Population profiles of child‐reported psychotic‐like experiences and their differential association with other psychopathologies

Abstract

Objectives. Childhood psychotic-like experiences (PLEs) increase risk for concurrent and future psychiatric disorders but are common in the population. Strategies are needed to identify vulnerable individuals who may benefit from monitoring or targeted intervention. This study aimed to delineate profiles of childhood PLEs that might be differentially associated with other psychopathologies, and multiple psychopathology.Design. Cross-sectional, online self-report survey.Methods. Participants were 27,000 Australian children from a population cohort (13,416 girls; mean age 11.91 years) who completed an online self-report questionnaire assessing PLEs (hallucinations and delusions) and Emotional, Peer Relationship, Conduct, and Hyperactivity-Inattention psychopathology. Latent class analysis differentiated classes of children showing different patterns of PLE responses, and multinomial logistic regression determined the association between the PLE classes and the various psychopathologies, adjusted for demographic covariates and the other psychopathologies.Results. Five latent profiles of PLE responses were characterized as follows: None (27.4% of children), Minor (29.7%), Moderate (11.8%), Hallucinatory (21.0%), and Strong (10.2%). These classes showed distinct associations with other psychopathologies (odds ratios between 1.27 and 4.58), and dose-response relationships indicated increasing likelihood of multiple psychopathology for the Hallucinatory and Strong classes (odds ratio = 21.87 for ≥3 psychopathologies in the Strong class).Children aged 11-12 years who report psychotic-like experiences (PLEs) can be classified into five different PLE profiles based on self-reported questionnaire responses, which may reflect different pathological processes. These PLE profiles show different patterns and magnitudes of increased risk for other types of psychopathology, and multiple psychopathology, suggesting that they present different treatment needs. Cross-sectional investigation of the associations between PLE profiles and other psychopathologies limits any conclusions as to the causal direction of these relationships. Multi-informant reports of psychopathology were unavailable.

Replication of Associations With Psychotic-Like Experiences in Middle Childhood From the Adolescent Brain Cognitive Development (ABCD) Study

“…The current study found important evidence supporting the validity of the PQ-BC, including replicating mean differences in sex and race, associations with several psychosis risk measures, cognitive impairments, and developmental milestone delays. PLEs were associated with both internalizing and externalizing scores, consistent with previous research, 21 , 31 , 32 , 58 and perhaps indicating both have roles in the etiology or early clinical manifestations of PLEs. The current study found associations similar in magnitude compared to the original sample (ie, βs ≤ .38).…”

Academic achievement and schizophrenia: a systematic meta-analysis

“…One, given the small number of studies included in both at-risk meta-analyses, our results may reflect the inclusion of a study with a small sample size that utilised standardised measures of academic achievement and reported large effect sizes differences (Dickson et al, 2014). Two, children experiencing PLEs and children with a family history of schizophrenia are more likely to present with externalising and internalising psychopathology (Lancefield, Raudino, Downs, & Laurens, 2016; Laurens et al, 2020; Sandstrom et al, 2019), which in turn has been reported to be associated with academic achievement and educational attainment (Masten et al, 2005; Melkevik, Nilsen, Evensen, Reneflot, & Mykletun, 2016). Three, some evidence suggests that type of comparison group (e.g.…”

“…Hannah Dickson et al internalising psychopathology (Lancefield, Raudino, Downs, & Laurens, 2016;Laurens et al, 2020;Sandstrom et al, 2019), which in turn has been reported to be associated with academic achievement and educational attainment (Masten et al, 2005;Melkevik, Nilsen, Evensen, Reneflot, & Mykletun, 2016). Three, some evidence suggests that type of comparison group (e.g.…”

Distressing psychotic-like experiences, cognitive functioning and early developmental markers in clinically referred young people aged 8–18 years

“…Empirical research shows that such experiences are commonly reported by children and adolescents and are not always distressing or impairing [3], with mixed findings regarding their specificity for future psychosis [4][5][6]. However, these experiences are reliably associated with increased distress and risk of co-occurring non-psychotic mental health difficulties [7][8][9]. Investigating hypothesised factors driving associated distress in young people seeking help for mental health difficulties, therefore, has important implications for developing early detection and intervention efforts in clinical services.…”