Emotional reactivity to daily life stress in psychosis

Background: The vulnerability-stress model of psychotic disorders describes , in essence, an interaction between personal vulnerability and environment al stressors. The present study investigated this interaction and studied e motional reactivity to daily life stress as a vulnerability marker for psyc hotic illness. Methods: Patients with psychotic illness (n=42), their first-degree relativ es (n=47), and control subjects (n=49) were studied with the Experience Sam pling Method (a structured diary technique assessing thoughts, current cont ext, and mood in daily life) to assess (1) appraised subjective stress of d aily events and smaller disturbances in daily life and (2) emotional reacti vity conceptualized as changes in both negative affect and positive affect. Results: Multilevel regression analyses showed that an increase in subjecti ve stress was associated with an increase in negative affect and a decrease in positive affect in all groups. However, the groups differed quantitativ ely in their pattern of reactions to stress. Patients with psychotic illnes s reacted with more intense emotions to subjective appraisals of stress in daily life than control subjects. The decrease in positive affect in the re latives was similar to that of the patients, while the increase in negative affect in this group was intermediary to that of patients and control subj ects. Conclusions: Higher levels of familial risk for psychosis were associated w ith higher levels of emotional reactivity to daily life stress in a dose-re sponse fashion. Subtle alterations in the way persons interact with their e nvironment may constitute part of the vulnerability for psychotic illness.