Stress Reactivity & Protective Factors in Schizophrenia

应激反应

• 批准号: 6472898
• 负责人: JOSEPH VENTURA
• 金额: $ 6.24万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6472898
• 关键词: behavioral /social science research tag; clinical research; cognition; functional ability; human data; human middle age (35-64); language; longitudinal human study; mathematical model; pathologic process; perception; psychobiology; psychological adaptation; psychological stressor; psychological tests; psychometrics; schizophrenia; short term memory; sign /symptom; young adult human (21-34)

Stressful life events significantly increase the risk of psychotic relapse and depressive exacerbation in people with schizophrenia, but not all individuals respond to stress in the same way. There are differences in reactivity and in individual's typical or "ambient" level of reactivity may change during the course of illness. Nuechterlein, Dawson, Gitlin, and I have proposed a multifactorial model positing that neurocognitive and psychophysiological vulnerability factors and stressful life experience interact with and modify each other over time to produce the characteristic psychotic symptoms of schizophrenia. This study proposes to use a longitudinal, prospective data set of frequently assessed stressful life events, cognitive appraisals of stress, working memory performance and repeated assessment of psychotic symptoms to learn more about stress reactivity and protective factors in the early course of schizophrenia. To address critical issues of predictors of course and outcome, we plan to use innovative biostatistical strategies such as random effects modeling. Our aims are to identify whether there are reliable individual differences in reactivity to stress and to determine if cognitive appraisal of stress is a mediator and a moderator of stress and psychotic symptoms. We propose a model that explains how an interaction among exposure to negative stressful life events, and working memory deficits may influence cognitive appraisal of stress, and the subsequent severity of psychotic symptoms.

生活压力事件会显着增加精神分裂症患者精神病复发和抑郁恶化的风险，但并非所有个体对压力的反应方式都相同。反应性存在差异，并且个体的典型或“环境”反应性水平在疾病过程中可能会发生变化。 Nuechterlein、Dawson、Gitlin 和我提出了一个多因素模型，假设神经认知和心理生理脆弱性因素以及压力生活经历随着时间的推移相互作用并相互改变，从而产生精神分裂症的特征性精神病症状。本研究建议使用经常评估的压力生活事件、压力的认知评估、工作记忆表现和精神病症状的重复评估的纵向前瞻性数据集，以更多地了解精神分裂症早期病程中的压力反应性和保护因素。为了解决过程和结果预测因素的关键问题，我们计划使用创新的生物统计策略，例如随机效应模型。我们的目的是确定对压力的反应是否存在可靠的个体差异，并确定对压力的认知评估是否是压力和精神病症状的中介和调节因素。我们提出了一个模型，解释了暴露于负面压力生活事件和工作记忆缺陷之间的相互作用如何影响压力的认知评估以及随后的精神病症状的严重程度。