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Schizophr Bull. 2014 Mar;40(2):278-86. doi: 10.1093/schbul/sbs194. Epub 2013 Feb 13.

Time-lagged moment-to-moment interplay between negative affect and paranoia: new insights in the affective pathway to psychosis.

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  • 1*To whom correspondence should be addressed; GGzE, Institute of Mental Health Care Eindhoven and the Kempen, PO Box 909, 5600 AX Eindhoven, the Netherlands; tel: +31 (0)40 2970170, fax: +31 (0)40 2613830, e-mail: ima.kramer@ggze.nl.

Abstract

Evidence suggests that affect plays a role in the development of psychosis but the underlying mechanism requires further investigation. This study examines the moment-to-moment dynamics between negative affect (NA) and paranoia prospectively in daily life. A female general population sample (n = 515) participated in an experience sampling study. Time-lagged analyses between increases in momentary NA and subsequent momentary paranoia were examined. The impact of childhood adversity, stress sensitivity (impact of momentary stress on momentary NA), and depressive symptoms on these time-lagged associations, as well as associations with follow-up self-reported psychotic symptoms (Community Assessment of Psychic Experiences and the Symptom Checklist-90-Revised) were investigated. Moments of NA increase resulted in a significant increase in paranoia over 180 subsequent minutes. Both stress sensitivity and depressive symptoms impacted on the transfer of NA to paranoia. Stress sensitivity moderated the level of increase in paranoia during the initial NA increase, while depressive symptoms increased persistence of paranoid feelings from moment to moment. Momentary paranoia responses to NA increases were associated with follow-up psychotic symptoms. Examination of microlevel momentary experience may thus yield new insights into the mechanism underlying co-occurrence of altered mood states and psychosis. Knowledge of the underlying mechanism is required in order to determine source and place where remediation should occur.

KEYWORDS:

childhood adversity; depressive symptoms; momentary assessment methodology; psychotic symptoms; stress

PMID:
23407984
PMCID:
PMC3932075
DOI:
10.1093/schbul/sbs194
[PubMed - indexed for MEDLINE]
Free PMC Article
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