Anxiety interacts with expressed emotion criticism in the prediction of psychotic symptom exacerbation.
Psychotic symptoms are exacerbated by social stressors in schizophrenia and schizoaffective disorder patients as a group. More specifically, critical attitudes toward patients on the part of family members and others have been associated with a higher risk of relapse in the patients. Some patients appear to be especially vulnerable in this regard. One variable that could affect the degree of sensitivity to a social stressor such as criticism is the individual's level of anxiety. The present longitudinal study assessed 27 relatively stable outpatients with schizophrenia or schizoaffective disorder and the single "most influential other" (MIO) person for each patient. As hypothesized, (1) patients with high critical MIOs showed increases in psychotic symptoms over time, compared with patients with low critical MIOs; (2) patients high in anxiety at the baseline assessment showed increases in psychotic symptoms at follow-up, compared with patients low in anxiety, and (3) patients with high levels of anxiety at baseline and high critical MIOs showed the greatest exacerbation of psychotic symptoms over time. Objectively measured levels of criticism were more predictive than patient-rated levels of criticism.
Docherty
Nancy M
NM
Department of Psychology, Kent State University, Kent, OH 44242, USA. ndochert@kent.edu
St-Hilaire
Annie
A
Aakre
Jennifer M
JM
Seghers
James P
JP
McCleery
Amanda
A
Divilbiss
Marielle
M
D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000453:epidemiology; D019260:Expressed Emotion; D030141:Feedback, Psychological; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000453:epidemiology / Q000523:psychology*; D012307:Risk Factors; D012559:Schizophrenia / Q000453:epidemiology; D012565:Schizophrenic Psychology; D055502:Secondary Prevention; D013315:Stress, Psychological / Q000150:complications*