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Introduction
Skills and Expertise
Publications
Publications (275)
Individuals at clinical high risk (CHR) for psychosis have been found to have altered cytokine levels, but whether these changes are related to clinical outcomes remains unclear. We addressed this issue by measuring serum levels of 20 immune markers in 325 participants (n=269 CHR, n=56 healthy controls) using multiplex immunoassays, and then follow...
The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social con...
Epidemiological evidence has linked an array of sociodemographic and psychosocial
factors with an increased risk of developing psychosis. However, research in samples from low- and middle-income countries is still scarce. This study used a Mexican sample to explore (i) sociodemographic and psychosocial differences between individuals with and witho...
Background
Adverse childhood experiences (ACE) can affect educational attainments, but little is known about their impact on educational achievements in people at clinical high risk of psychosis (CHR).
Methods
In total, 344 CHR individuals and 67 healthy controls (HC) were recruited as part of the European Community’s Seventh Framework Programme-f...
Schizophrenia-spectrum psychopathology appears best understood as being expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. This brief report describes a comprehensive replication study examining the associations of positive, negative, and disorganized schizotypy with interview ratings of impa...
Schizotypy and schizophrenia are associated with disruptions in the experience of affect. Temporal patterns of affect, or affective dynamics, offer unique information about the expression of multidimensional schizophrenia-spectrum psychopathology. The present study employed experience sampling methodology to examine affective intensity, inertia, va...
BACKGROUND AND HYPOTHESIS: Around 20% of people at clinical high risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions [SIs]) in noise in CHR participants and examined whether this was associated with adverse clinical outcome...
The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy...
Ambivalence has a longstanding history in schizophrenia-spectrum and borderline personality psychopathology, although it has been largely overlooked in current psychopathology research. The Schizotypal Ambivalence Scale (SAS) provides a brief, psychometrically sound questionnaire for assessing ambivalence characteristic of the schizotypy spectrum....
The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia during the COVID-19 pandemic. Given Croatia's recent transgenerational war trauma and the relative lack of available prodromal data, this study presents a unique opportunity to examine the impact of loneliness and other psychosocial...
Background and hypothesis: Around 20% of people at clinical high-risk (CHR) for psychosis later develop a psychotic disorder, but it is difficult to predict who this will be. We assessed the incidence of hearing speech (termed speech illusions) in noise in CHR participants and examined whether this was associated with adverse clinical outcomes. Stu...
Objective:
People at ultra-high risk (UHR) for psychosis have a high prevalence of tobacco smoking, and rates are even higher among the subgroup that later develop a psychotic disorder. However, the longitudinal relationship between the course of tobacco smoking and clinical outcomes in UHR subjects is unknown.
Methods:
We investigated associati...
Schizotypal personality disorder (SPD) first appeared in the American Psychiatric Association diagnostic nosology in 1980, although its roots stretch back more than 100 years under labels such as borderline, ambulatory, and latent schizophrenia. SPD is unique in that it is conceptualized both as stable personality pathology and also as a milder man...
Background and Hypothesis
Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem,...
Objective
To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis.
Methods
265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-centre study. After a baseline assessment using magnetic resonance...
Objectives:
The aim of this study was to evaluate the potential moderator role of poor mentalization in the association between borderline personality disorder (BPD) traits and somatization, specifically focusing on the polarities of self- and other-mentalizing.
Design:
This is a cross-sectional, general population study evaluating adolescents (...
The family environment represents an important psychosocial factor that impacts psychosis prognosis, but little is known about its effect on the at-risk stages of psychosis. This study presents a comprehensive review and summarizes the state of the art of study on the wide range of family factors related to family functioning in the At-Risk Mental...
The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. Models of pathological personality provide useful frameworks for assessing t...
Leading theoretical models of psychosis implicate a wide range of psychological factors in the development of positive symptoms. Ambulatory assessment allows us to repeatedly assess people's mental experiences within and across days to explore putative moment-to-moment prospective relationships that impact the onset and exacerbation of positive sym...
Background: Hair cortisol concentrations (HCC) provide a retrospective examination of long-term cortisol production as a measure of the hypothalamic-pituitary-adrenal (HPA) axis functioning, one of the major neural systems implicated in mediating the effects of stress on mental illness. However, evidence about the relationship between HCC with stre...
Mentalizing, or social cognition, refers to the brain’s higher order capacity that allows humans to be aware of one’s own and others’ mental states (e.g., emotions, feelings, intentions). While cognition in social anxiety has been broadly analyzed, there is a paucity of research regarding the role of social cognition. Moreover, mentalizing or socia...
Background
The high prevalence rates and impact of tobacco smoking in individuals with a psychotic disorder have become an increasing interest. Little is known about tobacco smoking in individuals at ultra-high risk of psychosis (UHR).
Methods
We studied 345 UHR individuals of the high-risk study of the European network of national schizophrenia n...
Robust deficits in cognitive functioning are present in people with psychosis and are evident in the early stages of the disorder. Impairments in verbal memory and verbal fluency are reliably seen in individuals at clinical high-risk for psychosis (CHR) compared to healthy populations. As previous studies have shown a relationship between cognition...
The assessment of schizotypy and schizophrenia‐spectrum psychopathology has historically been adversely impacted by multiple forms of measurement bias, including racial bias. The Multidimensional Schizotypy Scale (MSS) was developed using modern scale construction methods to minimize measurement bias in the assessment of schizotypic traits. However...
Introduction
Diagnoses of anxiety and/or depression are common in subjects at Ultra-High Risk for Psychosis (UHR) and associated with extensive functional impairment. Less is known about the impact of affective comorbidities on the prospective course of attenuated psychotic symptoms (APS).
Method
Latent class mixed modelling identified APS traject...
Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, compr...
The vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms and impairment known as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. Openness to experience offers a useful personality domain for exploring multidimensional schi...
Bipolar disorders are increasingly understood as part of a spectrum of clinical and subclinical symptoms and impairment. Upwards of 50% of patients with bipolar disorders experience psychotic symptoms as part of their mood episodes. However, studies largely have not examined the extent to which people with subclinical bipolar spectrum psychopatholo...
Serum neuronal autoantibodies, such as those to the NMDA receptor (NMDAR), are detectable in a subgroup of patients with psychotic disorders. It is not known if they are present before the onset of psychosis or whether they are associated with particular clinical features or outcomes. In a case-control study, sera from 254 subjects at clinical high...
The present study examined the associations of positive, negative, and disorganized schizotypy dimensions assessed by the Multidimensional Schizotypy Scale with 5 interview-rated personality disorder diagnoses and traits in 151 young adults. As hypothesized, all 3 schizotypy dimensions were associated with impaired functioning. Positive schizotypy...
Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients’ SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients’ SE...
Background: Research suggests dissociation and insecure attachment serve as explanatory mechanisms in the pathway from childhood trauma to paranoia. However, past work has not examined these mechanisms concurrently in nonclinical populations.
Objective: The current study sought to examine dissociation and insecure attachment as parallel mediators o...
Background: Self-concepts are being intensively investigated in relation to paranoia, but research has shown some contradictory findings. Studying subclinical phenomena in a non-clinical population should allow for a clearer understanding given that clinical confounding factors are avoided. We explored self-esteem, self-schemas, and implicit/explic...
This manual provides information on the development and use of the Multidimensional Schizotypy Scale (MSS; Kwapil, Gross, Silvia, Raulin, & Barrantes-Vidal, 2018) and the Multidimensional Schizotypy Scale-Brief Edition (MSS-B, Gross, Kwapil, Raulin, Silvia, & Barrantes-Vidal, 2018). Note that complete information about the scales and their developm...
Research suggests that the ability to understand one’s own and others’ minds, or mentalizing, is a key factor for mental health. Most studies have focused the attention on the association between global measures of mentalizing and specific disorders. In contrast, very few studies have analyzed the association between specific mentalizing polarities...
This study evaluated the psychometric properties and factor structure of the Calgary Depression Scale for Schizophrenia (CDSS) across different levels of the schizotypy continuum. A combined sample of high-schizotypy, at-risk mental states, and patients with first-episode psychosis was assessed for depression and other clinical and functional outco...
The main aim of this paper is to analyze to what extent insight (i.e., mentalization referring to one’s own mental state) moderates recovering from daily life events. A total of 110 participants (84.5% women; mean age: M = 21.5; SD = 3.2) filled in the Trait Meta-Mood Scale (TMMS-24) and the Eysenck Personality Questionnaire (EPQ-R), and were inter...
Background:
Psychosis is associated with a reasoning bias, which manifests as a tendency to 'jump to conclusions'. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes.
Methods:
In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups we...
Background. Psychosis is associated with a reasoning bias, which manifests as a tendency to ‘jump to conclusions’. We examined this bias in people at clinical high-risk for psychosis (CHR) and investigated its relationship with their clinical outcomes.
Methods. In total, 303 CHR subjects and 57 healthy controls (HC) were included. Both groups were...
Psychiatric disorders are complex illnesses with multiple factors underlying their aetiology (genetic, environmental and personal factors). Gene–environment interaction (GxE) approaches explore how genetic risk variants in combination with environmental factors such as childhood trauma shape the risk for severe psychiatric disorders, including schi...
Background
No studies have examined the association between self‐esteem and paranoia developmentally across the critical stages of psychosis emergence. The present study fills this gap and extends previous research by examining how different dimensions, measures, and types of self‐esteem relate to daily‐life paranoia across at‐risk mental states fo...
Importance
Biomarkers that are predictive of outcomes in individuals at risk of psychosis would facilitate individualized prognosis and stratification strategies.
Objective
To investigate whether proteomic biomarkers may aid prediction of transition to psychotic disorder in the clinical high-risk (CHR) state and adolescent psychotic experiences (P...
The present study employed structured diagnostic interviews to assess the construct validity of the brief version of the Multidimensional Schizotypy Scale (MSS-B), which was developed to assess positive, negative, and disorganized dimensions of schizotypy. It was hypothesized that the MSS-B subscales would be associated with differential patterns o...
Background
A key clinical challenge in the management of individuals at clinical high risk for psychosis (CHR) is that it is difficult to predict their future clinical outcomes. Here, we investigated if the levels of circulating molecular lipids are related to adverse clinical outcomes in this group.
Methods
Serum lipidomic analysis was performed...
Aberrant perceptional experiences are a potential early marker of psychosis development. Earlier studies have found experimentally assessed speech illusions to be associated with positive symptoms in patients with psychotic disorders, but findings for attenuated symptoms in individuals without psychotic disorders have been inconsistent. Also, the r...
Mechanisms underlying the manifestation of relatives’ expressed emotion (EE) in the early stages of psychosis are still not properly understood. The present study aimed to examine whether relatives’ psychological distress and subjective appraisals of the illness predicted EE dimensions over-and-above patients’ poor clinical and functional status. B...
Background
Daily-life stressors, specially of a social nature, seem to play an important role in the origin and expression of the continuum of psychosis vulnerability. This study examined whether social stress and social positive appraisals in daily-life were associated, respectively, with the occurrence and the decrease of momentary psychotic-like...
Background
The traumagenic neurodevelopment model of psychosis poses that prolonged or severe stress exposure in critical developmental periods (i.e., childhood) disrupts psychobiological stress regulation mechanisms, increasing liability for the onset and persistence of psychotic symptoms after re-exposure to stressful events (Read et al., 2014)....
Background
As theorized by Abraham Maslow, a fundamental need of all humans is to seek a sense of belonging through meaningful social relationships. This universal process drives social identification, the incorporation of these important relationships into one’s own identity. Over the past several decades, social identity has been implicated in va...
Background
Individuals at clinical high risk (CHR) of psychosis have an approximately 20% probability of developing psychosis within 2 years, as well as an associated risk of non-psychotic disorders and functional impairment. People with subclinical psychotic experiences (PEs) are also at risk of future psychotic and non-psychotic disorders and dec...
Background
Genetic vulnerability to psychosis is polygenic, involving multiple genes with small individual effects (Psychiatric Genomics Consortium (PGC), 2014). The risk of psychosis is also related to environmental factors, such as childhood trauma (Lardinois et al, 2011). Although the onset of psychosis is thought to result from the interaction...
The present study examined the associations of positive, negative, and disorganized schizotypy with psychotic-like experiences, affect, and social functioning in daily life using experience sampling methodology (ESM) in 2 samples (ns = 165 and 203) that employed different measures of schizotypy. Schizotypy is a useful framework for understanding sc...
We previously reported that fearful attachment mediated associations of childhood maltreatment with subclinical psychotic phenomena. At an eight-year follow-up, we aimed to replicate and extend this finding by examining the mediating role of disorganized attachment. Participants were 169 young adults who completed baseline and eight-year follow-up...
Background
Sex differences in cognitive functioning have long been recognized in schizophrenia patients and healthy controls (HC). However, few studies have focused on patients with an at-risk mental state (ARMS) for psychosis. Thus, the aim of the present study was to investigate sex differences in neurocognitive performance in ARMS patients compa...
Objective:
To investigate the association between facial affect recognition (FAR) and type of adverse childhood experiences (ACEs) in a sample of clinical high risk (CHR) individuals and a matched sample of healthy controls (HCs).
Methods:
In total, 309 CHR individuals and 51 HC were recruited as part of an European Union-funded multicenter stud...
Background
There is limited research on the interaction of both positive and negative daily-life environments with stress-related genetic variants on psychotic experiences (PEs) and negative affect (NA) across the extended psychosis phenotype. This study examined whether the FK506 binding protein 51 ( FKBP5 ) variability moderates the association o...
A key clinical challenge in the management of individuals at clinical high risk for psychosis (CHR) is that it is difficult to predict their future clinical outcomes. Here, we investigated if the levels of circulating molecular lipids are related to adverse clinical outcomes in this group. Serum lipidomic analysis was performed in 263 CHR individua...
The present study assessed the construct validity of the Multidimensional Schizotypy Scale (MSS). Specifically, it assessed the associations of the MSS positive, negative, and disorganized schizotypy subscales with interview-rated symptoms and impairment in 177 young adults. As hypothesized, the MSS positive schizotypy subscale was associated with...
Current models of schizophrenia suggest that it is the most severe expression of a broad range of clinical and subclinical symptoms and impairment referred to as schizotypy. This chapter reviews the predictive validity of schizotypy for schizophrenia-spectrum psychopathology in nonclinical and genetic and clinical high-risk participants, as well as...
Expressed emotion (EE) is an aspect of the family environment that influences the course of multiple forms of psychopathology. However, there is limited research about how EE dimensions [i.e., criticism and emotional over-involvement (EOI)] are expressed in real-world settings. The present study used experience sampling methodology to investigate:...
Importance
The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear.
Objective
To examine the association be...
for the EU-GEI High Risk Study Group IMPORTANCE The development of adverse clinical outcomes in patients with psychosis has been associated with behavioral and neuroanatomical deficits related to emotion processing. However, the association between alterations in brain regions subserving emotion processing and clinical outcomes remains unclear. OBJ...
A common reaction experienced by family members of patients with psychosis is grief for the loss of their healthy relative. Importantly, high levels of perceived loss have been related to the manifestation of high expressed emotion (EE), which includes the negative attitudes expressed by relatives toward an ill family member. However, the mechanism...
Social anxiety (SA) means fear of scrutiny and of others’ negative evaluation, thus indicating that hypermentalizing (HMZ) (i.e., the over-attribution of intentions and thoughts to others) might be the most common error of social cognition in SA. However, evidence for this is weak. One explanation is that HMZ is not stable in SA, but rather context...
Past research indicates that a history of depression and exposure to abuse and neglect represent some of the most robust predictors of depression in emerging adults. However, studies rarely test the additive or interactive risk associated with these distinct risk factors. In response, the present study explored how these three risk factors (prior d...
Background:
Gender differences in symptomatology in chronic schizophrenia and first episode psychosis patients have often been reported. However, little is known about gender differences in those at risk of psychotic disorders. This study investigated gender differences in symptomatology, drug use, comorbidity (i.e. substance use, affective and an...
Somatization processes are usually associated with a lack of insight or with emotional unawareness, especially in adolescents where the ability for self-reflection is beginning to mature. However, the extent to which different levels of insight explain variations in somatization remains understudied. This study aimed to evaluate whether high-level...
20190423 Data MZ-somat.sav.
This is the file from which all data analyses were performed.
(SAV)
Background
Individuals at clinical high risk (CHR) for psychosis have approximately a 25% chance of transitioning to psychosis in the first 2 years after first presentation to clinical services. A key aim in this field is to determine the risk of conversion for an individual meeting the criteria for CHR based on clinical, demographic and neuropsych...
