Vargas Teresa, Zou Denise S, Conley Rachel E, Mittal Vijay A
Department of Psychology, Northwestern University, Evanston, IL 60208, USA.
Department of Psychology, Department of Psychiatry, Department of Medical Social Sciences, Institute for Innovations in Developmental Sciences, Institute for Policy Research, Northwestern University, Evanston, IL 60208, USA.
J Clin Med. 2019 Jul 9;8(7):994. doi: 10.3390/jcm8070994.
Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a psychotic disorder.
CHR individuals ( = 35) and healthy volunteers ( = 28) completed structured clinical interviews as well as our group's newly developed Individual and Structural Exposure to Stress in Psychosis-risk-states (ISESP) interview. Lifetime cumulative scores were calculated, and severity of stress was reported for multiple developmental periods/ages. Group differences were tested, and associations with current symptom domains were examined.
Significant group differences were not observed for lifetime cumulative events, though CHR trended toward endorsing more events and greater stress severity. For stress severity across development, there were trending group differences for the 11-13 age range, and significant group differences for the 14-18 age range; notably, comparisons for earlier time points did not approach statistical significance. Associations between negative symptoms and cumulative severity of exposure were observed.
Results suggest exploring exposure to cumulative environmental risk factors/stressors and stress severity across developmental periods is generally informative and possibly specifically so for predictive models and diathesis-stress psychosis risk conceptualizations.
在整个发育过程中暴露于累积的环境风险因素与一系列不良健康/功能结果有关。在针对临床高危(CHR)个体发展精神障碍的研究中,缺乏纳入不同发育时期暴露信息的观点。
CHR个体(n = 35)和健康志愿者(n = 28)完成了结构化临床访谈以及我们小组新开发的精神病风险状态下个体与结构性应激暴露(ISESP)访谈。计算了终生累积得分,并报告了多个发育时期/年龄的应激严重程度。检验了组间差异,并检查了与当前症状领域的关联。
在终生累积事件方面未观察到显著的组间差异,尽管CHR个体倾向于认可更多事件和更高的应激严重程度。对于整个发育过程中的应激严重程度,在11 - 13岁年龄范围存在组间差异趋势,在14 - 18岁年龄范围存在显著组间差异;值得注意的是,早期时间点的比较未达到统计学显著性。观察到阴性症状与累积暴露严重程度之间的关联。
结果表明,探索整个发育时期累积环境风险因素/应激源的暴露情况以及应激严重程度通常是有益的,对于预测模型和素质 - 应激精神病风险概念化可能尤其如此。