Temporal Relationship Between Momentary Negative Affect Intensity and Momentary Attenuated Delusions in Individuals...

Research suggests that stress contributes to psychosis risk through an affective pathway, where heightened emotional responses to stressors lead to increased vulnerability. Specifically, individuals at clinical high-risk for psychosis (CHR-p) display more intense negative affect (NA) intensity, which is thought to exacerbate psychosis risk. The present study explored temporal dynamics between momentary NA intensity and delusional severity in CHR-p using ecological momentary assessment (EMA). Aims were to: (1) examine group differences in NA intensity and variability and (2) explore bidirectional associations between NA and attenuated delusions in the context of daily life.

A sample of 120 CHR participants and 59 healthy controls completed 1 week of EMA surveys examining NA and attenuated delusions. Multilevel models examined time-lagged effects of NA reactivity on attenuated delusions and vice versa.

Consistent with previous research, individuals at CHR displayed greater levels of NA intensity compared to healthy controls. Additionally, the CHR group exhibited variability affective changes throughout the day, suggesting a disrupted return to emotional homeostasis. Contrary to predictions, NA intensity did not predict subsequent delusional severity, highlighting potential complexities in the association that may be revealed by EMA methodologies. Instead, the study demonstrated that heightened attenuated delusional severity predicted subsequent increases in NA intensity.

These results demonstrated attenuated delusions exacerbate momentary elevations in NA intensity. Together with evidence from previous literature, findings underscore this relationship may be sensitive to the timescale of measurement, indicating the need for elucidating mechanisms underlying these associations to improve outcomes.