Myin-Germeys Inez, van Os Jim
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands.
Clin Psychol Rev. 2007 May;27(4):409-24. doi: 10.1016/j.cpr.2006.09.005. Epub 2007 Jan 10.
This paper will review a series of studies using the Experience Sampling Method that suggest that altered sensitivity to stress is an endophenotype for psychosis. The Experience Sampling Method is a structured diary technique allowing the assessment of emotional reactivity to stressors occurring in normal daily life. Elevated emotional reactivity to stress was found in subjects vulnerable to psychosis, suggesting that affective responses to stressors in the flow of daily life are an indicator of genetic and/or environmental liability to psychosis. Indeed, the small stressors in daily life associated with affective responses also predict more intense moment-to-moment variation of subtle positive psychotic experiences. Increased emotional reactivity was found to be independent from cognitive impairments, and argued to constitute evidence of an affective pathway to psychosis that may underlie a more episodic, reactive, good-outcome type of psychosis. Evidence for this hypothesis was found in data suggesting that the experience of stressful life events and early trauma were associated with increased stress-sensitivity, and that women were more likely to display elevated stress-reactivity. These findings are discussed in the light of recent biological and psychological mechanisms.
本文将回顾一系列使用经验取样法的研究，这些研究表明对应激的敏感性改变是精神病的一种内表型。经验取样法是一种结构化日记技术，可用于评估对正常日常生活中出现的应激源的情绪反应。在易患精神病的受试者中发现对应激的情绪反应增强，这表明在日常生活中对应激源的情感反应是遗传和/或环境导致精神病易感性的一个指标。事实上，与情感反应相关的日常生活中的小应激源也预示着微妙的阳性精神病体验会有更强烈的瞬间变化。研究发现情绪反应增强与认知障碍无关，并被认为构成了一条通向精神病的情感途径的证据，这条途径可能是一种更具发作性、反应性、预后良好型精神病的基础。在数据中发现了支持这一假设的证据，这些数据表明应激性生活事件和早期创伤的经历与应激敏感性增加有关，而且女性更有可能表现出应激反应增强。将根据最近的生物学和心理学机制对这些发现进行讨论。
