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Three types of psychotic-like experiences in youth at clinical high risk for psychosis

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European Archives of Psychiatry and Clinical Neuroscience Aims and scope Submit manuscript

Abstract

Background: A fully dimensional model of psychosis implies that psychotic-like experiences (PLEs) connect the entire psychosis spectrum. Three types of self-reported PLEs—persecutory ideation, bizarre experiences, and perceptual abnormalities—are commonly found in the general population. This study assessed the construct, predictive, and incremental validity of self-reported PLEs in youth at clinical high risk for psychotic disorders (CHR). Methods: Self-report data on PLEs (community assessment of psychic experiences; CAPE) were collected from 105 CHR youth (mage = 19.3). Interview measures of attenuated psychotic symptoms and self-report measures of psychosis proneness, depression, and anxiety were collected at baseline and 12-month follow-up (n = 70 at follow-up). Factor, cross-sectional, and longitudinal analyses examined relationships between study variables. Results: Self-reported PLEs were best represented by the same three factors found in the general population: persecutory ideation, bizarre experiences, and perceptual abnormalities. Cross-sectionally, PLEs—particularly persecutory ideation—correlated with interview-rated attenuated psychotic symptoms and self-reported psychosis proneness, depression, and anxiety. Longitudinally, baseline PLEs trended toward predicting 12-month change in positive attenuated psychotic symptoms (r = .29, pFDR = .058). Incrementally, baseline PLEs predicted 12-month change in positive and disorganized symptoms, when accounting for the effect of baseline positive symptoms and demographics. Conclusions: Three types of PLEs were valid in this CHR sample. Self-reported PLEs may be used not only to screen individuals for inclusion in the CHR classification, but also to characterize individuals within this population. Self-reported PLEs may help to forecast which CHR individuals will progress toward psychotic illness.

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Data availability

The data and analysis code that support the findings of this study are available from the corresponding author upon reasonable request. All measures are widely available online.

Notes

  1. Demographics included age, sex, income, and education.

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Acknowledgements

The authors wish to express their gratitude to the study participants. This work was supported in part by the Canadian Institutes of Health Research (DFS-152268 to HRC) and by the National Institutes of Health (R01MH112545-01, R01MH116039-01A1, and R01MH094650 to VAM).

Funding

This work was supported in part by the Canadian Institutes of Health Research (DFS-152268 to HRC) and by the National Institutes of Health (R01MH112545-01, R01MH116039-01A1, and R01MH094650 to VAM). The funding sources were not involved in study design, analysis, or manuscript writing.

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Authors and Affiliations

  1. Department of Psychology, Northwestern University, Swift Hall, 2029 Sheridan Rd., Evanston, IL, 60208, USA

    Henry R. Cowan

  2. Psychology, Psychiatry, Medical Social Sciences, Institute for Policy Research, Northwestern University, Evanston, IL, USA

    Vijay A. Mittal

Authors
  1. Henry R. Cowan
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  2. Vijay A. Mittal
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Contributions

Both authors contributed to study planning and data collection. HRC conducted data analysis in consultation with VAM. HRC wrote the initial draft of the manuscript and both authors contributed revisions. Both authors have approved this final version of the manuscript.

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Correspondence to Henry R. Cowan.

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The authors assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional committees on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008.

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Communicated by Andrea Schmitt.

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Cowan, H.R., Mittal, V.A. Three types of psychotic-like experiences in youth at clinical high risk for psychosis. Eur Arch Psychiatry Clin Neurosci 271, 733–744 (2021). https://doi.org/10.1007/s00406-020-01143-w

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