Incorporating cortisol into the NAPLS2 individualized risk calculator for prediction of psychosis

Cortisol Levels in Childhood Associated with Emergence of Attenuated Psychotic Symptoms in Early Adulthood

“…Our finding that adding cortisol and stress measures to the base model increased the proportion of variance explained in total PQ score by 10%, and that diurnal cortisol and daily stressors were independently associated with outcome, is partially consistent with previous studies. In the NAPLS-2 cohort of CHR individuals, childhood trauma and life events were not significant predictors of transition and made little contribution to the multivariable model (40), whilst basal salivary cortisol significantly improved model performance and was independently associated with transition (37). It is possible that psychosocial stress and basal/diurnal cortisol abnormalities both contribute to the development of AP symptoms, but that cortisol plays a greater role in promoting transition to full psychosis among those at CHR.…”

Cortisol Levels in Childhood Associated With Emergence of Attenuated Psychotic Symptoms in Early Adulthood

“…Our finding that adding cortisol and stress measures to the base model increased the proportion of variance explained in total PQ score by 10%, and that diurnal cortisol and daily stressors were independently associated with outcome, is partially consistent with previous studies. In the NAPLS-2 cohort of CHR individuals, childhood trauma and life events were not significant predictors of transition and made little contribution to the multivariable model ( 40), whilst basal salivary cortisol significantly improved model performance and was independently associated with transition (37). It is possible that psychosocial stress and basal/diurnal cortisol abnormalities both contribute to the development of AP symptoms, but that cortisol plays a greater role in promoting transition to full psychosis among those at CHR.…”

Translating RDoC to real-world impact in developmental psychopathology: A neurodevelopmental framework for application of mental health risk calculators

“…The majority of the research on mental health risk calculators, albeit small, is on the conversion to psychosis from prodromal stages (Cannon et al, 2008(Cannon et al, , 2016Carrión et al, 2016;Ciarleglio et al, 2019;Fusar-Poli et al, 2017;Fusar-Poli, Werbeloff et al, 2019;Irving et al, 2021;Lee et al, 2020;Oliver et al, 2020Oliver et al, , 2021Osborne & Mittal, 2019;Studerus et al, 2020;Worthington et al, 2021;Zhang et al, 2018Zhang et al, , 2019. Individuals at clinical high risk (CHR) for psychosis typically exhibit attenuated positive (e.g., hallucinations) and negative (e.g., anhedonia) symptoms and decreased socio-occupational functioning (McGlashan, Walsh, & Woods, 2010).…”

“…Given the large heterogeneity in risk factors and the dynamic developmental window for developing fully psychotic symptoms, a developmentally informed calculator leveraging multiple measurement occasions could have significant potential. For example, Worthington et al (2021) included salivary cortisol as a new predictor in the established NAPLS-2 risk calculator and observed marked improvement from the original model. This finding speaks to the relevance of stress-sensitivity for emerging psychosis.…”