Stress-reactivity in psychosis: Evidence for an affective pathway to psychosis
Abstract
This paper will review a series of studies using the Experience Sampling Method that suggest that altered sensitivity to stress is an endophenotype for psychosis. The Experience Sampling Method is a structured diary technique allowing the assessment of emotional reactivity to stressors occurring in normal daily life. Elevated emotional reactivity to stress was found in subjects vulnerable to psychosis, suggesting that affective responses to stressors in the flow of daily life are an indicator of genetic and/or environmental liability to psychosis. Indeed, the small stressors in daily life associated with affective responses also predict more intense moment-to-moment variation of subtle positive psychotic experiences. Increased emotional reactivity was found to be independent from cognitive impairments, and argued to constitute evidence of an affective pathway to psychosis that may underlie a more episodic, reactive, good-outcome type of psychosis. Evidence for this hypothesis was found in data suggesting that the experience of stressful life events and early trauma were associated with increased stress-sensitivity, and that women were more likely to display elevated stress-reactivity. These findings are discussed in the light of recent biological and psychological mechanisms.
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Patients with psychosis perceive daily hassles as more stressful than healthy subjects.
“patients with psychosis seem also to perceive daily hassles as more stressful than healthy subjects”
From Abnormal cortisol levels during the day and cortisol awakening response in first-episode psychosis: The role of stress and of antipsychotic treatment (2010) · cites this paper as Myin-Germeys and van Os, 2007
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Experience sampling research in psychopathology: opening the black box of daily life
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Self-citationExperience sampling methodology in mental health research: new insights and technical developments.
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Affective traits in schizophrenia and schizotypy
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“Subsequent refinements of this model have emphasized cumulative and chronic stress exposure, neurobiological sensitization, and allostatic load as mechanisms through which stress can lower the threshold for psychotic symptom expression [17,18].”
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- Authors
- Myin-Germeys, I., & van Os, J.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2007-05
- Volume
- 27
- Issue
- 4
- Pages
- 409-424
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2089854473
- Cited by
- 719
- References
- 145
- Citations by year
- 2026: 26 · 2025: 53 · 2024: 44 · 2023: 52 · 2022: 39 · 2021: 40 · 2020: 38 · 2019: 26 · 2018: 37 · 2017: 50 · 2016: 45 · 2015: 38 · 2014: 43 · 2013: 37 · 2012: 35
- FWCI
- 3.53
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Lirias (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- stress reactivity, psychosis, endophenotypes, daily stress, life events, early trauma, sex differences, ecological momentary assessment
- MeSH terms
- Affect, Arousal, Female, Humans, Life Change Events, Male, Psychotic Disorders, Risk Factors, Sex Factors, Social Environment, Stress, Psychological, Genetic Predisposition to Disease
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