Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany.
Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, Germany.
J Psychiatr Res. 2022 Sep;153:260-268. doi: 10.1016/j.jpsychires.2022.06.047. Epub 2022 Jul 1.
Affective disturbances in psychosis are well-documented but our understanding of their phenotypic nature in everyday life remains limited. Filling this gap could advance mechanistic models of the affective pathway to psychosis and pave the ground for new research avenues. Therefore, this study focused on temporal affect dynamics in psychosis, i.e., the patterns with which affect fluctuates over time. We applied experience-sampling with nine assessments per day over one week in participants with psychotic disorders (PSY), participants with attenuated psychotic symptoms (AS), clinical controls with obsessive compulsive disorders (OCD) and healthy controls (HC; total N = 139) to assess whether in PSY and AS, dynamics in affective valence and arousal are characterized by higher instability (i.e., extreme and frequent moment-to-moment fluctuations of affect intensities), higher affective variability (i.e., larger range of affect intensities), or lower inertia (i.e., higher frequency of affective changes), compared to the clinical and healthy control samples. Mixed-model ANOVAs revealed higher instability in both PSY and OCD compared to HC, but no significant differences for variability and inertia. AS had an intermediate position and did not differ significantly from any other group. We found evidence for small to medium effect sizes for the influence of mean affect levels on the dynamic indicators. Our findings indicate that individuals with psychotic disorders have increased affective instability and that this could be a transdiagnostic phenomenon. Zooming in on the variability and inertia components did not confer additional benefits. Emotion-focused interventions for psychosis should focus on reducing frequent and extreme affective fluctuations.
精神病性障碍中的情感障碍已有大量记载，但我们对其日常生活中的表型本质的理解仍有限。填补这一空白可以推进精神病性情感途径的机制模型，并为新的研究途径铺平道路。因此，本研究侧重于精神病性障碍患者（PSY）、有减弱精神病症状的患者（AS）、强迫症患者（OCD）和健康对照者（HC）的时间性情感动态，即情感随时间波动的模式。我们通过每日九次、为期一周的经验采样，评估了是否在 PSY 和 AS 中，情感效价和唤醒的动态表现出更高的不稳定性（即情感强度的极端和频繁的瞬间波动）、更高的情感变异性（即更大的情感强度范围）或更低的惯性（即更高的情感变化频率），与临床和健康对照组相比。混合模型方差分析显示，PSY 和 OCD 组的不稳定性均高于 HC 组，但在变异性和惯性方面没有显著差异。AS 处于中间位置，与任何其他组均无显著差异。我们发现，平均情感水平对动态指标的影响具有小到中等的效应量。我们的研究结果表明，精神病性障碍患者的情感不稳定性增加，这可能是一种跨诊断现象。关注变异性和惯性成分并没有带来额外的好处。以情绪为中心的精神病干预措施应侧重于减少频繁和极端的情感波动。
