Are Screening Instruments Valid for Psychotic-Like Experiences? A Validation Study of Screening Questions for Psychotic-Like Experiences Using In-Depth Clinical Interview

Abstract

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.

Persisting psychotic-like experiences are associated with both externalising and internalising psychopathology in a longitudinal general population child cohort

“…We have previously demonstrated good internal consistency among the nine items for children aged 9-11 years (Laurens et al, 2007), with all items loading on a single latent construct that is distinguished from internalising and externalising 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 a 'certainly-true' rating on any PLE item and clinician-rated psychotic symptoms on diagnostic interview (Kelleher et al, 2011).…”

Toward earlier identification and preventative intervention in schizophrenia: evidence from the London Child Health and Development Study

“…Recent metaanalyses indicate that auditory hallucinations are more prevalent among children aged 9-12 years (median prevalence: 17 % [21]) than in the adolescent (7.5 %) or adult (5-8 % [22]) general population, with questionnaire measures typically eliciting higher rates than clinical interviews [23]. Discrepancy in our rates of self-and caregiver-reported childhood PLEs (66.0 vs. 9.7 %; also reported by others [24,25]) implies that children do not necessarily report these phenomena to adults, or that they interpret their experiences differently than do caregivers. Whilst the majority of children reporting PLEs will not go on to develop a SSD in adulthood, for many children, these experiences are not benign; more than a third (40.9 %) reported distress or functional impairment associated with these experiences, particularly those presenting the antecedent triad (68.1 % [9]).…”

“…In children, similarly to the adult population [26], the PLE items load on a construct which is correlated with, but dissociable from, the constructs underpinning internalising and externalising problems [15]. Two items assessing hallucination-like experiences appeared most suited to identifying children with vulnerability to psychotic illness in the general population [15], with such items previously also showing strong criterion validity for psychotic symptoms elicited by diagnostic interview among 11-13-year olds [24].…”

Avaliação da fidedignidade e validade do Mini - Rastreio de Transtornos Mentais (Mini-RTM)

“…Estudando as características psicométricas do APSS (Kelleher et al, 2011) Assim, o MINI-RTM é composto por nove itens sendo:…”

“…(Kroenke et al, 2009;de Lima Osório, 2002;Meneses-Gaya et al, 2010;Annahein et al, 2010;Kelleher et al, 2011).O MINI-RTM avalia transtornos depressivos, ansiosos, abuso e/ou dependência de álcool e substâncias e transtornos psicóticos. É um instrumento breve, de rastreio para múltiplos transtornos mentais e de fácil aplicação.…”