Sensitivity to stress may help to determine whether traumatic life events will lead to psychosis, research suggests.
The relationship was particularly strong in women, report Lauren Ellman (Temple University, Philadelphia, Pennsylvania, USA) and colleagues.
“Our findings support emerging research of differential trajectories in the etiology of psychosis for males and females”, they write in the Journal of Psychiatric Research. However, they note that the 671 undergraduate students in their study were predominantly (71%) female, which may have affected their ability to detect an association in men.
The study participants completed the positive scale (45 items) of the 92-item Prodromal Questionnaire, endorsing an average of 8.8 distressing attenuated positive symptoms; 13.0% endorsed eight or more symptoms and were therefore considered at high risk of psychosis.
Stress sensitivity, measured on the Perceived Stress Scale (PSS), was higher in women than men and significantly correlated with the number of attenuated psychotic symptoms reported. It was also increased in participants who reported traumatic life events on the Life Events Checklist (LEC).
Traumatic life events were significantly associated with psychotic symptoms in women, with any events increasing the likelihood of women reporting at least eight symptoms 2.35-fold and four or more events increasing it 6.05-fold.
However, the inclusion of stress sensitivity in the model reduced the size of these associations, and statistical testing for mediation was significant, indicating that increased sensitivity to stress raised the likelihood that traumatic life events would result in women developing subclinical psychosis.
In men, by contrast, traumatic life events were not significantly associated with psychotic symptoms,
The researchers note that traumatic life events reportedly “affect the trajectory of psychosis, indicating a more persistent and increasingly severe clinical course, thus underscoring the importance of understanding the contributors to this relationship.”
They therefore suggest that treatment to reduce stress sensitivity could be a useful preventative measure in people at risk of psychosis or already experiencing attenuated symptoms. “Although therapeutic efforts cannot completely control the number of stressors a person experiences, improvement of coping skills, social supports and post-traumatic sequelae may offer promising treatment avenues.”
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