# Belief inflexibility reduces the impact of allostatic overload on psychotic-like experiences among Ukrainian refugees

## TL;DR

This study explores how stress and rigid thinking affect psychosis-like symptoms in Ukrainian refugees, finding that rigid beliefs reduce the impact of stress on these symptoms.

## Contribution

The study reveals a novel interaction between allostatic load, belief inflexibility, and refugee status in predicting psychosis-like experiences.

## Key findings

- Refugees showed higher levels of stress, anxiety, and belief inflexibility compared to controls.
- Higher belief inflexibility reduced the impact of physiological stress on psychosis-like experiences.
- The interaction between stress and cognitive rigidity was stronger in refugees.

## Abstract

Refugees are chronically exposed to cumulative stress, which may increase allostatic load (AL) and vulnerability to psychotic-like experiences (PLEs). Belief inflexibility, reflecting difficulties in revising beliefs in response to new information, may influence how physiological stress affects psychosis proneness. This study examined whether AL index interacts with cognitive biases and refugee status in predicting PLEs.

Sixty Ukrainian refugees and fifty matched controls underwent psychiatric evaluation, assessment of cognitive biases, and measurement of AL biomarkers.

Refugees had fewer years of education and showed higher depressive, anxiety, PLEs, trauma-related symptoms, greater belief inflexibility and elevated AL index. Significant positive correlations were found between AL index and PLEs and between AL index and belief inflexibility. Moderation analyses revealed that both AL index and belief inflexibility were positively associated with PLEs, and refugee status amplified these effects. However, the interaction between AL index and belief inflexibility was negative, suggesting that higher cognitive rigidity weakened the direct impact of physiological stress on PLEs. Subsequent analyses indicated that this attenuating effect was especially pronounced in the refugee group.

These findings highlight the complex interplay between stress physiology andcognitive style in shaping psychosis vulnerability and adaptation in trauma exposed refugee populations.