title: Bridging psychophysiological and phenomenological characteristics of psychosis--Preliminary evidence for the relevance of emotion regulation.
abstract: In psychosis, the alleged increased subjective stress-sensitivity is reflected in abnormal physiological arousal such as higher heart rate, elevated skin conductance levels, decreased vagal activity, and unusual cortisol levels. Despite ongoing research, possible mechanisms that explain the interplay between the phenomenological (i.e., subjective stress and symptoms) and psychophysiological processes are not thoroughly understood. Building on the model of neurovisceral integration by Thayer and Lane (2000) that focuses on regulative mechanisms, we postulate that emotion regulation will be associated with vagal activity, and with both subjective and physiological stress. In the present analysis, we used data from a baseline relaxation period including a 5-minute assessment of heart rate variability (HRV), salivary cortisol, and momentary subjective stress ratings from a sample of 19 participants with psychosis (mean age=40.9, SD=11.1; 36.8% female). Emotion regulation modification skills were assessed for specific emotions (i.e., stress and arousal, anxiety, anger, sadness, shame) if these were present during the previous week. Vagal HRV was significantly and moderately associated with emotion regulation. Both stress parameters (i.e., cortisol, subjective stress) were significantly associated with emotion regulation, but not with HRV. We provide preliminary support for the notion that emotion regulatory processes represent a crucial link between phenomenological and psychophysiological phenomena in psychosis. A potential model that ascribes emotion regulation a central role in the restoration of homeostasis is discussed. Future studies are needed to verify its generalizability and predictive value.
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany. Electronic address: annika.clamor@uni-hamburg.de.
authors.forename: Annika
authors.initials: A
authors.lastname: Clamor
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany.
authors.forename: Björn
authors.initials: B
authors.lastname: Schlier
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Köther
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany.
authors.forename: Maike M
authors.initials: MM
authors.lastname: Hartmann
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Germany.
authors.forename: Steffen
authors.initials: S
authors.lastname: Moritz
authors.affiliation: Department of Clinical Psychology and Psychotherapy, University of Hamburg, Germany.
authors.forename: Tania M
authors.initials: TM
authors.lastname: Lincoln
mesh_terms: D000328:Adult; D004644:Emotions / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011601:Psychophysics / Q000379:methods*; D011618:Psychotic Disorders / Q000175:diagnosis / Q000209:etiology*; D011863:Radioimmunoassay; D012559:Schizophrenia / Q000150:complications*; D013223:Statistics as Topic; D064232:Visual Analog Scale
chemical_list: D006854:Hydrocortisone
keywords: Cortisol; Heart rate variability; Schizophrenia; Stress