Format

Send to

Choose Destination
Schizophr Res. 2014 Dec;160(1-3):104-9. doi: 10.1016/j.schres.2014.09.017. Epub 2014 Nov 7.

Stress exposure and sensitivity in the clinical high-risk syndrome: initial findings from the North American Prodrome Longitudinal Study (NAPLS).

Author information

1
Department of Psychology, Emory University, Atlanta, GA 30322, USA. Electronic address: htrotma@emory.edu.
2
Department of Psychology, Emory University, Atlanta, GA 30322, USA.
3
Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
4
Semel Institute for Neuroscience and Human Behavior and Department of Psychology, University of California, Los Angeles, CA, USA.
5
Department of Psychiatry, University of California, San Diego, CA, USA.
6
Department of Psychology, Yale University, New Haven, CT, USA.
7
Department of Psychiatry, Zucker Hillside Hospital, New York, NY, USA.
8
National Institute of Mental Health, Bethesda, MD, USA.
9
Department of Psychiatry, University of California, San Francisco, CA, USA.
10
Department of Psychiatry, University of California, Irvine, CA, USA.
11
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA.
12
Department of Psychology, Harvard University, Boston, MA, USA.
13
Department of Psychiatry, Yale University, New Haven, CT, USA.

Abstract

There is inconsistent evidence for increased stress exposure among individuals at clinical high risk (CHR) for psychosis. Yet similar to patients with a diagnosed psychotic illness, the preponderance of evidence suggests that CHR individuals tend to experience stressful life events (LE) and daily hassles (DH) as more subjectively stressful than healthy individuals. The present study utilizes data from the North American Prodrome Longitudinal Study Phase 2 (NAPLS-2) to test the hypotheses that (1) CHR individuals manifest higher self-reported stress in response to both LE and DH when compared to healthy controls (HC), (2) group differences in self-reported stress increase with age, (3) baseline self-reported stress is associated with follow-up clinical status, and (4) there is a sensitization effect of LE on the response to DH. In contrast to some previous research, the present findings indicate that the CHR group (N=314) reported exposure to more LE when compared to the HC group (N=162). As predicted, CHR participants rated events as more stressful, and those who progressed to psychosis reported a greater frequency of LE and greater stress from events compared to those whose prodromal symptoms remitted. There was also some evidence of stress-sensitization; those who experienced more stress from LE rated current DH as more stressful. The results indicate that the "prodromal" phase is a period of heightened stress and stress sensitivity, and elevated cumulative lifetime exposure to stressful events may increase reactions to current stressors.

KEYWORDS:

Clinical high risk; Daily Stress Inventory; Daily hassles; PERI Life Events Scale; Prodrome; Stress

PMID:
25443665
PMCID:
PMC4593703
DOI:
10.1016/j.schres.2014.09.017
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center