Associations between physiological responses to social-evaluative stress and daily functioning in first-episode schizophrenia

Alexandra C. Reed, Junghee Lee, Michael F. Green, Holly K. Hamilton, Gregory A. Miller, Kenneth L. Subotnik, Joseph Ventura, Keith H. Nuechterlein, Cindy M. Yee

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Schizophrenia (SZ) is associated with impaired adaptive functioning, including difficulties managing the demands of independent living, work, school, and interpersonal relationships. Prior studies have linked the physiological stress response with less effective coping in daily life. Differences in stress-response tendencies may also support heterogeneity in daily functioning in SZ. The present study examined two established measures of the stress response in patients with first-episode SZ. Salivary cortisol was included as an index of hypothalamic–pituitary–adrenal response. Vagal suppression (VS), a measure of stress-related reduction in heart rate variability, was used to assess parasympathetic flexibility. Greater cortisol response and VS to social-evaluative stress were predicted to be associated with better functioning in SZ over and above relationships with social cognition and neurocognition, two well-established predictors of functional outcome. Thirty-eight first-episode SZ outpatients and 29 healthy comparison subjects (HC) provided social cognitive, neurocognitive, and physiological measurements before and after the Trier Social Stress Test (TSST). Although SZ and HC did not differ on VS to the TSST, patients exhibited significant associations between VS and functioning across all four domains of the Role Functioning Scale. Furthermore, greater VS predicted more effective functioning with friends, beyond the contributions associated with social cognition and neurocognition, and strengthened the positive effects of higher levels of social cognition on independent living/self-care. VS elicited by social-evaluative stress in the laboratory may reflect stress-response tendencies in daily life that are relevant for daily functioning in first-episode SZ.

Original languageEnglish
Pages (from-to)233-239
Number of pages7
JournalSchizophrenia Research
Volume218
DOIs
StatePublished - Apr 2020
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2020 Elsevier B.V.

Funding

Funding was provided by NIMH ( P50 MH066286 , T32 MH096682 , R01 MH37705 , R01 MH110544 ) and the NSF Graduate Research Fellowship Program. ACR, JL, HKH, MFG, GAM, and CMY have no conflicts to report. KHN has received research support from Posit Science, Inc., and Janssen and has been a consultant to Astellas, Biogen, Genentech, Janssen, Medincell, Otsuka, Takeda, and Teva. KLS has received funding from Janssen Scientific Affairs, LLC, through grants to KHN, has served as a consultant to Alkermes, Inc., and Medincell, Inc., and has been on speaker bureaus for Janssen Canada and Otsuka America Pharmaceutical, Inc. JV has received funding from Brain Plasticity, Inc., Genentech, Inc., and Janssen Scientific Affairs, LLC, and has served as a consultant to Boehringer-Ingelheim, GmbH, and Brain Plasticity, Inc. Funding was provided by NIMH (P50 MH066286, T32 MH096682, R01 MH37705, R01 MH110544) and the NSF Graduate Research Fellowship Program.

FundersFunder number
Astellas, Biogen, Genentech
Brain Plasticity, Inc.
Brain Plasticity, Inc., Genentech, Inc.
Janssen Scientific Affairs, LLC
Medincell, Inc.
Posit Science, Inc.
National Science Foundation
National Institute of Mental HealthR01MH110544, P50 MH066286, R01 MH37705, T32 MH096682
National Sleep Foundation
Janssen Biotech
Teva Pharmaceutical Industries
Takeda Pharmaceuticals U.S.A.
Otsuka America Pharmaceutical

    Keywords

    • Cortisol
    • Functional outcome
    • Schizophrenia
    • Stress
    • Vagal suppression

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