Individuals who report psychotic-like experiences are at increased risk of future clinical psychotic disorder. They constitute a unique "high-risk" group for studying the developmental trajectory to schizophrenia and related illnesses. Previous research has used screening instruments to identify this high-risk group, but the validity of these instruments has not yet been established. We administered a screening questionnaire with 7 items designed to assess psychotic-like experiences to 334 adolescents aged 11-13 years. Detailed clinical interviews were subsequently carried out with a sample of these adolescents. We calculated sensitivity and specificity and positive predictive value (PPV) and negative predictive value (NPV) for each screening question for the specific symptom it enquired about and also in relation to any psychotic-like experience. The predictive power varied substantially between items, with the question on auditory hallucinations ("Have you ever heard voices or sounds that no one else can hear?") providing the best predictive power. For interview-verified auditory hallucinations specifically, this question had a PPV of 71.4% and an NPV of 90.4%. When assessed for its predictive power for any psychotic-like experience (including, but not limited to, auditory hallucinations), it provided a PPV of 100% and an NPV of 88.4%. Two further questions-relating to visual hallucinations and paranoid thoughts-also demonstrated good predictive power for psychotic-like experiences. Our results suggest that it may be possible to screen the general adolescent population for psychotic-like experiences with a high degree of accuracy using a short self-report questionnaire.
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"The nine items demonstrate good internal consistency among children aged 9–11 years (Laurens et al., 2007), and all items load on a single latent construct that is distinguishable from Psychopathology and psychotic symptoms 3 internalizing and externalizing psychopathology constructs (Laurens et al., 2012). A comparable, seven-item instrument used to screen paediatric community samples for PLEs has demonstrated good criterion validity between self-reported questionnaire items and clinician-rated psychotic symptoms on diagnostic interview (Kelleher, Harley, Murtagh, & Cannon, 2011). For the present study, a dichotomous variable was created to index PLE presence at follow-up assessment as the outcome variable for logistic regression analyses, defined as a " certainly true " rating on at least one of the nine PLE items. "
[Show abstract][Hide abstract] ABSTRACT: Adolescent internalizing and externalizing psychopathology is strongly associated with adult psychiatric morbidity, including psychotic disorders. This study examined whether internalizing or externalizing trajectories (continuity/discontinuity of symptoms) from middle childhood were associated with adolescent psychotic-like experiences (PLEs). Prospective data were collected from a community sample of 553 children (mean age = 10.4 years; 50% male) and their primary caregivers. Participants completed questionnaire reports of internalizing and externalizing psychopathology and PLEs at baseline, and again approximately 2 years later. Logistic regression was used to examine the association of adolescent PLEs with four trajectories of internalizing and externalizing psychopathology (persistent, incident, remitting, and none), controlling for a range of potential confounders and sampling bias. Significant associations were identified between adolescent PLEs and the incident internalizing (adjusted odds ratio [adj. OR] = 2.96; 95% confidence interval [CI] = 1.60-5.49) and externalizing psychopathology (adj. OR = 2.14; 95% CI = 1.11-4.14) trajectories, as well as the persistent internalizing (adj. OR = 1.90; 95% CI = 1.13-3.18) and externalizing (adj. OR = 1.81, 95% CI = 1.02-3.19) trajectories. Children with remitting psychopathology trajectories were no more likely to present later PLEs than those who never experienced psychopathology. While for many individuals symptoms and illness remit during development without intervention, this study provides important insights regarding potential targets and timing for delivery of early intervention and prevention programs.
Full-text · Article · Feb 2016 · Development and Psychopathology
"Although the scree plot suggested the single-factor solution, the unidimensionality of the PDI could not been confirmed by the confirmatory factor analysis (the asymptotically distribution free method) because of the small size of the study sample. What is more, specifying the prevalence of delusion-like experiences on the basis of the results of self-reports can distort these results and show higher values than real prevalence of delusion-like experiences [44, 45]. However, the results of previous studies show that scale scores on the basis of self-reports also allow to accurately calculate the risk of psychotic dis- orders [9, 15] and to predict the development of psychosis [27, 46, 47]. "
"The items were validated by numerous groups (e.g. Kelleher et al., 2011; Polanczyk et al., 2010) and found to have good predictive validity for a diagnosis of schizophrenia during adulthood (Poulton et al., 2000). All items were originally in English and directly translated to Dutch for the current study. "
[Show abstract][Hide abstract] ABSTRACT: The current exploratory study examined the associations between auditory vocal hallucinations (AVH) and delusions and religiosity in young adolescents. 337 children from a population-based case-control study with and without AVH, were assessed after five years at age 12 and 13, on the presence and appraisal of AVH, delusions and religiosity. AVH status (persistent, remittent, incident or control) was examined in relationship to religiosity. Results demonstrated a non-linear association between AVH and religiosity. Moderately religious adolescents were more likely to report AVH than non-religious adolescents (O.R.= 2.6). Prospectively, moderately religious adolescents were more likely to have recently developed AVH than non-religious adolescents (O.R.= 3.6) and strongly religious adolescents (O.R.= 7.9). Of the adolescents reporting voices in this sample (16.3%), more than half reported positive voices. Religious beliefs were often described as supportive, useful or neutral (82%), regardless of the level of religiosity, for both adolescents with and without AVH. Co-occurrence of AVH and delusions, and severity of AVH were not related to religiosity. The present findings suggest there may be a non-linear association between religiosity and hearing voices in young adolescents. A speculative explanation may be that religious practices were adopted in response to AVH as a method of coping.