Family history of schizophrenia and the relationship of stress to symptoms: preliminary findings

Objective: It has been hypothesized that patients with a diagnosis of schiz ophrenia who have a positive family history for schizophrenia will show gre ater reactivity of their symptoms to increasing levels of stress or negativ e affect than will patients without such a family history. In the past this hypothesis has only been tested through manipulations of negative affect i n laboratory settings. In this paper we test this hypothesis using longitud inal clinical data. Method: Data were derived from an earlier longitudinal study using monthly assessments of daily stressors (Hassles Scale) and symptom measures (the Sc ale for the Assessment of Positive Symptoms and the Scale for the Assessmen t of Negative Symptoms). We compared longitudinal stress to symptom relatio ns in 12 patients with schizophrenia for whom a positive family history of schizophrenia could be identified with 12 matched schizophrenic patients wi thout any known family history of psychiatric illness. Results: There was evidence that patients with a family history of schizoph renia demonstrated a stronger relation between stress and total score on th e Scale for the Assessment of Positive Symptoms. This difference appears to have primarily reflected a greater reactivity to stress of reality distort ion symptoms in the positive family history group. The two groups did not d iffer in apparent reactivity to stress of the disorganization and psychomot or poverty dimensions of symptomatology. Conclusions: The results of this study provide support from a naturalistic, longitudinal clinical study for the hypothesis that reactivity to stress o f some symptoms of schizophrenia may vary as a function of family history o f the disorder.