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Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance.
Schizophr Bull 2011; 37(3):561-71SB

Abstract

Evidence from clinical patient populations indicates that affective dysregulation is strongly associated with reality distortion, suggesting that a process of misassignment of emotional salience may underlie this connection. To examine this in more detail without clinical confounds, affective regulation-reality distortion relationships, and their clinical relevance, were examined in a German prospective cohort community study. A cohort of 2524 adolescents and young adults aged 14-24 years at baseline was examined by experienced psychologists. Presence of psychotic experiences and (hypo)manic and depressive symptoms was assessed at 2 time points (3.5 and up to 10 years after baseline) using the Munich-Composite International Diagnostic Interview. Associations were tested between level of affective dysregulation on the one hand and incidence of psychotic experiences, persistence of these experiences, and psychotic Impairment on the other. Most psychotic experiences occurred in a context of affective dysregulation, and bidirectional dose-response was apparent with greater level of both affective dysregulation and psychotic experiences. Persistence of psychotic experiences was progressively more likely with greater level of (hypo)manic symptoms (odds ratio [OR] trend=1.51, P<.001) and depressive symptoms (OR trend=1.15, P=.012). Similarly, psychotic experiences of clinical relevance were progressively more likely to occur with greater level of affective dysregulation (depressive symptoms: OR trend=1.28, P=.002; (hypo)manic symptoms: OR trend=1.37, P=.036). Correlated genetic liabilities underlying affective and nonaffective psychotic syndromes may be expressed as correlated dimensions in the general population. Also, affective dysregulation may contribute causally to the persistence and clinical relevance of reality distortion, possibly by facilitating a mechanism of aberrant salience attribution.

Authors+Show Affiliations

Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, European Graduate School of Neuroscience, Maastricht University Medical Centre, PO Box 616 (DRT 10), 6200 MD Maastricht, The Netherlands.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19793794

Citation

van Rossum, Inge, et al. "Affective Dysregulation and Reality Distortion: a 10-year Prospective Study of Their Association and Clinical Relevance." Schizophrenia Bulletin, vol. 37, no. 3, 2011, pp. 561-71.
van Rossum I, Dominguez MD, Lieb R, et al. Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. Schizophr Bull. 2011;37(3):561-71.
van Rossum, I., Dominguez, M. D., Lieb, R., Wittchen, H. U., & van Os, J. (2011). Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. Schizophrenia Bulletin, 37(3), pp. 561-71. doi:10.1093/schbul/sbp101.
van Rossum I, et al. Affective Dysregulation and Reality Distortion: a 10-year Prospective Study of Their Association and Clinical Relevance. Schizophr Bull. 2011;37(3):561-71. PubMed PMID: 19793794.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Affective dysregulation and reality distortion: a 10-year prospective study of their association and clinical relevance. AU - van Rossum,Inge, AU - Dominguez,Maria-de-Gracia, AU - Lieb,Roselind, AU - Wittchen,Hans-Ulrich, AU - van Os,Jim, Y1 - 2009/09/30/ PY - 2009/10/2/entrez PY - 2009/10/2/pubmed PY - 2011/9/10/medline SP - 561 EP - 71 JF - Schizophrenia bulletin JO - Schizophr Bull VL - 37 IS - 3 N2 - Evidence from clinical patient populations indicates that affective dysregulation is strongly associated with reality distortion, suggesting that a process of misassignment of emotional salience may underlie this connection. To examine this in more detail without clinical confounds, affective regulation-reality distortion relationships, and their clinical relevance, were examined in a German prospective cohort community study. A cohort of 2524 adolescents and young adults aged 14-24 years at baseline was examined by experienced psychologists. Presence of psychotic experiences and (hypo)manic and depressive symptoms was assessed at 2 time points (3.5 and up to 10 years after baseline) using the Munich-Composite International Diagnostic Interview. Associations were tested between level of affective dysregulation on the one hand and incidence of psychotic experiences, persistence of these experiences, and psychotic Impairment on the other. Most psychotic experiences occurred in a context of affective dysregulation, and bidirectional dose-response was apparent with greater level of both affective dysregulation and psychotic experiences. Persistence of psychotic experiences was progressively more likely with greater level of (hypo)manic symptoms (odds ratio [OR] trend=1.51, P<.001) and depressive symptoms (OR trend=1.15, P=.012). Similarly, psychotic experiences of clinical relevance were progressively more likely to occur with greater level of affective dysregulation (depressive symptoms: OR trend=1.28, P=.002; (hypo)manic symptoms: OR trend=1.37, P=.036). Correlated genetic liabilities underlying affective and nonaffective psychotic syndromes may be expressed as correlated dimensions in the general population. Also, affective dysregulation may contribute causally to the persistence and clinical relevance of reality distortion, possibly by facilitating a mechanism of aberrant salience attribution. SN - 1745-1701 UR - https://www.unboundmedicine.com/medline/citation/19793794/Affective_dysregulation_and_reality_distortion:_a_10_year_prospective_study_of_their_association_and_clinical_relevance_ L2 - https://academic.oup.com/schizophreniabulletin/article-lookup/doi/10.1093/schbul/sbp101 DB - PRIME DP - Unbound Medicine ER -