Schizophrenia (SZ) is associated with impaired adaptive functioning, including difficulties managing the demands of independent living, work, school, and interpersonal relationships. Prior studies have linked the physiological stress response with less effective coping in daily life. Differences in stress-response tendencies may also support heterogeneity in daily functioning in SZ. The present study examined two established measures of the stress response in patients with first-episode SZ. Salivary cortisol was included as an index of hypothalamic-pituitary-adrenal response. Vagal suppression (VS), a measure of stress-related reduction in heart rate variability, was used to assess parasympathetic flexibility. Greater cortisol response and VS to social-evaluative stress were predicted to be associated with better functioning in SZ over and above relationships with social cognition and neurocognition, two well-established predictors of functional outcome. Thirty-eight first-episode SZ outpatients and 29 healthy comparison subjects (HC) provided social cognitive, neurocognitive, and physiological measurements before and after the Trier Social Stress Test (TSST). Although SZ and HC did not differ on VS to the TSST, patients exhibited significant associations between VS and functioning across all four domains of the Role Functioning Scale. Furthermore, greater VS predicted more effective functioning with friends, beyond the contributions associated with social cognition and neurocognition, and strengthened the positive effects of higher levels of social cognition on independent living/self-care. VS elicited by social-evaluative stress in the laboratory may reflect stress-response tendencies in daily life that are relevant for daily functioning in first-episode SZ.

中文翻译：

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首发精神分裂症患者对社会评价压力的生理反应与日常功能之间的关联

精神分裂症 (SZ) 与适应性功能受损有关，包括难以处理独立生活、工作、学校和人际关系的需求。先前的研究已将生理压力反应与日常生活中较不有效的应对方式联系起来。压力反应倾向的差异也可能支持 SZ 日常功能的异质性。本研究检查了两种既定的 SZ 患者应激反应指标。唾液皮质醇被列为下丘脑-垂体-肾上腺反应的指标。迷走神经抑制 (VS) 是一种衡量与压力相关的心率变异性降低的指标，用于评估副交感神经的灵活性。预测更大的皮质醇反应和对社会评价压力的 VS 与 SZ 更好的功能相关，而不是与社会认知和神经认知的关系，这是两个公认的功能结果预测因子。38 名第一期 SZ 门诊患者和 29 名健康对照受试者 (HC) 在特里尔社会压力测试 (TSST) 前后提供了社会认知、神经认知和生理测量。尽管 SZ 和 HC 在 VS 与 TSST 上没有差异，但患者在角色功能量表的所有四个领域中表现出 VS 与功能之间的显着关联。此外，除了与社会认知和神经认知相关的贡献，更大的 VS 预测与朋友更有效的功能，并加强了更高水平的社会认知对独立生活/自我照顾的积极影响。实验室中社会评价压力引起的 VS 可能反映日常生活中与第一集 SZ 中的日常功能相关的压力反应趋势。