Thoughts falling apart: disorganized schizotypy specifically predicts both psychotic- and stress-reactivity in daily life

Psychotic-like experiences predict the risk of subsequent psychotic disorders and may signal a broader vulnerability to mental health problems. Schizotypy, a multidimensional personality construct with disorganization at its core, predicts future psychosis risk. Heightened stress-reactivity is associated with vulnerability to psychosis, and positive and negative schizotypal traits predict distress-induced psychotic-like experiences (PLE-reactivity) in everyday life. Nevertheless, these findings require further investigation, since previous studies neither assessed the link between disorganization and stress- and PLE-reactivity in daily life, nor disentangled within- vs. between-person processes. We conducted an experience sampling study where participants reported PLEs, event-unpleasantness (pleasantness of a recent significant event), and exposure to stressors (e.g., decline in salary, housing, health, and relationships). Schizotypal traits were assessed with the Multidimensional Schizotypy Scale - Brief (MSS-B). We obtained 4611 observations from 126 participants from the general population. Multilevel models were used to examine the main effects of schizotypal traits and their interaction with changes in stressor exposure in predicting PLEs and event-unpleasantness. Individuals with higher disorganized (but not positive or negative) schizotypy reported not only more intense PLEs in daily life but also were more likely to have PLEs when stressor exposure had risen. However, in those with higher negative schizotypy, such PLE-reactivity to stressors was reversed. Moreover, individuals with higher disorganization found events more unpleasant overall, and for them, being exposed to more stressors was related to a steeper rise in unpleasantness. Disorganization but not positive or negative schizotypy might be a specific determinant of stressor-related increases in psychotic-like experiences and stress-appraisal in everyday life in the general population. This supports that disorganization might be a critical predictor of vulnerability to stress-related mental health impairments. Our results also confirm the MSS-B's ecological validity, which can be a valuable discovery for the prevention of psychotic disorders.