Background: Hair cortisol concentrations (HCC) provide a retrospective examination of long-term cortisol production as a measure of the hypothalamic-pituitary-adrenal (HPA) axis functioning, one of the major neural systems implicated in mediating the effects of stress on mental illness. However, evidence about the relationship between HCC with stressors and symptoms is scattered. In the present study, we aimed to examine the association between HCC and a wide range of stress-related and transdiagnostic subclinical measures in a sample of non-clinical young adults with a wide distribution of schizotypy.Methods: A total sample of 132 non-clinical young adults recruited at college and technical schools oversampled for schizotypy scores were assessed on distal and proximal stressful experiences, appraisals of stress, traits and symptoms of the affective, psychosis and dissociation spectrums, as well as stress-buffering measures, and provided 3 cm-hair samples.Results: No significant associations were found between HCC and any of the stress-related and subclinical measures. Only suspiciousness and disorganization showed a trend for a positive association with HCC but the magnitude was small.Conclusions: The present findings support previous studies indicating an overall lack of concordance between a broad range of stress-related and (sub)clinical phenotypic measures with hair cortisol. This study examined for the first time the relationship of HCC with the non-clinical expression of the psychosis spectrum, that is, schizotypy, which complements previous studies on clinical high risk and established psychosis and offers a promising strategy for studying possible HPA dysfunctions characterizing the subclinical psychosis continuum without the confounds associated to clinical psychosis.
Background The traumagenic neurodevelopment model of psychosis poses that prolonged or severe stress exposure in critical developmental periods (i.e., childhood) disrupts psychobiological stress regulation mechanisms, increasing liability for the onset and persistence of psychotic symptoms after re-exposure to stressful events (Read et al., 2014). This disruption seems to result in a process of behavioral and biological sensitization by which the individual manifests an enhanced stress sensitivity to subsequent minor adversities in adulthood (Belda et al., 2015), which may cause an increased risk for psychosis. The behavioral manifestation of stress sensitization has been examined in samples at clinical risk for psychosis, but it has been scarcely studied in nonclinical populations. The first goal of the present study was to investigate whether the association between childhood trauma (CT) and perceived stress was moderated by the impact of recent life events in a nonclinical sample. The second goal was to test whether the association between CT and suspiciousness was mediated by perceived stress, and whether this mediation was moderated by the impact of life events. Following stress sensitization hypotheses, it was expected that the association between CT and suspiciousness would be mediated by higher levels of perceived stress. In turn, the impact of negative recent life events was expected to moderate the effect of CT on suspiciousness via increased levels of perceived stress. Methods The sample consisted of 168 Spanish nonclinical youngsters (mean age=28.01), belonging to the ongoing Barcelona Longitudinal Investigation of Schizotypy Study (BLISS). From a large pool of unselected college students, a selected subsample oversampled for schizotypy scores continues regular follow-up assessments. They were assessed for life events, perceived stress and suspiciousness at the concurrent assessment, whereas CT was assessed 7 years earlier at baseline. Linear regression and simple slope analyses were performed to test whether recent life events moderated the association between CT and suspiciousness. Moderated mediation analyses were conducted to examine the indirect effect of CT on suspiciousness via perceived stress moderated by the impact of recent life events. Results Recent life events significantly moderated the association between CT and perceived stress. Simple slope analyses indicated that this association was significant when subjects experienced negative or neutral life events, but not positive life events. Moderated mediation analyses revealed an indirect effect of CT on suspiciousness through perceived stress, which was moderated by the impact of recent life events. Thus, these mediational effects were significant for those subjects with a greater subjective appraisal of a negative or neutral impact of life events, but not for those experiencing a positive impact. The magnitude of the conditional indirect effect (as indicated by the Index of Moderated Mediation) was significantly different across levels of impact of recent life events (i.e., negative, neutral, positive). Discussion These findings provide further supporting evidence to the stress sensitization hypothesis for psychosis by showing its manifestation across both the clinical and nonclinical ranges of the hypothesized psychosis continuum. CT and perceived stress were associated when the impact of recent life events was negative or neutral, but not positive, suggesting that positive life events may play a protective role in the perception of stress and the role that stress shows in the mechanistic pathway to suspiciousness.
Background and hypothesis Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. Study design At baseline, 344 CHR participants and 67 healthy controls were presented with a computerized white noise task and asked whether they heard speech, and whether speech was neutral, affective, or whether they were uncertain about its valence. After 2 years, we assessed whether participants transitioned to psychosis, or remitted from the CHR state, and their functioning. Study results CHR participants had a lower sensitivity to the task. Logistic regression revealed that a bias towards hearing targets in stimuli was associated with remission status (OR = 0.21, P = 042). Conversely, hearing SIs with uncertain valence at baseline was associated with reduced likelihood of remission (OR = 7.72. P = .007). When we assessed only participants who did not take antipsychotic medication at baseline, the association between hearing SIs with uncertain valence at baseline and remission likelihood remained (OR = 7.61, P = .043) and this variable was additionally associated with a greater likelihood of transition to psychosis (OR = 5.34, P = .029). Conclusions In CHR individuals, a tendency to hear speech in noise, and uncertainty about the affective valence of this speech, is associated with adverse outcomes. This task could be used in a battery of cognitive markers to stratify CHR participants according to subsequent outcomes.
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