Neuroticism and low self-esteem as risk factors for psychosis
- PDF / 222,508 Bytes
- 6 Pages / 595 x 785 pts Page_size
- 22 Downloads / 168 Views
© Steinkopff Verlag 2002
ORIGINAL PAPER
Lydia Krabbendam · Ilse Janssen · Maarten Bak · Rob V. Bijl · Ron de Graaf · Jim van Os
Neuroticism and low self-esteem as risk factors for psychosis Accepted: 29 October 2001
■ Abstract Background Low self-esteem and high neuroticism are common features in psychosis, but in the absence of longitudinal studies it is unclear whether they represent consequences of the illness or risk factors acting before illness onset. Methods A population sample of 3,929 individuals with no lifetime evidence of psychosis were interviewed with the Composite International Diagnostic Interview and were administered the Groningen Neuroticism Scale and the Rosenberg SelfEsteem Scale at baseline and 1 and 3 years later. At year 3, individuals with CIDI evidence of psychotic symptoms were interviewed by clinicians to identify incident psychotic or psychosis-like symptoms. Results Baseline neuroticism and self-esteem predicted first-ever onset of psychotic symptoms at year 3 (neuroticism, OR 1.16, 95 % CI 1.09, 1.23; self-esteem, OR 1.09, 95 % CI 1.01, 1.18). When adjusted for each other and for level of anxiety and depression, neuroticism was the strongest independent predictor for onset of psychotic symptoms (OR 1.16, 95 % CI 1.07, 1.26). Conclusions Neuroticism increases the risk for development of psychotic symptoms. Mechanisms of risk may involve certain cognitive styles associated with neuroticism, such as beliefs about L. Krabbendam, MA, PhD · I. Janssen, MA · M. Bak, MD · Jim van Os, MD, PhD () Department of Psychiatry and Neuropsychology (PAR45) Maastricht University P. O. Box 616 6200 MD Maastricht, The Netherlands Jim van Os, MD, PhD Division of Psychological Medicine Institute of Psychiatry De Crespigny Park Denmark Hill, London R. V. Bijl, MA, PhD Research and Documentation Center (WODC) – Ministry of Justice The Hague, The Netherlands
■ Key words psychosis – risk factors – population – neuroticism – self-esteem
Introduction Poor self-esteem and negative self-appraisals are common in individuals with persecutory delusions (Freeman et al. 1998) and auditory hallucinations (Close and Garety 1998). Low self-esteem in psychosis may be best understood as both a maintaining factor and a consequence of the illness (Freeman et al. 1998), in a way similar to what has been reported for depression (Beck 1987; Bernet et al. 1993). On the one hand, psychotic beliefs will be more firmly held when their content is consistent with negative beliefs about the self,others and the world (Bowins and Shugar 1998). On the other hand, variables related to the impact of psychosis, such as social functioning, perceived stigma and illness attribution, may influence self-esteem (Brekke et al. 1993; Iqbal et al. 2000; Mechanic et al. 1994). Garety and Freeman have argued that low self-esteem may already act before illness onset as a risk factor for psychosis (Garety et al. 2001). For depression, the aetiological significance of low self-esteem has been demonstrated by several longitudinal studies (Brown et al.
Data Loading...
