Pictorial representation of illness and self-measure (PRISM) was developed as screening tool assessing implicit reaction to somatic illnesses. Conclusion is based on comparisons of the positions of illness-related (“Illness” and major symptoms) and unrelated (“Me”, “Family”, “Work/study”) objects on the list.

Due to its easiness and implicitness PRISM could be promising addition to illness representation questionnaires in mental illnesses.

Aim was to reveal validity of the PRISM in youth with ultra-high risk for psychosis.

Eighty-one male patients 16–25 years old meeting criteria of ultra-high risk for psychosis; preliminary diagnoses of mood disorders 34, personality disorders 26, schizotypal disorder 21 patients) filled PRISM, beck cognitive insight scale, symptom checklist 90-r, illness perception questionnaire, quality of life and enjoyment questionnaire and happiness scale.

According to hierarchical regression, conditional “Self-Illness” distance (after control for mean distances on the list) was related to less psychopathological complaints, lower subjective illness severity and emotional representations, higher treatment control and better quality of life. “Self-symptoms” distance was related to better cognitive insight, lower emotional representations and consequences and moderated the relationship between “Self-Illness” distance and appraisals of illness length and dynamic.

Conditional “Self-Illness” distance in PRISM could reflect cognitive appraisal of illness based on symptoms and related to life satisfaction while “Self-Symptoms” distance reflects merely emotional reaction based on cognitive insight.

The authors have not supplied their declaration of competing interest.