Positive affect as a buffer in the daily relationship between stress and psychotic experiences across the psychosis continuum.

Abstract

Background: There is growing interest in potential protective factors that may attenuate the impact of psychotic experiences (PEs), but research is still scarce. The present study investigates contemporaneous and temporal associations between daily reports of experienced stress and PEs in individuals at different early risk stages of psychosis, focusing on the possible moderating role of positive affect (PA) in these relationships (within-person moderation). Second, the buffering effect of PA differs across early risk stages (between-person moderation).

Methods: This study used 90-day daily diary data from 96 individuals allocated into 4 subgroups reflecting increasing psychosis risk: increased psychometric risk without current symptoms (subgroup 1; n = 25), low risk (subgroup 2; n = 27), mild risk (subgroup 3; n = 24), and ultra-high risk (subgroup 4; n = 20). Multilevel models, including double and triple interaction testing, applied to examine associations between experienced stress, PEs, and PA, and to compare these associations across subgroups.

Results: Experienced stress showed a significant contemporaneous effect on PEs, which was stronger in subgroup 4 than in other subgroups and stronger in subgroup 3 compared to subgroup 1. PA significantly moderated the contemporaneous effect of experienced stress on PEs; this moderating effect did not differ between subgroups. No significant temporal effect of experienced stress on PEs was found, nor was this effect moderated by either PA or subgroups.

Conclusions: Experienced stress is associated with PEs contemporaneously among individuals in early risk stages, and PA buffers this association, underscoring PA as a potentially important protective factor.