General psychopathology links burden of recent life events and psychotic symptoms in a network approach

Linda T. Betz; Nora Penzel; Lana Kambeitz-Ilankovic; Marlene Rosen; Katharine Chisholm; Alexandra Stainton; Theresa K. Haidl; Julian Wenzel; Alessandro Bertolino; Stefan Borgwardt; Paolo Brambilla; Rebekka Lencer; Eva Meisenzahl; Stephan Ruhrmann; Raimo K. R. Salokangas; Frauke Schultze-Lutter; Stephen J. Wood; Rachel Upthegrove; Nikolaos Koutsouleris; Joseph Kambeitz

doi:10.1038/s41537-020-00129-w

General psychopathology links burden of recent life events and psychotic symptoms in a network approach

Linda T. Betz^*, Nora Penzel, Lana Kambeitz-Ilankovic, Marlene Rosen, Katharine Chisholm, Alexandra Stainton, Theresa K. Haidl, Julian Wenzel, Alessandro Bertolino, Stefan Borgwardt, Paolo Brambilla, Rebekka Lencer, Eva Meisenzahl, Stephan Ruhrmann, Raimo K. R. Salokangas, Frauke Schultze-Lutter, Stephen J. Wood, Rachel Upthegrove, Nikolaos Koutsouleris, Joseph Kambeitz

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Recent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.

Original language	English
Article number	40
Journal	npj Schizophrenia
Volume	6
Issue number	1
DOIs	https://doi.org/10.1038/s41537-020-00129-w
Publication status	Published - 15 Dec 2020

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Final published version, 2.12 MBLicence: CC BY 3.0
General psychopathology links burden of recent life events
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Final published version, 1.26 MBLicence: CC BY 3.0

Cite this

Betz, L. T., Penzel, N., Kambeitz-Ilankovic, L., Rosen, M., Chisholm, K., Stainton, A., Haidl, T. K., Wenzel, J., Bertolino, A., Borgwardt, S., Brambilla, P., Lencer, R., Meisenzahl, E., Ruhrmann, S., Salokangas, R. K. R., Schultze-Lutter, F., Wood, S. J., Upthegrove, R., Koutsouleris, N., & Kambeitz, J. (2020). General psychopathology links burden of recent life events and psychotic symptoms in a network approach. npj Schizophrenia, 6(1), Article 40. https://doi.org/10.1038/s41537-020-00129-w

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abstract = "Recent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.",

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note = "This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article{\textquoteright}s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article{\textquoteright}s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.",

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Betz, LT, Penzel, N, Kambeitz-Ilankovic, L, Rosen, M, Chisholm, K, Stainton, A, Haidl, TK, Wenzel, J, Bertolino, A, Borgwardt, S, Brambilla, P, Lencer, R, Meisenzahl, E, Ruhrmann, S, Salokangas, RKR, Schultze-Lutter, F, Wood, SJ, Upthegrove, R, Koutsouleris, N & Kambeitz, J 2020, 'General psychopathology links burden of recent life events and psychotic symptoms in a network approach', npj Schizophrenia, vol. 6, no. 1, 40. https://doi.org/10.1038/s41537-020-00129-w

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AU - Betz, Linda T.

AU - Penzel, Nora

AU - Kambeitz-Ilankovic, Lana

AU - Rosen, Marlene

AU - Chisholm, Katharine

AU - Stainton, Alexandra

AU - Haidl, Theresa K.

AU - Wenzel, Julian

AU - Bertolino, Alessandro

AU - Borgwardt, Stefan

AU - Brambilla, Paolo

AU - Lencer, Rebekka

AU - Meisenzahl, Eva

AU - Ruhrmann, Stephan

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AU - Wood, Stephen J.

AU - Upthegrove, Rachel

AU - Koutsouleris, Nikolaos

AU - Kambeitz, Joseph

N1 - This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

PY - 2020/12/15

Y1 - 2020/12/15

N2 - Recent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.

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General psychopathology links burden of recent life events and psychotic symptoms in a network approach

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