMS). An exploratory SEM analysis was repeated in the subsample of FEP patients.

RESULTS

ARMS individuals reported more emotional neglect and worse social adaptation compared to FEP. SEM analysis showed that childhood trauma is associated with a worse social adaptation, in a direct way with domains involving interpersonal relationships, and mediated by depressive symptoms with those domains involving leisure, work and socio-cultural interests.

CONCLUSIONS

Childhood trauma has a negative effect on social adaptation in young people with early psychosis. Depressive symptoms play a mediation role in this association, especially in domains of leisure and work.

Maladaptive mood repair predicts suicidal behaviors among young adults with depression histories

BACKGROUND

As the rates of suicidal behaviors continue to rise, research is needed that can facilitate prevention. The present study therefore examined whether a modifiable process, dysfunctional regulation of sadness (maladaptive mood repair), predicts a range of suicidal behaviors and if its impact is affected by risk and protective factors.

METHODS

Young adults with histories of childhood-onset mood disorder (COMD) (n = 173) or no histories of major psychiatric illness (controls, n = 96) were followed for approximately 3 years. Self-rated questionnaires and psychiatric evaluations were administered at study entry (T1) and across the follow-up (T2) and clinicians assessed the DSM-range of non-fatal suicidal behaviors. We hypothesized that the impact of depression on suicidal behaviors was mediated by dysfunctional regulation of sadness.

RESULTS

At T1, 90% of the COMD group had histories of various suicidal behaviors; 63% had past suicide attempts. During follow-up, 40% exhibited suicidal behaviors; 7% reported suicide attempts. Controlling for prior suicidal behaviors, T1 maladaptive mood repair predicted suicidal behavior during the follow-up and differentiated recurrent thoughts of death from other forms of suicidality. Protective and risk factors lost their predictive power in the presence of maladaptive mood repair.

LIMITATIONS

Few control cases exhibited suicidal behavior during the follow-up and the high inter-correlations among several key variables constrained the models that could be fitted.

CONCLUSIONS

Programs to prevent suicidal behavior among high-risk individuals should include maladaptive mood repair as an intervention target. Further research is needed on whether recurrent thoughts of death constitute a valid index of suicidality.