The Cascade of Stress: A Network Approach to Explore Differential Dynamics in Populations Varying in Risk for Psychosis.
Stress plays a central role in the development and persistence of psychosis. Network analysis may help to reveal mechanisms at the level of the micro-dynamic effects between stress, other daily experiences and symptomatology. This is the first study to examine time-lagged networks of the relations between minor daily stress, momentary affect/thoughts, psychotic experiences, and other potentially relevant daily life contexts in individuals varying in risk for psychosis. Intensive longitudinal data were obtained through 6 studies. The combined sample consisted of 654 individuals varying in risk for psychosis: healthy control subjects (n = 244), first-degree relatives of psychotic patients (n = 165), and psychotic patients (n = 245). Using multilevel models combined with permutation testing, group-specific time-lagged network connections between daily experiences were compared between groups. Specifically, the role of stress was examined. Risk for psychosis was related to a higher number of significant network connections. In all populations, stress had a central position in the network and showed direct and significant connections with subsequent psychotic experiences. Furthermore, the higher the risk for psychosis, the more variables "loss of control" and "suspicious" were susceptible to influences by other network nodes. These findings support the idea that minor daily stress may play an important role in inducing a cascade of effects that may lead to psychotic experiences.
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.|Department of Neurosciences, Center for Contextual Psychiatry (CCP), KU Leuven, Leuven, Belgium.
Annelie
A
Klippel
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Wolfgang
W
Viechtbauer
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Ulrich
U
Reininghaus
University of Groningen, University Medical Center Groningen (UMCG), University Center Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands.
Johanna
J
Wigman
University of Groningen, University Medical Center Groningen (UMCG), University Center Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands.|Department of Psychology, Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands.
Claudia
C
van Borkulo
Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.|Department of Neurosciences, Center for Contextual Psychiatry (CCP), KU Leuven, Leuven, Belgium.
Inez
I
Myin-Germeys
University of Groningen, University Medical Center Groningen (UMCG), University Center Psychiatry (UCP), Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), Groningen, The Netherlands.
Marieke
M
Wichers
D000293:Adolescent; D000328:Adult; D000072860:Ecological Momentary Assessment / Q000706:statistics & numerical data*; D005190:Family; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011618:Psychotic Disorders / Q000453:epidemiology* / Q000209:etiology; D012306:Risk; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult