VU University and Amsterdam Public Health research institute, Department of Clinical Psychology, Amsterdam, the Netherlands; Parnassia Psychiatric Institute, The Hague, the Netherlands.
VU University and Amsterdam Public Health research institute, Department of Clinical Psychology, Amsterdam, the Netherlands; Arkin Mental Health Care Institute, Amsterdam, the Netherlands.
Schizophr Res. 2018 Dec;202:80-85. doi: 10.1016/j.schres.2018.06.042. Epub 2018 Jun 27.
Higher liability to psychosis is associated with low self-esteem and increased sensitivity to social stress. Recently, we reported a positive relation between liability to psychosis and affective and psychotic responses to social stress. This study investigated how self-esteem moderates paranoia, peak subjective distress and stress reactivity of people with different psychosis liability in response to social stressors in virtual reality.
Ninety-four individuals with lower (41 siblings and 53 controls) and 75 persons with higher psychosis liability (55 with recent onset psychotic disorder and 20 at ultra-high risk for psychosis) explored five times a virtual café with various social stressors (crowdedness, ethnic minority status, and hostility). They rated momentary paranoia (State Social Paranoia Scale) after each experiment and subjective distress on a visual analogue scale before and after the experiments. Positive and negative self-esteem were assessed with the Self-Esteem Rating Scale.
Momentary paranoia, peak subjective distress, and reactivity to social stressors were associated with negative self-esteem, but not positive self-esteem. Effects of both positive and negative self-esteem on psychotic and affective stress responses, but not stress reactivity, became significantly stronger when individuals were exposed to more stressful environments. Effects of self-esteem on momentary paranoia and peak subjective distress did not differ between the high liability and low liability group. Persons with lower psychosis liability had a stronger effect of negative self-esteem on stress reactivity than persons with higher liability.
Positive and negative self-esteem may play an important role in affective and psychotic responses to social stress.
较高的精神病易感性与低自尊和对社会压力的敏感性增加有关。最近，我们报告了精神病易感性与对社会压力的情感和精神病反应之间的正相关。本研究调查了自尊如何调节不同精神病易感性人群对虚拟现实中社会应激源的偏执、主观痛苦峰值和应激反应。
94 名低精神病易感性个体（41 名兄弟姐妹和 53 名对照者）和 75 名高精神病易感性个体（55 名近期发病精神病患者和 20 名精神病超高风险个体）五次探索一个有各种社会应激源（拥挤、少数民族身份和敌意）的虚拟咖啡馆。他们在每次实验后评估即时偏执（状态社会偏执量表），并在实验前后在视觉模拟量表上评估主观痛苦。积极和消极的自尊用自尊评定量表进行评估。
即时偏执、主观痛苦峰值和对社会压力的反应性与消极自尊有关，但与积极自尊无关。当个体处于压力较大的环境中时，积极和消极自尊对精神病和情感应激反应的影响，但不是应激反应的影响，变得明显更强。自尊对即时偏执和主观痛苦峰值的影响在高易感性和低易感性组之间没有差异。低精神病易感性个体的消极自尊对应激反应的影响比高精神病易感性个体更强。
积极和消极的自尊可能在对社会压力的情感和精神病反应中发挥重要作用。
