The French version of the IES-R has satisfactory internal validity and test-retest reliability. Further, the factor structure of the translation was similar to the proposed theoretical structure of the IES-R.
Psychotic symptoms are exacerbated by stressful life events in schizophrenia patients as a group. Some individuals appear to be more vulnerable than others in this regard. This study tested whether schizophrenia patients are highly emotionally reactive compared with controls and whether the level of trait emotional reactivity in patients influences the degree to which they respond to life stressors with exacerbations of psychosis. Schizophrenic outpatients and nonpsychiatric controls were assessed for levels of trait emotional reactivity, arousability, and trait anxiety. Severity of symptoms was also rated in the patients. Patients were then followed up 9 months later, assessed for independent stressful life events occurring during the month before the follow-up session, and reassessed for symptom levels. The patients scored higher than the control subjects on all 3 measures of reactivity at the initial assessment. At follow-up, the occurrence of potentially stressful life events predicted increases in psychotic symptoms in patients, and there was a significant interaction between level of initial trait reactivity and the occurrence of life events in the prediction of these increases. High-trait-reactive patients showed increases in psychotic symptoms in response to life stressors, whereas low-trait-reactive patients did not. These findings support the idea that patients as a group have higher than normal levels of trait reactivity and also that patients with very high levels of trait reactivity are at elevated risk of psychotic relapse under stress. Such patients might benefit particularly from interventions designed to assist them in coping with potentially stressful life events and circumstances.
Many studies have found that people experiencing persecutory delusions have a marked tendency to use external-personal attributions when establishing the causes of negative events. Although nonclinical populations also tend to attribute negative events to external causes, those causes are typically believed to be universal in nature, rather than personal. The central goal of the present study was to investigate whether individuals with remitted persecutory delusions would display this external-personal bias regarding negative events, in comparison to remitted patients whose delusions were not paranoid in nature and to nonpsychiatric controls. Results indicate that currently paranoid patients were significantly more likely than all other groups, including the remitted paranoid group, to use external-personal attributions in negative events. Interestingly, all patient groups also were found to be significantly more likely than the controls to use internal-personal and internal-universal attributions when explaining negative events.
Anhedonia is a negative prognostic indicator in schizophrenia. However, the underlying nature of this emotional deficit is unclear. Laboratory studies examining patients' emotional reactions under controlled circumstances have failed to find evidence for a diminished hedonic response, instead finding that patients' reactions to laboratory stimuli are characterised by high levels of negative emotion. The present study employed lexical analysis of natural speech in 52 patients and 49 nonpatient controls while they discussed separate neutral, pleasant and unpleasant autobiographical memories. Patients with clinically rated anhedonia, versus other patients and controls, showed a dramatic increase in negative emotion expression when discussing pleasurable memories, but they showed no corresponding decrease in positive emotion. These findings provide further evidence that ''anhedonia'' is more reflective of negative emotional states than the absence of positive ones. These findings also raise questions about how positive and negative emotions can be simultaneously co-activated in patients with schizophrenia.
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