General psychopathology links burden of recent life events and psychotic symptoms in a network approach

Research output: Contribution to journalArticlepeer-review


  • the PRONIA consortium

Colleges, School and Institutes

External organisations

  • University Hospital Cologne
  • University of Munich
  • Department of Psychology
  • Aston University
  • The National Centre of Excellence in Youth Mental Health
  • Centre for Youth Mental Health
  • Universita degli Studi di Bari
  • University of Basel
  • Universitat zu Lubeck
  • Università degli Studi di Milano and oINFN-Milan
  • Muenster University
  • Heinrich-Heine-Universität
  • University of Turku
  • Airlangga University
  • Max-Planck Institute of Psychiatry
  • King's College London


Recent life events have been implicated in the onset and progression of psychosis. However, psychological processes that account for the association are yet to be fully understood. Using a network approach, we aimed to identify pathways linking recent life events and symptoms observed in psychosis. Based on previous literature, we hypothesized that general symptoms would mediate between recent life events and psychotic symptoms. We analyzed baseline data of patients at clinical high risk for psychosis and with recent-onset psychosis (n = 547) from the Personalised Prognostic Tools for Early Psychosis Management (PRONIA) study. In a network analysis, we modeled links between the burden of recent life events and all individual symptoms of the Positive and Negative Syndrome Scale before and after controlling for childhood trauma. To investigate the longitudinal associations between burden of recent life events and symptoms, we analyzed multiwave panel data from seven timepoints up to month 18. Corroborating our hypothesis, burden of recent life events was connected to positive and negative symptoms through general psychopathology, specifically depression, guilt feelings, anxiety and tension, even after controlling for childhood trauma. Longitudinal modeling indicated that on average, burden of recent life events preceded general psychopathology in the individual. In line with the theory of an affective pathway to psychosis, recent life events may lead to psychotic symptoms via heightened emotional distress. Life events may be one driving force of unspecific, general psychopathology described as characteristic of early phases of the psychosis spectrum, offering promising avenues for interventions.

Bibliographic note

Funding Information: PRONIA is a Collaboration Project funded by the European Union under the 7th Framework Programme (grant agreement n° 602152). J.K. has received funding from the German Research Foundation (DFG; grant agreement n° KA 4413/1-1). Publisher Copyright: © 2020, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.


Original languageEnglish
Article number40
JournalNPJ schizophrenia
Issue number1
Publication statusPublished - 15 Dec 2020

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