Stress and Psychosis

Question 1

Familial high-risk approach

Answer 1

• There is a genetic risk for psychosis (SNPs, Twins and even just siblings/offspring) + environmental risks

BUT many people with schizo do not have a relative with the illness

Question 2

Schizotypal personality disorder

Answer 2

• Makes it more likely to develop psychosis
• Term ‘schizotypy’ used to describe features of relatives with inherited phenotype
• Studies include individuals who fulfil SPD criteria or who have high levels of schizotypy
• SPD included in DSM and ICD – attenuated traits and symptoms that characterise schizophrenia (e.g., magical thinking, odd thinking and speech) often individuals have no need for clinical care
• Traits/features can also be assessed via questionnaire (e.g., Chapman scales) to identify ‘high schizotypy’ groups
• Transition studies but NAPLS 36% transitioned in 2.5 yrs (Woods et al., 2009)

Question 3

What is the dominant approach?

Answer 3

It is a ‘close-in’ strategy that aims to identify individuals in
the prodromal phase of psychosis–> those who are CHR (Yung & McGorry, 1999)

Question 4

Who is in the CHR group?

Answer 4

Help-seeking individuals with either:
* Attenuated psychotic symptoms (APS)
* Brief limited, intermittent psychosis (BLIP)
* Family history or SPD + functional decline

Question 5

What are PLEs and who experiences them?

Answer 5

Members of general population experience alterations in perceptions and reality that occur at subclinical level known as PLEs (van Os et al, 2009)

• Qualitatively different to symptoms experienced by CHR, less distressing and/or intrusive, often transient and confer no need for care

PLEs are
Very low threshold of experiences
Very common in general population
Very different from traits of actual psychosis
Fueled by the idea that psychotic symptoms exist on a spectrium in society

Question 6

What are some psychosocial stressors?

Answer 6

1. Major life event
2. Daily hustles
3. Momentary stressor
4. CT
5. Migration

Question 7

What is a measurement error?

Answer 7

Random error (i.e., non-systematic) that occurs across all
groups/individuals equally, that does not bias the results of the study in one direction or another

Question 8

What is a measurement bias?

Answer 8

Occurs differentially (i.e., systematically) such that some
groups/individuals are affected more than others, which biases the results of the study to favour one direction

Can result in misleading findings

Question 9

What are some ways to measure stress?

Answer 9

1. Informant interview/report
2. Self-report
3. Official records
4. Assumed exposure