Abstract
Introduction: Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. This perspective incorporating information regarding exposure at differing developmental periods is lacking in research surrounding individuals at Clinical High Risk (CHR) for developing a psychotic disorder. Methods: CHR individuals (n = 35) and healthy volunteers (n = 28) completed structured clinical interviews as well as our group’s newly developed Individual and Structural Exposure to Stress in Psychosis-risk-states (ISESP) interview. Lifetime cumulative scores were calculated, and severity of stress was reported for multiple developmental periods/ages. Group differences were tested, and associations with current symptom domains were examined. Results: Significant group differences were not observed for lifetime cumulative events, though CHR trended toward endorsing more events and greater stress severity. For stress severity across development, there were trending group differences for the 11–13 age range, and significant group differences for the 14–18 age range; notably, comparisons for earlier time points did not approach statistical significance. Associations between negative symptoms and cumulative severity of exposure were observed. Discussion: Results suggest exploring exposure to cumulative environmental risk factors/stressors and stress severity across developmental periods is generally informative and possibly specifically so for predictive models and diathesis-stress psychosis risk conceptualizations.
Highlights
Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes
Exposure to environmental factors may increase risk for developing psychopathology in those with a pre-existing vulnerability, through exacerbating chronic stress exposure [1,2]. This is especially impactful when exposure occurs during critical neurodevelopmental periods [3,4]. Though this is well understood, scales assessing exposure to environmental stressors during development are scarce for Clinical High Risk for Psychosis (CHR) populations
The current study presents preliminary data for the ISESP
Summary
Exposure to cumulative environmental risk factors across development has been linked to a host of adverse health/functional outcomes. Given the marked putative association between environmental risk exposure and symptom progression in psychosis, it is critical to further understand its role prior to psychotic illness onset during the prodromal stage This period happens during adolescence and young adulthood and is marked by attenuated psychotic symptoms and accompanying functional impairment. More fully clarifying the influence of environmental risk exposure at this stage of illness progression could allow us to understand relations to etiology free of confounds intrinsic to chronic psychotic illness, such as medication use This neural diathesis approach conceptually dating back to Meehl’s theory of schizotypy is bound to aid in elucidating adverse life experiences that, together with subclinical/attenuated symptomatology, may precipitate a clinical psychotic state [32]. Adopting this approach could be useful in informing prevention and intervention models to prevent transition to a psychotic disorder in at-risk individuals [8]
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