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Persistent and distressing psychotic-like experiences using adolescent brain cognitive development℠ study data

Molecular Psychiatry volume 27, pages 1490–1501 (2022)Cite this article

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Abstract

Childhood psychotic-like experiences (PLEs) are associated with a range of impairments; a subset of children experiencing PLEs will develop psychiatric disorders, including psychotic disorders. A potential distinguishing factor between benign PLEs versus PLEs that are clinically relevant is whether PLEs are distressing and/or persistent. The current study used three waves of Adolescent Brain Cognitive Development℠ (ABCD) study PLEs assessments to examine the extent to which persistent and/or distressing PLEs were associated with relevant baseline risk factors (e.g., cognition) and functioning/mental health service utilization domains. Four groups varying in PLE persistence and distress endorsement were created based on all available data in ABCD Release 3.0, with group membership not contingent on complete data: persistent distressing PLEs (n = 272), transient distressing PLEs (n = 298), persistent non-distressing PLEs (n = 221), and transient non-distressing PLEs (n = 536) groups. Using hierarchical linear models, results indicated youth with distressing PLEs, whether transient or persistent, showed delayed developmental milestones (β = 0.074, 95%CI:0.013,0.134) and altered structural MRI metrics (β = −0.0525, 95%CI:−0.100,−0.005). Importantly, distress interacted with PLEs persistence for the domains of functioning/mental health service utilization (β = 0.079, 95%CI:0.016,0.141), other reported psychopathology (β = 0.101, 95%CI:0.030,0.170), cognition (β = −0.052, 95%CI:0.−0.099,−0.002), and environmental adversity (β = 0.045, 95%CI:0.003,0.0.86; although no family history effects), with the interaction characterized by greatest impairment in the persistent distressing PLEs group. These results have implications for disentangling the importance of distress and persistence for PLEs with regards to impairments, including functional, pathophysiological, and environmental outcomes. These novel longitudinal data underscore that it is often only in the context of distress that persistent PLEs were related to impairments.

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Fig. 1: Overview of the groups, domains, and individuals components included in analyses.
Fig. 2: Depictions of mean score estimates and confidence intervals for each of the four groups (i.e., persistent distressing PLEs, transient distressing PLEs, persistent non-distressing PLEs, transient non-distressing PLEs) for each of the PCA-generated domains.

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Acknowledgements

Data used in the preparation of this article were obtained from the Adolescent Brain Cognitive Development (ABCD) Study (https://abcdstudy.org), held in the NIMH Data Archive (NDA). This is a multisite, longitudinal study designed to recruit more than 10,000 children age 9-10 and follow them over 10 years into early adulthood. The ABCD Study is supported by the National Institutes of Health and additional federal partners under award numbers U01DA041022, U01DA041028, U01DA041048, U01DA041089, U01DA041106, U01DA041117, U01DA041120, U01DA041134, U01DA041148, U01DA041156, U01DA041174, U24DA041123, U24DA041147, U01DA041093, and U01DA041025. A full list of supporters is available at https://abcdstudy.org/federal-partners.html. A listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/Consortium_Members.pdf. ABCD consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. This manuscript reflects the views of the authors and may not reflect the opinions or views of the NIH or ABCD consortium investigators. The ABCD data repository grows and changes over time. The ABCD data used in this report came from https://doi.org/10.15154/1519007. We thank the families participating in the Adolescent Brain and Cognitive Development study.

Funding

This work was supported by National Institute on Drug Abuse (U01 DA041120 to DMB and KJS); National Institute of Mental Health (K23MH121792-01 and L30 MH120574-01 to NRK) (MH018261-31 to MS); National Institute on Alcohol Abuse and Alcoholism K05-AA017242 to KJS); the Canadian Institutes of Health Research (CIHR) and Fonds de Recherche du Quebec-Sante (FRQS) (CM).

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Authors and Affiliations

  1. Washington University School of Medicine, Dept. of Psychiatry, St. Louis, MO, USA

    Nicole R. Karcher & Deanna M. Barch

  2. University of California, San Francisco, Dept. of Psychiatry, San Francisco, CA, USA

    Rachel L. Loewy & Mark Savill

  3. National Institute of Mental Health, Bethesda, MD, USA

    Shelli Avenevoli

  4. University of Utah, Dept. of Psychiatry, Salt Lake City, UT, USA

    Rebekah S. Huber

  5. University of California San Diego, Dept. of Radiology, San Diego, CA, USA

    Carolina Makowski

  6. University of Missouri, Dept. of Psychological Sciences, Columbia, MO, USA

    Kenneth J. Sher

  7. Washington University in St. Louis, Dept. of Psychological and Brain Sciences, St. Louis, MO, USA

    Deanna M. Barch

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NRK and DMB designed the research. NRK analyzed the data. NRK and DMB drafted the manuscript, and RLL, MS, SA, RSH, CM and KJS provided interpretation of the data and critical feedback. All authors approved the manuscript.

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Correspondence to Nicole R. Karcher.

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Dr. Loewy is a Lundbeck International Neuroscience Foundation faculty member. The remaining authors declare no competing interest.

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Karcher, N.R., Loewy, R.L., Savill, M. et al. Persistent and distressing psychotic-like experiences using adolescent brain cognitive development℠ study data. Mol Psychiatry 27, 1490–1501 (2022). https://doi.org/10.1038/s41380-021-01373-x

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