Categorical versus dimensional models of early psychosis

Phalen, Peter; Millman, Zachary B.; Rouhakhtar, Pamela Rakhshan; Andorko, Nicole D.; Reeves, Gloria; Schiffman, Jason

doi:10.1111/eip.13128

Cited by 4 publications

(3 citation statements)

References 37 publications

(39 reference statements)

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“…These findings provide support for the use of a dimensional conceptualization of psychosis [17]. van Os & Guloksuz [18] posit that given the SIPS already measures symptoms dimensionally (by presence and severity of symptoms), such a dimensional diagnostic method for CHR-P might be useful.…”

Section: Discussionmentioning

confidence: 68%

Heterogeneity of clinical symptomatology in pediatric patients at clinical high risk for psychosis

Rintell,

Carroll,

Wales

et al. 2024

BMC Res Notes

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Objective Widespread use of diagnostic tools like the Structured Interview for Prodromal Symptoms (SIPS) has highlighted that youth at Clinical High Risk for Psychosis (CHR-P) present with heterogeneous symptomatology. This pilot study aims to highlight the range of clinical characteristics of CHR-P youth, investigate the role of the non-positive (negative, disorganization, and general) symptoms in risk assessment, and determine if specific profiles are associated with severe symptomatology. Methods 38 participants aged 7–18 were administered the SIPS and designated as CHR-P. Descriptive statistics and mean difference t-tests were used to describe the range in prevalence and severity of SIPS symptoms and to identify symptoms associated with greater overall symptomatology. Results Participants who had a greater number of positive symptoms also had significantly more negative, disorganization, and general symptoms. A number of SIPS symptoms were associated with greater number of positive symptoms. Conclusion CHR-P youth represent a heterogeneous group, presenting with a wide range in clinical presentation as reflected in both the number of SIPS symptoms and their severity. Though the severity and duration of positive SIPS symptoms determines the CHR-P classification, high ratings on several of the other SIPS negative, disorganization, and general items may be useful indicators of elevated symptomatology.

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Section: Discussionmentioning

confidence: 68%

Heterogeneity of clinical symptomatology in pediatric patients at clinical high risk for psychosis

Rintell,

Carroll,

Wales

et al. 2024

BMC Res Notes

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“…As PLEs are potential markers of later psychosis spectrum disorders and general psychopathology (Kelleher et al, 2014), greater PLE endorsement may reflect a need for consistent care, which may explain the strong association with all three service use variables. Finally, PLEs emerged as a strong predictor of MHCU within a risk enriched sample, indicating the importance of dimensional assessment of PLEs for understanding clinical or functional outcomes (Phalen et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

Mental health care utilization in individuals with high levels of psychosis-like experiences: Associations with race and potentially traumatic events.

Petti¹,

Klaunig²,

Smith³

et al. 2023

Cultural Diversity & Ethnic Minority Psychology

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Objective: Racial inequities in mental health care utilization (MHCU) are well documented. Marginalized racial groups are more likely to report psychosis-like experiences (PLEs) and are at elevated risk for racial discrimination and trauma, impacting PLE severity. Little is known about how factors associated with race impact treatment seeking among individuals reporting PLEs. The present study examined associations between race, trauma, discrimination, PLEs, and MHCU among people endorsing high levels of PLEs. Method: Participants were Asian/Asian American, Black/African American, or White/European American college students ages 18–25 years meeting PLE self-report measure cutoff scores (N = 177). Binary logistic and multiple linear regressions were used to examine associations between past, current, and prospective MHCU and race, potentially traumatic events, discrimination, and PLEs. Results: Participants endorsing more PLEs were more likely to report past and current treatment and to be considering future services. Asian/Asian American and Black/African American participants were less likely to endorse past, current, and prospective future mental health care. Potentially traumatic events predicted increased utilization of past treatment. Conclusions: Results suggest service differences among participants, such that Black/African American and Asian/Asian American young adults reporting PLEs were less likely than White/European American counterparts to seek treatment even when accounting for traumatic events and discrimination. These findings highlight the need to further elucidate MHCU among marginalized racial groups experiencing psychosis-like symptoms.

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“…A dimensional approach to characterizing psychosis has gained more recent attention in lieu of the traditional diagnostic classification system as research shows it may be more predictive of functioning than categorical risk status (Phalen et al, 2022). This approach appears to be more clinically useful in children, given the diagnostic instability of psychotic symptoms in youth (Tor et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis

Carroll

Wales

Rintell

et al. 2022

J Am Psychiatr Nurses Assoc

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Background: Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P). Objective: This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver–child relationship, severity of illness, and frequency of psychiatric hospitalizations. Methods: A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire–Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression–Severity scale. Results: The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years ( SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support ( r = −.408, p = .002), lower levels of parenting confidence ( r = −.514, p < .001), higher levels of relational frustration ( r = .612, p < .001), and higher severity of illness ( r = .316 p = .025). Conclusions: These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.

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Categorical versus dimensional models of early psychosis

Cited by 4 publications

References 37 publications

Heterogeneity of clinical symptomatology in pediatric patients at clinical high risk for psychosis

Heterogeneity of clinical symptomatology in pediatric patients at clinical high risk for psychosis

Mental health care utilization in individuals with high levels of psychosis-like experiences: Associations with race and potentially traumatic events.

Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis

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