Kogler Lydia, Regenbogen Christina, Müller Veronika I, Kohn Nils, Schneider Frank, Gur Ruben C, Derntl Birgit
Department of Psychiatry and Psychotherapy, Tübingen Centre for Mental Health (TüCMH), Medical Faculty, University of Tübingen, Calwerstrasse 14, 72076 Tübingen, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany.
J Clin Med. 2023 Apr 6;12(7):2749. doi: 10.3390/jcm12072749.
Stress is an important factor in the development, triggering, and maintenance of psychotic symptoms. Still, little is known about the neural correlates of cognitively regulating stressful events in schizophrenia. The current study aimed at investigating the cognitive down-regulation of negative, stressful reactions during a neuroimaging psychosocial stress paradigm (non-regulated stress versus cognitively regulated stress). In a randomized, repeated-measures within-subject design, we assessed subjective reactions and neural activation in schizophrenia patients (SZP) and matched healthy controls in a neuroimaging psychosocial stress paradigm. In general, SZP exhibited an increased anticipation of stress compared to controls ( = 0.020). During non-regulated stress, SZP showed increased negative affect ( = 0.033) and stronger activation of the left parietal operculum/posterior insula ( < 0.001) and right inferior frontal gyrus/anterior insula ( = 0.005) than controls. Contrarily, stress regulation compared to non-regulated stress led to increased subjective reactions in controls ( = 0.003) but less deactivation in SZP in the ventral anterior cingulate cortex ( = 0.027). Our data demonstrate stronger reactions to and anticipation of stress in patients and difficulties with cognitive stress regulation in both groups. Considering the strong association between mental health and stress, the investigation of cognitive regulation in individuals vulnerable to stress, including SZP, has crucial implications for improving stress intervention trainings.
压力是精神病症状发展、触发和维持的一个重要因素。然而，对于精神分裂症患者认知调节应激事件的神经相关性，我们知之甚少。当前的研究旨在调查在神经影像学社会心理应激范式（非调节应激与认知调节应激）中对负面应激反应的认知下调情况。在一项随机、重复测量的受试者内设计中，我们在神经影像学社会心理应激范式中评估了精神分裂症患者（SZP）和匹配的健康对照者的主观反应和神经激活情况。总体而言，与对照组相比，SZP表现出对应激的预期增加（P = 0.020）。在非调节应激期间，与对照组相比，SZP表现出更大的负面影响（P = 0.033），以及左侧岛盖部/后岛叶（P < 0.001）和右侧额下回/前岛叶（P = 0.005）更强的激活。相反，与非调节应激相比，应激调节导致对照组的主观反应增加（P = 0.003），但SZP腹侧前扣带回皮质的失活减少（P = 0.027）。我们的数据表明患者对应激的反应和预期更强，且两组在认知应激调节方面都存在困难。鉴于心理健康与压力之间的紧密联系，对包括SZP在内的易受压力影响个体的认知调节进行研究，对于改进压力干预训练具有至关重要的意义。
