title: Modeling the Interplay Between Psychological Processes and Adverse, Stressful Contexts and Experiences in Pathways to Psychosis: An Experience Sampling Study.
abstract: Several integrated models of psychosis have implicated adverse, stressful contexts and experiences, and affective and cognitive processes in the onset of psychosis. In these models, the effects of stress are posited to contribute to the development of psychotic experiences via pathways through affective disturbance, cognitive biases, and anomalous experiences. However, attempts to systematically test comprehensive models of these pathways remain sparse. Using the Experience Sampling Method in 51 individuals with first-episode psychosis (FEP), 46 individuals with an at-risk mental state (ARMS) for psychosis, and 53 controls, we investigated how stress, enhanced threat anticipation, and experiences of aberrant salience combine to increase the intensity of psychotic experiences. We fitted multilevel moderated mediation models to investigate indirect effects across these groups. We found that the effects of stress on psychotic experiences were mediated via pathways through affective disturbance in all 3 groups. The effect of stress on psychotic experiences was mediated by threat anticipation in FEP individuals and controls but not in ARMS individuals. There was only weak evidence of mediation via aberrant salience. However, aberrant salience retained a substantial direct effect on psychotic experiences, independently of stress, in all 3 groups. Our findings provide novel insights on the role of affective disturbance and threat anticipation in pathways through which stress impacts on the formation of psychotic experiences across different stages of early psychosis in daily life.
authors.affiliation: Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Belgium.|Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: Annelie
authors.initials: A
authors.lastname: Klippel
authors.affiliation: Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Belgium.
authors.forename: Inez
authors.initials: I
authors.lastname: Myin-Germeys
authors.affiliation: Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
authors.forename: UnYoung
authors.initials: U
authors.lastname: Chavez-Baldini
authors.affiliation: Psychology & Human Development, Vanderbilt University, Nashville, TN, USA.
authors.forename: Kristopher J
authors.initials: KJ
authors.lastname: Preacher
authors.affiliation: Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
authors.forename: Matthew
authors.initials: M
authors.lastname: Kempton
authors.affiliation: Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.|National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
authors.forename: Lucia
authors.initials: L
authors.lastname: Valmaggia
authors.affiliation: Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Calem
authors.affiliation: Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China.
authors.forename: Suzanne
authors.initials: S
authors.lastname: So
authors.affiliation: Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Beards
authors.affiliation: Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Hubbard
authors.affiliation: Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Gayer-Anderson
authors.affiliation: Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
authors.forename: Adanna
authors.initials: A
authors.lastname: Onyejiaka
authors.affiliation: University of Groningen, University Medical Centre Groningen (UMCG), University Center Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, The Netherlands.
authors.forename: Marieke
authors.initials: M
authors.lastname: Wichers
authors.affiliation: Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.|National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: McGuire
authors.affiliation: Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.|National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
authors.forename: Robin
authors.initials: R
authors.lastname: Murray
authors.affiliation: Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.|National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
authors.forename: Philippa
authors.initials: P
authors.lastname: Garety
authors.affiliation: Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.|Psychosis Studies Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.
authors.forename: Jim
authors.initials: J
authors.lastname: van Os
authors.affiliation: Psychology Department, Institute of Psychiatry, Psychology & Neuroscience, King's College, London, UK.|National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
authors.forename: Til
authors.initials: T
authors.lastname: Wykes
authors.affiliation: National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre (BRC) at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.|Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Craig
authors.initials: C
authors.lastname: Morgan
authors.affiliation: Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.|Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
authors.forename: Ulrich
authors.initials: U
authors.lastname: Reininghaus
mesh_terms: D000293:Adolescent; D000328:Adult; D000072860:Ecological Momentary Assessment; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D011618:Psychotic Disorders / Q000209:etiology* / Q000503:physiopathology* / Q000523:psychology*; D012306:Risk; D013315:Stress, Psychological / Q000150:complications*; D055815:Young Adult
keywords: stress sensitivity; aberrant salience; threat anticipation; experience sampling method; first-episode psychosis; at-risk mental state