The stress-vulnerability-protective factors model is often used to explain the etiology and known risk and protective factors of initial psychotic symptoms and symptomatic relapses. Over the past 40 years since its initial conception, the model has evolved and gathered a plethora of evidence of varying quality for its different components. The objective of this metareview is to analyze the quality of the evidence and the effect sizes for each component of the model not previously reviewed. Recent meta-analyses covering each component of the model in relation to the onset of psychotic symptoms or symptomatic relapse in schizophrenia were reviewed with the grading of recommendations, assessment, development, and evaluation system. Thirty-one meta-analyses were kept, from 3,044 papers reviewed. We did not add to previous metareviews in terms of obstetric/prenatal or genetic vulnerabilities. For stressors, moderate to strong research evidence was found for childhood adversity, cannabis, methamphetamine abuse, and expressed emotions as triggers of psychotic relapse or as linked to the onset of psychotic symptoms. For protective factors, moderate to strong evidence was found for antipsychotic medication in adults, family interventions, social skills training, as well as interventions focusing on recovery management skills. Poor evidence or no evidence (i.e., absence of meta-analyses) were found for the other components of the model. More rigorous studies and systematic reviews are needed in order to validate the various components of the model in regard to symptom onset and relapse.

The inability to synthesize information into experience of self and others could be one significant cause of negative symptoms. To explore this possibility, we examined the relationships between baseline metacognition and concurrent and prospective negative symptoms controlling for verbal memory. The participants were 62 adults diagnosed with serious mental illness enrolled in outpatient treatment. Metacognition was measured with the Metacognitive Assessment Scale–Abbreviated, symptoms were assessed using the Brief Psychiatric Rating Scale, and verbal memory was assessed using the California Verbal Learning Test. Significant correlations were found, indicating that poorer overall metacognition was associated with greater levels of negative symptoms assessed concurrently (r = 0.39) and 1 month later (r = 0.36). A significant relationship persisted after controlling for verbal memory and education. These findings support the idea that metacognitive deficits are related to negative symptoms and point to the potential of metacognitive interventions to positively influence negative symptoms.

Aim: To assess the feasibility, acceptability and potential impact of a cognitive behavioural group intervention occurring over 12 sessions and focusing on romantic relationships for single men with early psychosis.Methods: Recruitment, drop-out and participation rates were collected. An A-B-A within-subject design (n = 7), where each participant acted as his own control, was used to determine potential impact (on social functioning, romantic relationship functioning, self-esteem, theory of mind [ToM] and self-stigma) across time (six time points).Results: Feasibility and acceptability were established. As for the potential impact of the intervention, participants did not all evolve the same way. Improvements were found on social functioning ("behaviours" subscale), romantic relationship functioning and ToM ("mentalizing" subscale).Conclusions: More studies are warranted to expand on these results and to further help men with early psychosis in their social and romantic development.

Faculté des arts et des sciences Mémoire présenté en vue de l'obtention du grade de maîtrise ès Sciences (M.Sc.