Recent Stress Exposure’s influence on Executive and Psychosocial Functioning in Youth at High Risk of Psychosis or Depression
Jonah Loshin (1), Katerina Konstas (1), Zachary B. Millman (1,2)
1. Division of Psychotic Disorders, McLean Hospital
2. Department of Psychiatry, Harvard Medical School
Background The early and high-risk stages of psychosis and depression share clinical features and risk factors, suggesting that comparative studies of these populations may inform treatment. Psychosocial functioning is a key treatment target but the contributing factors are complex. External considerations such as stressful life events can impact on more internal ones such as executive functioning and shape functioning as well as clinical symptoms. Here we will study the interrelations between external measures of stress exposure, executive function, and clinical presentation in a sample of youth in the early and high-risk stages of psychosis or depression.
Methods A small ongoing pilot study is enrolling participants ages 14-30 with clinical psychosis-risk, depressive syndromes, or no psychopathology. Participants complete clinical interviews, a recent life stress questionnaire, and an executive functioning task. We will compare groups on the measures of interest and examine correlations between these measures across groups to determine similarities and differences in the relation between stress, executive function, and clinical presentation. We expect that greater recent life stress is associated with lower executive performance which in turn is associated with lower psychosocial functioning transdiagnostically.
Results Preliminary results from 22 individuals (mean age 21.3 +/- 3.12) suggest that psychosocial impairment appears greatest in psychosis-risk youth with a similar pattern suggested for stress exposure, but executive performance appears lowest in depression. Executive functioning shows a preliminary positive relation to psychosocial functioning in the combined sample. We will present these results with an updated dataset in addition to correlations between measures across clinical groups.
Conclusions Stress and executive functioning have previously been shown to be interrelated contributors to clinical concerns in young people. The study of these relations in a transdiagnostic risk/early-stage population will contribute important information to our understanding of clinical presentation at a critical developmental stage.