Resilience factors and their role in clinical high-risk for psychosis.

OBJECTIVE

Recent approaches in psychosis research have emphasized the importance of the combined analysis of risk and resilience factors. A resilience-integrated approach offers a more comprehensive understanding of the mechanisms underlying symptom associations and progression in individuals at clinical high-risk (CHR) for psychosis. Network analysis allows the examination of relationships among mental health conditions together with both risk and resilience factors. To our knowledge, this is the first study that investigated associations between resilience, risk factors, and psychosis-risk using network analysis.

METHODS

This secondary analysis of data from the ZInEP study (Zurich Early Recognition Program) examined 116 individuals at CHR for psychosis aged 18-35 years. We investigated the relationships between two candidate resilience factors (self-efficacy and self-esteem), daily hassles as a candidate risk factor, functioning level, and psychosis risk symptoms using network analysis.

RESULTS

Self-esteem and self-efficacy were negatively associated with general symptoms, negative symptoms, and daily hassles. Resilience factors and daily hassles were not associated with positive and disorganized symptoms, nor with functioning level. Centrality analyses further revealed that self-esteem had stronger node strength and bridge strength than self-efficacy.

CONCLUSIONS

This study emphasizes the utility of a resilience-oriented approach in psychosis risk. Self-esteem and self-efficacy may play a crucial role in negative and general symptoms. Resilience factors may enrich our theoretical understanding of psychosis risk and help pave the way for resilience-based interventions.