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Interpersonal sensitivity in the at-risk mental state for psychosis

Published online by Cambridge University Press:  09 January 2012

A. Masillo ,
F. Day ,
J. Laing ,
O. Howes ,
P. Fusar-Poli ,
M. Byrne ,
S. Bhattacharyya ,
P. Fiori Nastro ,
P. Girardi  and
P. K. McGuire
...Show all authors
A. Masillo
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK NESMOS Department (Neurosciences, Mental Health and Sensory Functions), ‘Sapienza’ University of Rome, 2nd Medical School, Sant'Andrea Hospital, Rome, Italy
F. Day
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
J. Laing
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK
O. Howes
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
P. Fusar-Poli
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
M. Byrne
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
S. Bhattacharyya
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
P. Fiori Nastro
Affiliation:
Department of Neurology and Psychiatry, ‘Sapienza’ University of Rome, 1st Medical School, Rome, Italy
P. Girardi
Affiliation:
NESMOS Department (Neurosciences, Mental Health and Sensory Functions), ‘Sapienza’ University of Rome, 2nd Medical School, Sant'Andrea Hospital, Rome, Italy Department of Neuropsychiatry, Villa Rosa, Suore Ospitaliere of the Sacred Heart of Jesus, Viterbo, Italy
P. K. McGuire
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK
L. R. Valmaggia*
Affiliation:
Department of Psychosis Studies, King's College London, King's Health Partners, Institute of Psychiatry, UK Outreach and Support in South London (OASIS), South London and Maudsley NHS Trust, UK Department of Psychiatry and Neuropsychology, Maastricht University, The Netherlands
*
*Address for correspondence: Dr L. R. Valmaggia, Department of Psychology and Psychosis Studies, King's College London, Institute of Psychiatry, 16 De Crespigny Park, PO box 67, London SE5 8AF, UK. (Email: lucia.valmaggia@kcl.ac.uk)
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Abstract

Background

Interpersonal sensitivity is a personality trait described as excessive awareness of both the behaviour and feelings of others. Although interpersonal sensitivity has been found to be one of the vulnerability factors to depression, there has been little interest in its relationship with the prodromal phase of psychosis. The aims of this study were to examine the level of interpersonal sensitivity in a sample of individuals with an at-risk mental state (ARMS) for psychosis and its relationship with other psychopathological features.

Method

Method. Sixty-two individuals with an ARMS for psychosis and 39 control participants completed a series of self-report questionnaires, including the Interpersonal Sensitivity Measure (IPSM), the Prodromal Questionnaire (PQ), the Ways of Coping Questionnaire (WCQ) and the Depression and Anxiety Stress Scale (DASS).

Results

Individuals with an ARMS reported higher interpersonal sensitivity compared to controls. Associations between interpersonal sensitivity, positive psychotic symptoms (i.e. paranoid ideation), avoidant coping and symptoms of depression, anxiety and stress were also found.

Conclusions

This study suggests that being ‘hypersensitive’ to interpersonal interactions is a psychological feature of the putatively prodromal phase of psychosis. The relationship between interpersonal sensitivity, attenuated positive psychotic symptoms, avoidant coping and negative emotional states may contribute to long-term deficits in social functioning. We illustrate the importance, when assessing a young client with a possible ARMS, of examining more subtle and subjective symptoms in addition to attenuated positive symptoms.

Keywords

At-risk mental statecopingdepressionearly detectioninterpersonal sensitivityprodromal psychotic symptoms
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 9 , September 2012 , pp. 1835 - 1845
Copyright
Copyright © Cambridge University Press 2012

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References

Addington, J, Epstein, I, Liu, L, French, P, Boydell, KM, Zipursky, RBA (2011). Randomized controlled trial of cognitive behavioral therapy for individuals at clinical high risk of psychosis. Schizophrenia Research 125, 54–61.CrossRefGoogle ScholarPubMed
An, SK, Kang, JI, Park, JY, Kim, KR, Lee, SY, Lee, E (2010). Attribution bias in ultra-high risk for psychosis and first-episode schizophrenia. Schizophrenia Research 118, 54–61.CrossRefGoogle ScholarPubMed
Bernstein, DP, Cohen, P, Velez, N, Schwab-Stone, M, Siever, L, Shinsato, L (1993). Prevalence and stability of the DSM-III-R personality disorders in a community-based sample of adolescents. American Journal of Psychiatry 150, 1237–1243.Google Scholar
Birchwood, M, Meaden, A, Trower, P, Gilbert, P, Plaistow, J (2000). The power and omnipotence of voices. Psychological Medicine 30, 337–344.CrossRefGoogle ScholarPubMed
Bleuler, E (1911). Dementia Praecox or the Group of Schizophrenias. Translated by J. Zinkin. International University Press: New York (1950).Google Scholar
Boyce, P, Mason, C (1996). An overview of depression-prone personality traits and the role of interpersonal sensitivity. Australian and New Zealand Journal of Psychiatry 30, 90–103.CrossRefGoogle ScholarPubMed
Boyce, P, Parker, G (1989). Development of a scale to measure interpersonal sensitivity. Australian and New Zealand Journal of Psychiatry 23, 341–351.CrossRefGoogle ScholarPubMed
Boyce, P, Parker, G, Barnett, B, Cooney, M, Smith, F (1991). Personality as a vulnerability factor to depression. British Journal of Psychiatry 159, 106–114.Google Scholar
Broome, MR, Woolley, JB, Johns, LC, Valmaggia, LR, Tabraham, P, Gafoor, R, Bramon, E, McGuire, PK (2005 b). Outreach and support in south London (OASIS): implementation of a clinical service for prodromal psychosis and the at risk mental state. European Psychiatry 20, 372–378.Google Scholar
Broome, MR, Woolley, JB, Tabraham, P, Johns, LC, Bramon, E, Murray, GK, Pariante, C, McGuire, PK, Murray, RM (2005 a). What causes the onset of psychosis? Schizophrenia Research 79, 23–34.CrossRefGoogle ScholarPubMed
Crawford, JR, Henry, JD (2003). The Depression Anxiety Stress Scales (DASS): normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology 42, 111–131.Google Scholar
Davidsen, KA (2009). Anomalous self-experience in adolescents at risk of psychosis. Psychopathology 42, 361–369.CrossRefGoogle ScholarPubMed
Davidson, J, Zisook, S, Giller, E, Helms, M (1989). Symptoms of interpersonal sensitivity in depression. Comprehensive Psychiatry 30, 357–368.CrossRefGoogle ScholarPubMed
Davidson, JR, Giller, EL, Zisook, S, Overall, JE (1988). An efficacy study of isocarboxazid and placebo in depression, and its relationship to depressive nosology. Archives of General Psychiatry 45, 120–127.CrossRefGoogle ScholarPubMed
Davidson, L, Strauss, JS (1992). Sense of self in recovery from severe mental illness. British Journal of Medical Psychology 65, 131–145.CrossRefGoogle ScholarPubMed
Davidson, M, Reichenberg, A, Rabinowitz, J, Weiser, M, Kaplan, Z, Mark, M (1999). Behavioral and intellectual markers for schizophrenia in apparently healthy male adolescents. American Journal of Psychiatry 156, 1328–1335.CrossRefGoogle ScholarPubMed
Demjaha, A, Valmaggia, L, Stahl, D, Byrne, M, McGuire, P (2010). Disorganization/cognitive and negative symptom dimensions in the at-risk mental state predict subsequent transition to psychosis. Schizophrenia Bulletin. Published online: 12 August 2010. doi:10.1093/schbul/sbq088.Google ScholarPubMed
Dittmann, J, Schuttler, R (1990). Disease consciousness and coping strategies of patients with schizophrenic psychosis. Acta Psychiatrica Scandinavica 82, 318–322.CrossRefGoogle ScholarPubMed
Falloon, IR, Talbot, RE (1981). Persistent auditory hallucinations: coping mechanism and implications for management. Psychological Medicine 11, 329–339.CrossRefGoogle ScholarPubMed
Folkman, S, Lazarus, RS (1985). If it changes it must be a process: study of emotion and coping during three stages of a college examination. Journal of Personality and Social Psychology 48, 150–170.CrossRefGoogle ScholarPubMed
Folkman, S, Lazarus, RS, Dunkel-Schetter, C, DeLongis, A, Gruen, RJ (1986 a). Dynamics of a stressful encounter: cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology 50, 992–1003.Google Scholar
Folkman, S, Lazarus, RS, Gruen, RJ, DeLongis, A (1986 b). Appraisal, coping, health status, and psychological symptoms. Journal of Personality and Social Psychology 50, 571–579.Google Scholar
Fornells-Ambrojo, M, Garety, PA (2009). Understanding attributional biases, emotions and self-esteem in ‘poor me’ paranoia: findings from an early psychosis sample. British Journal of Clinical Psychology 48, 141–162.CrossRefGoogle ScholarPubMed
Freeman, D, Dunn, G, Garety, PA, Bebbington, P, Slater, M, Kuipers, E, Fowler, D, Green, C, Jordan, J, Ray, K (2005). The psychology of persecutory ideation I: A questionnaire survey. Journal of Nervous and Mental Disease 193, 302–308.Google Scholar
Freeman, D, Gittins, M, Pugh, K, Antley, A, Slater, M, Dunn, G (2008). What makes one person paranoid and another person anxious? The differential prediction of social anxiety and persecutory ideation in an experimental situation. Psychological Medicine 38, 1121–1132.CrossRefGoogle Scholar
Fusar-Poli, P, Byrne, M, Valmaggia, L, Day, F, Tabraham, P, Johns, L, McGuire, P; OASIS Team (2010). Social dysfunction predicts two years clinical outcome in people at ultra high risk for psychosis. Journal of Psychiatric Research 44, 294–301.Google Scholar
Garety, PA, Kuipers, E, Fowler, D, Freeman, D, Bebbington, PE (2001). A cognitive model of the positive symptoms of psychosis. Psychological Medicine 31, 189–195.CrossRefGoogle ScholarPubMed
Green, CE, Freeman, D, Kuipers, E, Bebbington, P, Fowler, D, Dunn, G, Garety, P (2011). Paranoid explanations of experience: a novel experimental study. Behavioural and Cognitive Psychotherapy 39, 21–34.Google Scholar
Häfner, H, an der Heiden, W (1999). The course of schizophrenia in the light of modern follow-up studies: the ABC and WHO studies. European Archives of Psychiatry and Clinical Neuroscience 249, s14–s26.Google Scholar
Häfner, H, Maurer, K, Loffler, W (1995). Onset and early course of schizophrenia. In Search for the Causes of Schizophrenia (ed. Häfner), H. G. W., vol. 3, pp. 43–66. Springer-Verlag: Berlin.CrossRefGoogle Scholar
Häfner, H, Riecher-Rössler, A, Hambrecht, M, Maurer, K, Meissner, S, Schmidtke, A, Fätkenheuer, B, Löffler, W, van der Heiden, W (1992). IRAOS: an instrument for the assessment of onset and early course of schizophrenia. Schizophrenia Research 6, 209–223.Google Scholar
Hambrecht, M, Häfner, H, Loffler, W (1994). Beginning schizophrenia observed by significant others. Social Psychiatry and Psychiatric Epidemiology 29, 53–60.CrossRefGoogle ScholarPubMed
Larsen, TK, Bechdolf, A, Birchwood, M (2003). The concept of schizophrenia and phase-specific treatment: cognitive-behavioral treatment in pre-psychosis and in nonresponders. Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry 31, 209–228.Google Scholar
Lee, SY, Kim, KR, Park, JY, Park, JS, Kim, B, Kang, JI, Lee, E, An, SK, Kwon, JS (2011). Coping strategies and their relationship to psychopathologies in people at ultra high-risk for psychosis and with schizophrenia. Journal of Nervous and Mental Disease 199, 106–110.CrossRefGoogle ScholarPubMed
Lencz, T, Smith, CW, Auther, A, Correll, CU, Cornblatt, B (2004). Nonspecific and attenuated negative symptoms in patients at clinical high-risk for schizophrenia. Schizophrenia Research 68, 37–48.CrossRefGoogle ScholarPubMed
Lin, A, Wigman, JT, Nelson, B, Vollebergh, WA, van Os, J, Baksheev, G, Ryan, J, Raaijmakers, QA, Thompson, A, Yung, AR (2011). The relationship between coping and subclinical psychotic experiences in adolescents from the general population: a longitudinal study. Psychological Medicine. Published online: 28 April 2011. doi:10.1017/S0033291711000560.Google Scholar
Loewy, RL, Bearden, CE, Johnson, JK, Raine, A, Cannon, TD (2005). The prodromal questionnaire (PQ): preliminary validation of a self-report screening measure for prodromal and psychotic syndromes. Schizophrenia Research 79, 117–125.CrossRefGoogle ScholarPubMed
Lovibond, PF, Lovibond, SH (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy 33, 335–343.Google Scholar
Luty, SE, Joycea, PR, Muldera, RT, Sullivan, PF, McKenzie, JM (2002). The interpersonal sensitivity measure in depression: associations with temperament and character. Journal of Affective Disorders 70, 307–312.CrossRefGoogle ScholarPubMed
McCabe, RE, Blankstein, KR, Mills, JS (1999). Interpersonal sensitivity and social problem-solving: relations with academic and social self-esteem, depressive symptoms, and academic performance. Cognitive Therapy and Research 23, 587–604.Google Scholar
McGlashan, TH, Addington, J, Cannon, T, Heinimaa, M, McGorry, P, O'Brien, M, Penn, D, Perkins, D, Salokangas, RKR, Walsh, B, Woods, SW, Yung, A (2007). Recruitment and treatment practices for help-seeking ‘prodromal’ patients. Schizophrenia Bulletin 33, 715–726.Google Scholar
Miller, TJ, McGlashan, TH, Rosen, JL, Somjee, L, Markovich, PJ, Stein, K, Woods, SW (2002). Prospective diagnosis of the initial prodrome for schizophrenia based on the Structured Interview for Prodromal Syndromes: preliminary evidence of interrater reliability and predictive validity. American Journal of Psychiatry 159, 863–865.CrossRefGoogle ScholarPubMed
Miller, TJ, McGlashan, TH, Woods, SW, Stein, K, Driesen, N, Corcoran, CM, Hoffman, R, Davidson, L (1999). Symptom assessment in schizophrenic prodromal states. Psychiatric Quarterly 70, 273–287.CrossRefGoogle ScholarPubMed
Nelson, B, Fornito, A, Harrison, BJ, Yücel, M, Sass, LA, Yung, AR, Thompson, A, Wood, SJ, Pantelis, C, McGorry, PD (2009 a). A disturbed sense of self in the psychosis prodrome: linking phenomenology and neurobiology. Neuroscience and Biobehavioural Reviews 33, 807–817.CrossRefGoogle ScholarPubMed
Nelson, B, Sass, LA, Skodlar, B (2009 b). The phenomenological model of psychotic vulnerability and its possible implications for psychological interventions in the ultra-high risk (‘prodromal’) population. Psychopathology 42, 283–292.Google Scholar
Nelson, B, Sass, LA, Thompson, A, Yung, AR, Francey, SM, Amminger, GP, McGorry, PD (2009 c). Does disturbance of self underlie social cognition deficits in schizophrenia and other psychotic disorders? Early Intervention in Psychiatry 3, 83–93.CrossRefGoogle ScholarPubMed
Nelson, B, Yung, AR, Bechdolf, A, McGorry, PD (2008). The phenomenological critique and self-disturbance: implications for ultra-high risk (‘Prodrome’) research. Schizophrenia Bulletin 34, 381–392.Google Scholar
Otani, K, Suzuki, A, Ishii, G, Matsumoto, Y, Kamata, M (2008). Relationship of interpersonal sensitivity with dimensions of the Temperament and Character Inventory in healthy subjects. Comprehensive Psychiatry 49, 184–187.CrossRefGoogle ScholarPubMed
Parker, JDA, Endler, NS, Bagby, RM (1993). If it changes, it might be unstable: examining the factor structure of the Ways of Coping Questionnaire. Psychological Assessment 5, 361–368.CrossRefGoogle Scholar
Parnas, J (2005). Clinical detection of schizophrenia-prone individuals: critical appraisal. British Journal of Psychiatry 48, s111–s112.CrossRefGoogle ScholarPubMed
Parnas, J (2011). A disappearing heritage: the clinical core of schizophrenia. Schizophrenia Bulletin 37, 1121–1130.Google Scholar
Parnas, J, Handest, J (2003). Phenomenology of anomalous self-experience in early schizophrenia. Comprehensive Psychiatry 44, 121–134.CrossRefGoogle ScholarPubMed
Parnas, J, Møller, P, Kircher, T, Thalbitzer, J, Jansson, L, Handest, P, Zahavi, D (2005). EASE: Examination of Anomalous Self-Experience. Psychopathology 38, 236–258.Google Scholar
Phillips, LJ, Leicester, SB, O'Dwyer, LE, Francey, SM, Koutsogiannis, J, Abdel-Baki, A, Kelly, D, Jones, S, Vay, C, Yung, AR, McGorry, PD (2002). The PACE clinic: identification and management of young people at ‘ultra’ high risk of psychosis. Journal of Psychiatric Practice 8, 255–269.CrossRefGoogle ScholarPubMed
Raballo, A, Larøi, F (2011). Psychosis risk syndrome and DSM-5: time for a dimensional approach to at-risk mental states? Clinical Schizophrenia and Related Psychoses 5, 155–158.CrossRefGoogle ScholarPubMed
Sass, LA, Parnas, J (2003). Schizophrenia, consciousness, and the self. Schizophrenia Bulletin 29, 427–444.CrossRefGoogle ScholarPubMed
Sato, T, Narita, T, Hirano, S, Kusunoki, K, Sakado, K, Uehara, T (2001). Is interpersonal sensitivity specific to non-melancholic depressions? Journal of Affective Disorders 64, 133–144.CrossRefGoogle ScholarPubMed
Subotnik, KL, Nuechterlein, KH (1988). Prodromal signs and symptoms of schizophrenic relapse. Journal of Abnormal Psychology 97, 405–412.Google Scholar
Sullivan, HS (1994). The onset of schizophrenia. 1927. American Journal of Psychiatry 151, s135–s139.Google Scholar
Tait, L, Birchwood, M, Trower, P (2004). Adapting to the challenge of psychosis: personal resilience and the use of sealing-over (avoidant) coping strategies. British Journal of Psychiatry 185, 410–415.Google Scholar
Tandon, R, Keshavan, MS, Nasrallah, HA (2008). Schizophrenia, ‘Just the Facts’: what we know in 2008 Part 1: Overview. Schizophrenia Research 100, 4–19.CrossRefGoogle Scholar
Trower, P, Chadwick, PDJ (1995). Pathways to the defence of the self: a theory of two types of paranoia. Clinical Psychology: Science and Practice 2, 263–278.Google Scholar
Valmaggia, LR, Freeman, D, Green, C, Garety, P, Swapp, D, Antley, A, Prescott, C, Fowler, D, Kuipers, E, Bebbington, P, Slater, M, Broome, M, McGuire, P (2007). Virtual reality and paranoid ideations in people with an ‘at-risk mental state’ for psychosis. British Journal of Psychiatry 51, s63–s68.Google Scholar
Wigman, JTW, Lin, A, Vollebergh, WAM, van Os, J, Raaijmakers, QAW, Nelson, B, Baksheev, G, Yung, AR (2011). Subclinical psychosis and depression: co-occurring phenomena that do not predict each other over time. Schizophrenia Research 130, 277–281.CrossRefGoogle Scholar
Wilhelm, K, Boyce, P, Brownhill, S (2004). The relationship between interpersonal sensitivity, anxiety disorders and major depression. Journal of Affective Disorders 79, 33–41.CrossRefGoogle ScholarPubMed
Yung, AR, McGorry, PD (1996 a). The prodromal phase of first-episode psychosis: past and current conceptualizations. Schizophrenia Bulletin 22, 353–370.CrossRefGoogle ScholarPubMed
Yung, AR, McGorry, PD (1996 b). The initial prodrome in psychosis: descriptive and qualitative aspects. Australian and New Zealand Journal of Psychiatry 30, 587–599.Google Scholar
Yung, AR, Phillips, LJ, Yuen, HP, Francey, SM, McFarlane, CA, Hallgren, M, McGorry, PD (2003). Psychosis prediction: 12-month follow up of a high-risk (‘prodromal’) group. Schizophrenia Research 60, 21–32.CrossRefGoogle ScholarPubMed
Yung, AR, Yuen, HP, McGorry, PD, Phillips, LJ, Kelly, D, Dell'Olio, M, Francey, SM, Cosgrave, EM, Killackey, E, Stanford, C, Godfrey, K, Buckby, J (2005). Mapping the onset of psychosis: the Comprehensive Assessment of At-Risk Mental States. Australian and New Zealand Journal of Psychiatry 39, 964–971.Google Scholar