Psychosis is a condition that alters the perception of reality, causing hallucinations (seeing or hearing things that don't exist) or delusions (mistaken beliefs).
Before the onset of psychosis, some people show warning signs. These people are more vulnerable to triggers such as psychosocial stress and interpersonal hypersensitivity.
Psychosocial stress includes the pressures of difficult life events (trauma, conflict) and stressful social interactions (discrimination, criticism).
Vulnerable people often suffer from past and recent traumas. Those who have experienced abuse or negative experiences in childhood are more sensitive to stress and are at greater risk of developing psychosis.
Repeated minor hassles, such as misunderstandings or failures, have a cumulative impact that amplifies symptoms.
Researchers observe that the more intense and frequent the stress, the more psychotic symptoms (hallucinations, delusions) worsen.
According to the stress-vulnerability model, chronic stress overloads the body and activates an underlying biological vulnerability.
The stress-vulnerability model emphasizes that a favorable outcome to a psychiatric disorder is more likely when several factors are taken into account:
- Reduction or effective management of environmental stress,
- Rigorous adherence to prescribed medication and avoidance of substances such as alcohol and drugs.
Interpersonal hypersensitivity corresponds to excessive sensitivity to judgment or social interaction. Hypersensitive people easily feel rejected or criticized, even in innocuous situations.
They tend to brood over their interactions, constantly worrying about what others think. They avoid social relationships to avoid the stress they cause, which compounds their isolation.
This hypersensitivity generates a vicious circle:
- It increases the stress felt in relationships,
- And this stress aggravates psychotic symptoms in vulnerable people.
Psychosocial stress and interpersonal hypersensitivity are closely linked and play a central role in the risk of psychosis. Stress amplifies the severity of psychotic symptoms.
Hypersensitivity makes relationships stressful, promoting social withdrawal and reducing the likelihood of receiving help.
To prevent psychosis, it is essential to reduce psychosocial stress, through therapies that teach how to better manage emotions and daily challenges, and to reinforce social skills, to reduce hypersensitivity and enable the creation of soothing relationships.
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Sources:
Georgiades, A., Almuqrin, A., Rubinic, P. et al.
Psychosocial stress, interpersonal sensitivity, and social withdrawal in clinical high risk for psychosis: a systematic review.
Schizophr 9, 38 (2023). https://doi.org/10.1038/s41537-023-00362-z