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 schizophrenia-spectrum psychopathology, and ESM offers a powerful approach for assessing schizotypy in real-world settings. Participants were signaled 8 times daily for 7 days to complete ESM questionnaires. As hypothesized, positive schizotypy was robustly associated with psychotic-like experiences in daily life, whereas negative schizotypy was associated with negative experiences, diminished positive affect, and social disinterest in both samples. As expected, disorganized schizotypy was associated with disorganization in daily life. Furthermore, it was associated with increased negative affect and diminished positive affect. Thus, positive, negative, and disorganized schizotypy were associated with unique, hypothesized patterns of experiences in daily life, and the findings across the two samples and two schizotypy measures were strikingly consistent. Note that when disorganized schizotypy was not entered as a predictor in the 2 samples, disorganized experiences and negative affect in daily life were associated with positive schizotypy. However, when disorganized schizotypy was included as a predictor, these daily life experiences were associated with disorganized, not positive, schizotypy. This is similar to findings from interview and questionnaire studies that have simultaneously assessed positive, negative, and disorganized schizotypy. The findings support the construct validity of the multidimensional model of schizotypy and the importance of including disorganization in the conceptualization and assessment of schizotypy.

Functional abdominal pain (FAP) is associated with enhanced pain responsiveness. Although impaired conditioned pain modulation (CPM) characterizes adults with a variety of chronic pain conditions, relatively little is known about CPM in youth with FAP. The present study assessed CPM to evoked thermal pain in 140 youth (ages 10 to 17), 63 of whom had FAP and 77 of whom were healthy controls. Multilevel models demonstrated weaker CPM effects in FAP than healthy youth, as evident in slower within-person decreases in pain ratings during the conditioning phase. Weaker CPM effects were associated with greater somatic symptom severity and functional disability. Pain responses in FAP youth were heterogeneous, with 43% of youth showing an unexpected increase in pain ratings during the conditioning phase, suggesting sensitization rather than CPM-related pain inhibition. These findings highlight directions for future research on the emergence and maintenance of FAP in youth.

Childhood sexual abuse (CSA) is highly prevalent and associated with a wide variety of negative mental and physical health outcomes. School-based CSA education and prevention programs have shown promise, but it is unclear to what extent community-level characteristics are related to their effectiveness. The present cluster randomized controlled trial evaluated community-level moderators of the Safe@Last program compared to a waitlist control condition. Knowledge gains from pre- to post-intervention were assessed in 5 domains: safe versus unsafe people; safe choices; problem-solving; clear disclosure; and assertiveness. Participants were 1,177 students (46% White, 26% African American, 15% Hispanic, 4% Asian American, 6% Other) in grades 1 through 6 from 14 public schools in Tennessee. Multilevel models accounting for the nesting of children within schools revealed large effect sizes for the intervention versus control across all knowledge domains (d’s ranged from 1.56 to 2.13). The effectiveness of the program was moderated by mean per capita income and rates of substantiated cases of child abuse and neglect in the community. Intervention effects were stronger for youth living in lower as compared to higher income counties, and for youth attending schools in counties with lower as compared to higher abuse/neglect rates. Child characteristics (sex, race) did not moderate intervention effects. This research identified two community-level factors that predicted the effectiveness of a CSA education and prevention program designed to improve children’s knowledge of personal safety skills. School-based CSA prevention programs may require modification for communities with higher rates of child abuse and neglect.

Background Altered hypothalamic-pituitary-adrenal (HPA) function is common in youth with major depressive disorder (MDD) but variability in the strength and direction of HPA alterations has prompted a search for symptom-based subtypes with unique neuroendocrine signatures. This study investigated the extent to which depressive symptom composites were differentially associated with cortisol responses to psychosocial stress. Methods This study examined salivary cortisol responses to the Trier Social Stress Test (TSST) in 145 adolescents who varied in their risk for MDD: 38 had current MDD; 35 were healthy but at high risk for MDD based on having one or both parents with unipolar MDD; and 72 were healthy youth with no personal or family history of a psychiatric disorder. Multilevel models examined within-person change in cortisol levels during a 2-hour resting phase prior to the TSST and both linear and quadratic changes in cortisol levels following the TSST. Results Anticipatory cortisol reactivity was lower in MDD youth compared to low-risk youth, and in youth with higher compared to lower depressive symptom severity. Whereas affective symptoms were associated with increased anticipatory cortisol reactivity and more rapid recovery to the TSST, neurovegetative symptoms were associated with decreased anticipatory cortisol reactivity and slower recovery. Limitations The cross-sectional design does not permit inferences regarding temporal relations between cortisol responses and depressive symptom composites. Conclusions The present findings suggest that heterogeneity among studies examining HPA reactivity in depressed youth may be driven, in part, by differences in depressive symptom composites across samples.

No abstract