Gerritsen Cory, Bagby R Michael, Sanches Marcos, Kiang Michael, Maheandiran Margaret, Prce Ivana, Mizrahi Romina
Centre for Addiction and Mental Health, 250 College St, Toronto, Ontario M5T 1R8, Canada; University of Toronto, 27 King's College Circle, Toronto, Ontario M5S 1A1, Canada.
Centre for Addiction and Mental Health, 250 College St, Toronto, Ontario M5T 1R8, Canada.
Schizophr Res. 2019 Aug;210:52-58. doi: 10.1016/j.schres.2019.06.015. Epub 2019 Jun 24.
The experience sampling method (ESM) has revealed associations between fluctuations in stress and positive symptoms in psychosis. It is unknown, however, how negative symptoms including anhedonia respond to stress. Stress is divided according to its source: event-related stress stemming from negative events, and activity-related stress stemming from engaging in tasks beyond one's skill or control. Anhedonia is divided into consummatory and anticipatory anhedonia, reflecting a lack of pleasure in current and expected activities. This study uses ESM to determine whether each form of anhedonia increases in response to stress. Antipsychotic-naïve individuals with first episode psychosis (n = 39), clinical high-risk states for psychosis (n = 44), and healthy controls (n = 34) responded to daily prompts on a palmtop computer for up to ten days by indicating levels of stress and anhedonia. Time-lagged multilevel modelling was employed to explore increases in anhedonia following increases in stress while controlling for prior levels of anhedonia. Mean levels of anhedonia were also compared across groups. Only activity-related stress produced increases in anhedonia. This effect did not vary between groups. Clinical groups showed greater overall levels of anhedonia than healthy controls, but did not differ from each other. Anhedonia responds only to activity-related stressors, suggesting that this form of stress has a specific causal role in anhedonia. The results also provide further evidence for global increases in anhedonia in antipsychotic-naïve psychosis spectrum individuals.
经验取样法（ESM）揭示了压力波动与精神病性阳性症状之间的关联。然而，包括快感缺失在内的阴性症状如何应对压力尚不清楚。压力根据其来源进行划分：源于负面事件的与事件相关的压力，以及源于从事超出个人技能或控制范围的任务的与活动相关的压力。快感缺失分为消费性快感缺失和预期性快感缺失，反映出在当前和预期活动中缺乏愉悦感。本研究使用经验取样法来确定每种形式的快感缺失是否会因压力而增加。首次发作精神病的未服用抗精神病药物个体（n = 39）、精神病临床高危状态个体（n = 44）和健康对照者（n = 34）通过在掌上电脑上对每日提示做出回应，持续长达十天，报告压力和快感缺失水平。采用时间滞后多水平模型来探究压力增加后快感缺失的增加情况，同时控制先前的快感缺失水平。还比较了各组之间快感缺失的平均水平。只有与活动相关的压力会导致快感缺失增加。这种效应在各组之间没有差异。临床组的快感缺失总体水平高于健康对照组，但两组之间没有差异。快感缺失仅对与活动相关的压力源有反应，这表明这种形式的压力在快感缺失中具有特定的因果作用。研究结果还为未服用抗精神病药物的精神病谱系个体中快感缺失的普遍增加提供了进一步证据。
