Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance
Open accessAbstract
Evidence from clinical patient populations indicates that affective dysregulation is strongly associated with reality distortion, suggesting that a process of misassignment of emotional salience may underlie this connection. To examine this in more detail without clinical confounds, affective regulation-reality distortion relationships, and their clinical relevance, were examined in a German prospective cohort community study. A cohort of 2524 adolescents and young adults aged 14-24 years at baseline was examined by experienced psychologists. Presence of psychotic experiences and (hypo)manic and depressive symptoms was assessed at 2 time points (3.5 and up to 10 years after baseline) using the Munich-Composite International Diagnostic Interview. Associations were tested between level of affective dysregulation on the one hand and incidence of psychotic experiences, persistence of these experiences, and psychotic Impairment on the other. Most psychotic experiences occurred in a context of affective dysregulation, and bidirectional dose-response was apparent with greater level of both affective dysregulation and psychotic experiences. Persistence of psychotic experiences was progressively more likely with greater level of (hypo)manic symptoms (odds ratio [OR] trend=1.51, P<.001) and depressive symptoms (OR trend=1.15, P=.012). Similarly, psychotic experiences of clinical relevance were progressively more likely to occur with greater level of affective dysregulation (depressive symptoms: OR trend=1.28, P=.002; (hypo)manic symptoms: OR trend=1.37, P=.036). Correlated genetic liabilities underlying affective and nonaffective psychotic syndromes may be expressed as correlated dimensions in the general population. Also, affective dysregulation may contribute causally to the persistence and clinical relevance of reality distortion, possibly by facilitating a mechanism of aberrant salience attribution.
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Psychometric properties of the Peters et al Delusions Inventory 21 in college students
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Affective lability across psychosis spectrum disorders
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To Treat or Not to Treat: Responding to Psychotic Experiences
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“The presence of paranoid symptoms impacts negatively on outcome even when expressed at subclinical level [7], and increases the risk for developing a full-blown psychotic disorder [8].”
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Abnormal GABAergic Function and Negative Affect in Schizophrenia
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Stress, Environment and Early Psychosis
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Beyond “Cold” Cognition: Exploring Cognitive Control of Emotion as a Risk Factor for Psychosis
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- Authors
- van Rossum, I., Dominguez, M.-D.-G., Lieb, R., Wittchen, H.-U., & van Os, J.
- Affiliations
- Maastricht University Medical Centre (NL)
- University of Basel (CH)
- ORCID
- Lieb, R.
- Venue
- Schizophrenia Bulletin
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-09-30
- Volume
- 37
- Issue
- 3
- Pages
- 561-571
- ISSN
- 0586-7614 (ISSN-L)
- 1745-1701
- PMC
- PMC3080695
- OpenAlex
- W2097810958
- Cited by
- 170
- References
- 49
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 5 · 2023: 8 · 2022: 7 · 2021: 5 · 2020: 6 · 2019: 10 · 2018: 9 · 2017: 10 · 2016: 15 · 2015: 11 · 2014: 13 · 2013: 20 · 2012: 17
- FWCI
- 8.04
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Schizophrenia Bulletin (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, other-oa)
- Max Planck Institute for Plasma Physics (submittedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Qucosa (Saxon State and University Library Dresden) (submittedVersion, other-oa)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- Eli Lilly and Company
- Pfizer
- AstraZeneca
- Deutsche Forschungsgemeinschaft (WI 709/8-1, WI 709/7-1, WI2246/1‐1, LA1148/1‐1)
- Servier
- H. Lundbeck A/S
- Cilag
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Social Sciences › Arts and Humanities › Philosophy › Mental Health and Psychiatry
- Keywords
- emotional dysregulation, reality distortion
- MeSH terms
- Adolescent, Affective Symptoms, Bipolar Disorder, Depression, Female, Follow-Up Studies, Germany, Humans, Male, Perceptual Distortion, Prospective Studies, Reality Testing, Risk Factors, Adolescent Development, Young Adult
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