Psychotic-like experiences in a community sample of 8000 children aged 9 to 11 years: An item response theory analysis

Research Unit for Schizophrenia Epidemiology, School of Psychiatry, University of New South Wales, Sydney, Australia.
Psychological Medicine (Impact Factor: 5.94). 10/2011; 42(7):1495-506. DOI: 10.1017/S0033291711002108
Source: PubMed


Psychotic-like experiences (PLEs) in the general population are common, particularly in childhood, and may constitute part of a spectrum of normative development. Nevertheless, these experiences confer increased risk for later psychotic disorder, and are associated with poorer health and quality of life.
This study used factor analytic methods to determine the latent structure underlying PLEs, problem behaviours and personal competencies in the general child population, and used item response theory (IRT) to assess the psychometric properties of nine PLE items to determine which items best represented a latent psychotic-like construct (PSY). A total of 7966 children aged 9-11 years, constituting 95% of eligible children, completed self-report questionnaires.
Almost two-thirds of the children endorsed at least one PLE item. Structural analyses identified a unidimensional construct representing psychotic-like severity in the population, the full range of which was well sampled by the nine items. This construct was discriminable from (though correlated with) latent dimensions representing internalizing and externalizing problems. Items assessing visual and auditory hallucination-like experiences provided the most information about PSY; delusion-like experiences identified children at more severe levels of the construct.
Assessing PLEs during middle childhood is feasible and supplements information concerning internalizing and externalizing problems presented by children. The hallucination-like experiences constitute appropriate items to screen the population to identify children who may require further clinical assessment or monitoring. Longitudinal follow-up of the children is required to determine sensitivity and specificity of the PLE items for later psychotic illness.

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    • "Delays or abnormalities in speech and/or motor development were assessed via nine items included in the caregiver questionnaire (Laurens et al. 2007). Social, emotional and behavioural problems were defined as a score in the clinical range on at least one of the four psychopathology scales of the Strengths and Difficulties Questionnaire (SDQ; Goodman, 2001): emotional symptoms (childreported ); conduct problems; hyperactivity–inattention; and peer relationship problems (caregiver-reported). Psychotic-like experiences were assessed via nine items in the child questionnaire (Laurens et al. 2012); each item was rated on a three-point scale (0 = not true, 1 = somewhat true, 2 = certainly true) with a score of 2 on any item indicating a positive rating. Children presenting abnormalities in all three antecedent domains (10% of the screening sample; Laurens et al. 2011) were eligible for the ASz group; TD children presented none of the antecedents and had no first-, second-or thirddegree relatives with a schizophrenia spectrum disorder, as confirmed subsequently using the Family Interview for Genetic Studies (FIGS; Maxwell, 1992). "
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    • "Un outil simple d'emploi a également démontré son excellente valeur prédictive en population générale : le 7-items Adolescent Psychotic-like Symptom Screener (APSS) (Tableau 1) [44] . Une étude EMC -Psychatrie/Pédopsychiatrie menée chez 7900 enfants âgés de 9 à 11 ans a effectivement pu montrer que l'item 4 de l'APSS portant sur les expériences hallucinatoires auditives et l'item 6 portant sur les expériences hallucinatoires visuelles possédaient le plus grand pouvoir discriminant dans la détection d'un construct « psychose » dans cette tranche d'âge [45] . "
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    • "According to the multidimensional perspective, PLEs are heterogeneous and differentially associated with mental health problems (Armando et al., 2010; Barragan et al., 2011). However, it has also been posited that these experiences could be represented by a unidimensional construct, as Laurens et al. (2012) observed in a large sample of children aged 9– 11 years, which parallels recent findings showing the existence of a general psychosis dimension in both early psychosis and enduring psychosis (Reininghaus et al., 2013). Various self-report screening questionnaires have been developed to measure PLEs in the general population (Kline et al., 2012). "
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    ABSTRACT: Psychotic-like experiences (PLEs) are prevalent in the general population and are associated with poor mental health and a higher risk of psychiatric disorders. The Community Assessment of Psychic Experiences—Positive (CAPE-P15) scale is a self-screening questionnaire to address subclinical positive psychotic symptoms (PPEs) in community contexts. Although its psychometric properties seem to be adequate to screen PLEs, further research is needed to evaluate certain validity aspects, particularly its internal structure and its functioning in different populations.
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