Exploring functional impairment in young people at ultra‐high risk for psychosis: A qualitative study

Cotter, Jack; Bucci, Sandra; Drake, Richard; Yung, Alison R.; Carney, Rebekah; Edge, Dawn

doi:10.1111/eip.12560

Cited by 12 publications

(10 citation statements)

References 45 publications

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“…Moreover, it is important to consider that childhood adversity and trauma may have different detrimental effects on individuals with impacts on brain development, cognition, interpersonal behavior and clinical symptoms. Additional unmeasured variables, such as genetic risk and neighborhood environmental factors, may also account for aspects of observed associations [ 65 ]. Furthermore, it should be noted that interestingly the TADS sum score was higher in the group included into the analyses than in the excluded patients from the sample.…”

Section: Discussionmentioning

confidence: 99%

Does childhood trauma predict schizotypal traits? A path modelling approach in a cohort of help-seeking subjects

Dizinger

Doll

Rosen

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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Schizotypy constitutes a susceptibility to beneficial and deleterious schizotypal traits, ranging from coping mechanisms to schizotypal personality disorder on a psychosis continuum. Growing evidence indicates a relationship between childhood adversity and trauma and schizotypy. However, the exact influence of childhood adversity and trauma on schizotypy and its relation to sex is not sufficiently understood. Therefore, we investigated sex-adjusted connections between childhood adversity and trauma subdomains (emotional/physical/sexual abuse, emotional/physical neglect) and positive (magical ideation, perceptual aberration) as well as negative schizotypy (physical/social anhedonia). In total, 240 outpatients of the Early Detection and Intervention Centre of the University Hospital Cologne were assessed with the Trauma and Distress Scale for childhood adversity and trauma and the Wisconsin Schizotypy Scales for schizotypy. Path analyses were performed to investigate sex-adjusted correlations. The well-fitting path model of the total sample linked emotional abuse to magical ideation (p = 0.03; SE = 0.20) and emotional neglect to social anhedonia (p = 0.01; SE = 0.26). In females, physical abuse predicted magical ideation (p = 0.01; SE = 0.33), while emotional neglect forecasted physical anhedonia (p = 0.03; SE = 0.34) and social anhedonia (p = 0.03; SE = 0.32). In males, sexual abuse predicted perceptive aberration (p = 0.04; SE = 0.19) and emotional abuse forecasted magical ideation (p = 0.03; SE = 0.27). Overall, the significance of sex-specific interrelations between trauma and schizotypy were highlighted. Magical ideation and perceptive aberration occurred prominently in the absence of negative and disorganized schizotypy, thus positive schizotypy could be discussed as a beneficial expression of coping with emotional, physical and sexual abuse. Furthermore, emotional neglect should be addressed particularly to prevent deleterious negative schizotypy in females.Trial registration number (20-1243), date of registration (May 19th 2020), retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Does childhood trauma predict schizotypal traits? A path modelling approach in a cohort of help-seeking subjects

Dizinger

Doll

Rosen

et al. 2022

Eur Arch Psychiatry Clin Neurosci

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“…This finding is important because there is evidence that a significant percentage of ARMS individuals continue to function poorly in the long term, regardless of symptomatic remission ( Addington et al, 2011 ). In a recent qualitative study, Cotter et al (2019) found that ARMS individuals attributed their impairment in social and occupational functioning to a combination of clinical, cognitive, and psychological factors, such as self-stigmatizing attitudes and dysfunctional metacognitive beliefs. It is important to note that the FHR group showed a good level of functioning, which confirms that a family history of psychosis is a significant risk factor but not an impediment for certain people to be able to perform adequately.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Functional Differences Between Mexican Youth at Clinical High Risk for Psychosis and With Familial High Risk

et al. 2022

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Few studies have explored the differences in clinical psychopathology between youth at high risk for psychosis and those at familial high risk for psychosis. This study seeks to describe and compare the sociodemographic, clinical, and functional characteristics of At-Risk Mental State (ARMS) for psychosis youth and those with a first- or second-degree relative with psychosis (Familial High-Risk: FHR) in a Mexican sample. Twenty-one ARMS individuals and 21 with FHR were evaluated for sociodemographic characteristics, psychopathological symptoms, and functional impairment. ARMS individuals were significantly younger, had fewer years of schooling, and were more likely to be male than those in the FHR group. Groups did not differ as regards marital status or occupation. The ARMS group showed greater severity of prodromal symptoms, schizotypal personality traits, and general psychopathology than the FHR group. In addition, they reported more premorbid adjustment deficit from early adolescence than the FHR group. Current overall social and role functioning was significantly lower in the ARMS group. Findings are consistent with ARMS studies from other countries. First- or second-degree relatives of patients with psychosis should be considered a vulnerable group as they display several symptoms of general psychopathology and may experience social adjustment problems in their adult lives. The lack of early detection and intervention psychosis programs in Mexico underlines the need to prioritize the development of preventive strategies to help close the care gap.

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“…Thus, the study group decided to primarily focus on quality of life, self-efficacy, and functioning. These areas have been shown to be most impacted in adolescents and often prompt them to seek help (18, 30, 44, 86, 87). In contrast, at-risk symptoms are not necessarily the cause of the highest psychological strain and burden for the patient.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Combined Treatment Approach “Robin” (Standardized Manual and Smartphone App) for Adolescents at Clinical High Risk for Psychosis

et al. 2019

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Introduction: The prevention of schizophrenia and other psychotic disorders has led researchers to focus on early identification of individuals at clinical high risk (CHR) for psychosis and to treat the at-risk symptoms in the pre-psychotic period. Although at-risk symptoms such as attenuated hallucinations or delusions are common in adolescents and associated with a marked reduction in global functioning, the evidence base of effective interventions for adolescents at CHR state and even ﬁrst-episode psychosis is limited. Thus, the present protocol describes a study design that combines therapy modules for CHR adolescents with a smartphone application supporting the young individuals between the therapy sessions. The treatment approach “Robin” is based on existing therapy strategies for adolescents with first episode of psychosis and the available recommendations for adults with at-risk symptoms. Methods: The evaluation aims firstly to compare the efficacy of Robin in 30 CHR adolescents aged 14–18 to an active control group (treatment as usual) from a previous study. Primary outcome measures will be at-risk symptomatology, comorbid diagnosis, functioning, self-efficacy, and quality of life. For the prospective intervention condition (16 weekly individual sessions + a minimum 4 family sessions), help-seeking adolescents with CHR for psychosis, aged 14–18, will be recruited over 3 years. At-risk and comorbid symptoms, functioning, self-efficacy, and quality of life are monitored at six time points (baseline, during the treatment period; immediately after intervention; and 6, 12, and 24 months later) and compared with the respective measures of the active control group. Discussion: To the best of our knowledge, this is the first controlled trial to test the efficacy of a specific early psychosis treatment in combination with a smartphone application for adolescents at CHR for developing psychosis. The results of the study are expected to add information that may substantially decrease the burden of CHR adolescents and increase their resilience. It may offer age-adapted and targeted strategies to guide clinicians in the treatment of these vulnerable individuals. Furthermore, research in the field of early intervention will be enriched by our findings. Clinical Trial Registration: , identifier NCT03829527.

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Exploring functional impairment in young people at ultra‐high risk for psychosis: A qualitative study

Abstract: We propose a model that attempts to explain how these variables interact to drive and sustain functional impairment in the UHR population. This will assist in the development of clinical interventions aimed at promoting functional recovery among UHR individuals.

Cited by 12 publications

References 45 publications

Does childhood trauma predict schizotypal traits? A path modelling approach in a cohort of help-seeking subjects

Does childhood trauma predict schizotypal traits? A path modelling approach in a cohort of help-seeking subjects

Clinical and Functional Differences Between Mexican Youth at Clinical High Risk for Psychosis and With Familial High Risk

Evaluation of the Combined Treatment Approach “Robin” (Standardized Manual and Smartphone App) for Adolescents at Clinical High Risk for Psychosis

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