Ilen Laura, Feller Clémence, Eliez Stephan, Schneider Maude
Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
Psychol Med. 2023 Oct;53(14):6623-6634. doi: 10.1017/S0033291722004019. Epub 2023 Feb 2.
Increased reactivity to minor stressors is considered a risk factor for psychosis, especially in vulnerable individuals. In the present study, we investigated affective and psychotic stress reactivity as well as its link with psychotic symptoms and psychopathology in youths with 22q11.2 deletion syndrome (22q11DS), a neurogenetic condition associated with a high risk for psychosis.
A 6-day ecological momentary assessment protocol was used to assess perceived daily-life stress as well as affective and psychotic reactivity to stress in participants with 22q11DS ( = 38, age = 18.4) and healthy controls (HC; = 53, age = 19.1). Psychotic symptoms, general psychopathology, and coping strategies were also assessed through clinical interviews and questionnaires.
Participants with 22q11DS reported higher levels of perceived social stress ( = 0.21, = 0.036) but lower levels of activity-related stress ( = -0.31, = 0.003) in their daily lives compared to HC. The groups did not differ in affective or psychotic reactivity to stress, but individuals with 22q11DS who reported increased affective reactivity to social stressors showed more severe positive psychotic symptoms ( = 0.505, = 0.008). Finally, avoidance coping strategies moderated the association between stress and negative affects.
Our results suggest an increased vulnerability for daily social stress in youths with 22q11DS, and link elevated social stress reactivity to heightened psychotic symptom severity. Given the high risk for psychosis in 22q11DS, interventions should focus on reducing social stress and developing adaptive coping strategies.
对轻微应激源反应性增加被认为是精神病的一个危险因素，尤其是在易患个体中。在本研究中，我们调查了患有22q11.2缺失综合征（22q11DS）的青少年的情感和精神病性应激反应性，以及它与精神病性症状和精神病理学的联系，22q11DS是一种与精神病高风险相关的神经遗传疾病。
采用为期6天的生态瞬时评估方案，评估22q11DS患者（n = 38，年龄 = 18.4岁）和健康对照者（HC；n = 53，年龄 = 19.1岁）感知到的日常生活应激以及对应激的情感和精神病性反应性。还通过临床访谈和问卷评估了精神病性症状、一般精神病理学和应对策略。
与HC相比，22q11DS患者在日常生活中报告的感知到的社会应激水平更高（β = 0.21，p = 0.036），但与活动相关的应激水平更低（β = -0.31，p = 0.003）。两组在对应激的情感或精神病性反应性方面没有差异，但报告对社会应激源情感反应性增加的22q11DS个体表现出更严重的阳性精神病性症状（β = 0.505，p = 0.008）。最后，回避应对策略调节了应激与消极情绪之间的关联。
我们的结果表明，22q11DS青少年对日常社会应激的易感性增加，并将社会应激反应性升高与精神病性症状严重程度增加联系起来。鉴于22q11DS中精神病的高风险，干预应侧重于减少社会应激和制定适应性应对策略。
