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Psychosis Symptom Trajectories Across Childhood and Adolescence in Three Longitudinal Studies: An Integrative Data Analysis with Mixture Modeling

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Abstract

Psychotic-like experiences (PLEs) are common throughout childhood, and the presence of these experiences is a significant risk factor for poor mental health later in development. Given the association of PLEs with a broad number of mental health diagnoses, these experiences serve as an important malleable target for early preventive interventions. However, little is known about these experiences across childhood. While these experiences may be common, longitudinal measurement in non-clinical settings is not. Therefore, in order to explore longitudinal trajectories of PLEs in childhood, we harmonized three school-based randomized control trials with longitudinal follow-up to identify heterogeneity in trajectories of these experiences. In an integrative data analysis (IDA) using growth mixture modeling, we identified three latent trajectory classes. One trajectory class was characterized by persistent PLEs, one was characterized by high initial probabilities but improving across the analytic period, and one was characterized by no reports of PLEs. Compared to the class without PLEs, those in the improving class were more likely to be male and have higher levels of aggressive and disruptive behavior at baseline. In addition to the substantive impact this work has on PLE research, we also discuss the methodological innovation as it relates to IDA. This IDA demonstrates the complexity of pooling data across multiple studies to estimate longitudinal mixture models.

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Data Availability

Data will be made available through the National Institutes of Mental Health Data archive at the completion of the grant period

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Acknowledgements

We are grateful for the collaboration of the Durham Public Schools, the Metropolitan Nashville Public Schools, the Bellefonte Area Schools, the Tyrone Area Schools, the Mifflin County Schools, the Highline Public Schools, and the Seattle Public Schools. We appreciate the hard work and dedication of the many staff members who implemented the project, collected the evaluation data, and assisted with data management and analyses.

the Conduct Problems Prevention Research Group (CPPRG)

The members of the Conduct Problems Prevention Research Group (CPPRG) are, in alphabetical order, Karen L. Bierman (Pennsylvania State University); John D. Coie (Duke University); D. Max Crowley (Pennsylvania State University); Kenneth A. Dodge (Duke University); Mark T. Greenberg (Pennsylvania State University); John E. Lochman (University of Alabama); Robert J. McMahon (Simon Fraser University and the B.C. Children’s Hospital Research Institute); and Ellen E. Pinderhughes (Tufts University).

Funding

The Fast Track project has been supported by the National Institute of Mental Health (NIMH) Grants R18 MH48043, R18 MH50951, R18 MH50952, R18 MH50953, R01 MH062988, R01 MH117559, K05 MH00797, and K05 MH01027; National Institute on Drug Abuse (NIDA) Grants R01 DA016903, R01 DA036523, R01 DA11301, K05 DA15226, RC1 DA028248, and P30 DA023026; National Institute of Child Health and Human Development Grant R01 HD093651; and Department of Education Grant S184U30002. The Center for Substance Abuse Prevention also provided support through a memorandum of agreement with the NIMH. Additional support for this study was provided by a B. C. Children’s Hospital Research Institute Investigator Grant Award and a Canada Foundation for Innovation award (to Robert J. McMahon). This study was supported by R01MH122214.

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Correspondence to Rashelle J. Musci.

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Ethical Approval

All procedures performed in the current study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study. The study was approved by the Johns Hopkins Bloomberg School of Public Health IRB.

Conflict of Interest

Drs. Bierman, Coie, Dodge, Greenberg, Lochman, McMahon, and Pinderhughes are the principal investigators on the Fast Track Project and have a publishing agreement with Guilford Publications, Inc. Royalties from that agreement are donated to a professional organization. They are also authors of the PATHS curriculum and donate all royalties from Channing-Bete, Inc. to a professional organization. Dr. Greenberg is a developer of the PATHS curriculum and has a separate royalty agreement with PATHS Program LLC. Bierman, Coie, Dodge, Greenberg, Lochman, and McMahon are the developers of the Fast Track curriculum and have a publishing and royalty agreement with Guilford Publications, Inc. McMahon is a coauthor of Helping the Noncompliant Child and has a royalty agreement with Guilford Publications, Inc. Dr. Crowley has no conflicts.

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Musci, R.J., Kush, J.M., Masyn, K.E. et al. Psychosis Symptom Trajectories Across Childhood and Adolescence in Three Longitudinal Studies: An Integrative Data Analysis with Mixture Modeling. Prev Sci 24, 1636–1647 (2023). https://doi.org/10.1007/s11121-023-01581-7

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